E NYK SHIPMANAGEMENT PTE LTD

1 Harbour Front Place,#15-01 Harbour Front Tower One,

Singapore 098633
Tel: 65-64167500 Fax: 65-64169921

APPLICATION FOR DISEMBARKATION

“M.V. KAIJIN”

Date and Place of

Name RANK Application

1. Request for “VACATION” by reason of completion of contract.

Date of Engaged Date and Place of Embarkation Require date and Place of Disembarkation

Total days service on Board Special Requirement or Application to Company Signature of Applicant
1.

2. Request of “EARLY VACATION” before completion of contract

Date of Engaged Date and Place of Embarkation Require date and Place of Disembarkation

Total days service on Board Special Requirement or Application to Company Signature of Applicant
.

3. Request of “EXTENSION” of contract

Date of Engaged Date and Place of Embarkation Require date and Place of Disembarkation

Total days service on Board Special Requirement or Application to Company Signature of Applicant

REMARKS:
Signature by Master
.

Master “M.V.KAIJIN”

Remarks: a) Submit one original to company while keep one copy into ship’s file
b) Master should apply his request of disembarkation on every crewmember to company well in advance
c) Signature by applicant and Master should be affixed on this application without fail.