THE PYA SEA SERVICE TESTIMONIAL

FOR MASTER & DECK OFFICERS

(MCA Approved for use in respect of service on
commercially and privately operated yachts and sail training vessels)

Part 1 – Service

This is to certify that:

Name
Email address
Date of birth

has served in CAPACITY of : Master / Chief Mate / OOW / Deckhand

ON BOARD :

Vessel name
Flag
Official No.
Type (M/Y, S/Y, other)
Length-metres
GT
From /date joined: Until/ date signed off:
(i.e. on board yacht (please fill in date
service) even if still on board)

The above service includes:

Actual Days at Sea: days

(vessel leaves port/under way/at anchor associated with a
24-hour passage)
Stand-by Service: days
(SHOULD NOT EXCEED DAYS AT SEA - waiting for owner,
uniformed/ready to depart Max. 14 consecutive days without
leaving port)
Shipyard Service: days
(max. 90 days allowed per application for OOW3000)
Watch keeping: (for HOLDERS OF MCA OOW3000 OR days
HIGHER ONLY- can be counted on cumulative basis: every 8
hours = 1 day of watch keeping service until the 09/04/15
and every 4 hours= 1 day after 09/04/15)

Leave of absence was granted as follows:

Areas cruised

QP SRB F001 - Rev. : 7 16/05/2018

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 THE PYA SEA SERVICE TESTIMONIAL
FOR MASTER & DECK OFFICERS
(MCA Approved for use in respect of service on
commercially and privately operated yachts and sail training vessels)

Part 2 – Official endorsement

ANY FALSE INFORMATION OR VERIFICATION SUBMITTED COULD LEAD TO THE

WITHDRAWAL OF THE SIGNING OFFICER’S CoC

IMPORTANT: By signing this testimonial, you agree for your personal details (name, email,
CoC number and position) to be passed on to the PYA for the purpose of contacting you to
verify that the information provided above is correct.
Signature (should not
be self-signed or left
blank)
Name (capitals)
Date
Capacity Owner / Master / Responsible Person in Management Company
If signing as Master:- CoC No.

CoC issuing authority

If signing as Position
Responsible Person
Organisation and
Address

Tel.
EMAIL ADDRESS for E-mail
verification purposes
(leaving blank will
result in delays)

Yacht / Company Stamp

PYA verification
Verified by:
Date:

QP SRB F001 - Rev. : 7 16/05/2018

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