DOCUMENT ID FORM C-3

PAGE NO. 1 of 6
Pre-Joining Documents ISSUE DATE 4/5/2019
REVISION NO. 1.2
ISSUED BY DPA

Instructions

The instructions for this piece of document are as followed:

• This document consists of 9 pages

• This document contains 3 sections, Section 1, Section 2 and Section 3.
• Section 1 is required to be completed everytime an employee board the vessel.
• Section 2 is meant for PCL employees only.
• Section 3 is meant for POSH employees only.

* Important: Before you begin, please enter your name and date into the footer on the next
page to sync the information across pages for your convenience.
 DOCUMENT ID FORM C-3
PAGE NO. 2 of 6
Pre-Joining Documents ISSUE DATE 4/5/2019
REVISION NO. 1.2
ISSUED BY DPA

Section 1(a): PRE-JOINING CHECKLIST

Under the Merchant Shipping Act, Part III, Clause number 50:
Any person serving or engaged to serve in any ship and holding any certificate or other document which is evidence
that he is qualified for the purposes of section 47 shall on demand produce it to the Director, the Port Master, a
surveyor of ships or any person authorised by the Director and (if he is not himself the Master) to the Master of the
ship; and if he fails to do so without reasonable cause he shall be guilty of an offence and shall be liable on
conviction to a fine not exceeding $2,000.

ALL PERSONNEL JOINING COMPANY VESSELS MUST BE HOLDING THEIR ORIGINAL CERTIFICATES.
Note: Master to verify all details are correct and send a signed copy via email to Crewing Department.
Joining Rank: 2ND ENGINEER Vessel Name: POSH MARIAM
Date & Port of Joining: 31.03.2021 & Vessel Flag: SINGAPORE

Document Reg Code Issued Expiry Certificate Number

Passport 25.09.19 24.09.29 C02868371
Seaman's Book 05.01.19 05.01.24 DQK 013360
Joining Port Visa (If Required)
Contract 26.03.21 C.R 2050107945
Pre-Employment Medical Certificate 23.02.21 23.02.23
Drug & Alcohol Test 23.02.21 23.02.22
Certificate of Competency / Proficiency 24.11.17 21.11.22 /0003270
COE/ CRA for COC 24.11.17 21.11.22 001108/17
GMDSS/ CRA for GMDSS/ GOC
Personal Survival Techniques 10.11.17 10.11.22 SO-3929-17
Firefighting 02.06.18 02.06.23 AB 1045212
Elementary 1st Aid & Medical Care 02.11.17 02.11.22 SN-0833-17
Personal Safety and Social Responsibilities 10.11.17 10.11.22 SO-3929-17
Prof In Survival Craft STCW 10.11.17 10.11.22 SL-2649-17
GMDSS/GOC STCW
Ship Security Basic Familiarization 10.11.17 10.11.22 SI-1739-17
Shipboard Safety Officer
ECDIS
Tanker Endorsement as applicable *
Chemical Endorsement as applicable *
Gas Endorsement as applicable *
DP License #
DP Maintenance # 06.04.16 12/30/1899 12160406001
Checked & Signed by (Crew Executive): Date: 28.03.2021
Checked & Signed by (Master): Date:
Note: Rows marked with an (*) are to be filled up by PCL Crew only, (#) by POSH Crew only
Name: Heydarov Zaur Date: 28.03.2021
 DOCUMENT ID FORM C-3
PAGE NO. 3 of 6
Pre-Joining Documents ISSUE DATE 4/5/2019
REVISION NO. 1.2
ISSUED BY DPA

Section 1(b): CREW ALLOTMENT / REMITTANCE

This section is required to facilitate remitting employees' wages to their beneficiary(s).

Particulars of Allotment: Home Allotment 1 Home Allotment 2

Amount Allocated :
Name of Beneficiary : Heydarov Zaur Sattar
Baku, Azerbaijan, Akhmedli,
Address of Beneficiary :
Pivzavod 28/3
Name of Beneficiary's Bank : Bank Respublika OJSC

Address beneficiary's Bank: Baku, Azerbaijan

Swift Address: BRESAZ 22 Chips UID: For Australia BSB Code:

Fir USA Per Wide Code: For USA ABA Code: For UK Sort Code:

Account No. of Beneficiary (Specify currency AZ23BRES00381184000905207401

and IBAN if available)

Name if intermediary bank : Deutsche Bank Trust Company, Americas, New York, USA

Special bank instructions (if any) :

The above allotment will be remitted at the end of each month beginning from:
Signature of Seaman: Date: 28.03.2021
Approval by: Date:

For remittances to Indonesia in Indonesian Rupiah, I hereby authorise Messrs. POSH Fleet Services Pte. Ltd to deduct
from my salary in order to send home allotment to the above beneficiary details via remittance to agents: PACC
SHIPMANAGERS PTE. LTD. or others remittance agents nominated by the company.
I further confirm that the receipt of the above remittance by the beneficiary's bank from you shall be deemed
receipt by me, and no further acknowledgement of receipt by me is required.
I agree to fully indemnify you and hold you harmless against any and all costs, expenses, claims, and liabilities of
whatever nature that may be brought against or incurred by you, your servants and/or agents in respect of the
foregoing request.

My indemnity and authorisation in this letter shall survive the termination of this arrangement by either party.

Name: Heydarov Zaur Date: 28.03.2021

 DOCUMENT ID FORM C-3
PAGE NO. 4 of 6
Pre-Joining Documents ISSUE DATE 4/5/2019
REVISION NO. 1.2
ISSUED BY DPA

Section 1(c): DECLARATION BY CREW ON CHARGES BY MANNING AGENTS

I, the under-mentioned seafarer, fully declare that I am not charged by my Manning Agents for recruitment and placement services
other than for my personal travel documents and by national requirements.

Signature : Witnessed By :

Name : Heydarov Zaur Name :

Rank : 2ND ENGINEER Designation :

Vessel Assigned : POSH MARIAM Name of Agents :

Date of Engagement: 31.03.2021 &

Note:
Two (2) originals copies of this form shall be signed. One original copy shall be retained by the Manning Agents and
the other by the crew which shall be carried onboard together with his Seafarer’s Employment Agreement (SEA).

Name: Heydarov Zaur Date: 28.03.2021

 DOCUMENT ID FORM C-3
PAGE NO. 5 of 6
Pre-Joining Documents ISSUE DATE 4/5/2019
REVISION NO. 1.2
ISSUED BY DPA

Section 1(d): AGREEMENT & DECLARATION

By signing this page, you agree to be employed subjected to the terms of the company policies which are found in
the Safety Management Manual.

(1) I have read, understood and agreed to the Drug & Alcohol Policy (Company Drug & Alcohol Policy)

(2) I have read, understood and agreed to the Good Conduct Declaration (CMM 2.7)

(3) I have read, understood and agreed to the Social Media Agreement (CMM 2.6)

(4) I have read, understood and agreed to the Data Collection Agreement (CMM 2.3)

Place Signed: Azerbaijan, Baku

Date Signed: 28.03.2021

Rank: 2ND ENGINEER

Signature:

Name: Heydarov Zaur Date: 28.03.2021

 DOCUMENT ID FORM C-3
PAGE NO. 6 of 6
Pre-joining Documents ISSUE DATE 4/5/2019
REVISION NO. 1.2
ISSUED BY DPA

Section 3: AGREEMENT & DECLARATION (REMUNERATION AGREEMENT)

Taxes
1) The Company will pay your personal income taxes or any other taxes which may be due to any state, or other
sovereign government, where the applicable vessel may be working.

2) You are responsible for any applicable income tax and/ or other deductions that may apply in your country of
residence. The company may withold a part of your wages as payment for your taxes and other mandatory
contributions as required by national regulations.

Indemnity

(a) indemnify and keep you, your directors, employees and agents indemnified against all claims, demands, losses,
liabilities, costs (including legal costs on a full indemnity basis), charges, damages or expenses of any nature
whatsoever which may be brought or prefered against you or which you may sustain or incur arising out of or in
whatsoever which may be brought or preferred against you or which you may sustain or incur arising out of or in
connection with your acceding to this arrangements at my request;

(b) agree that you shall, under no circumstances, be liable to me for any claims, demands, losses, liabilities, costs
(including legal costs on a full indemnity basis), charges, damages or expenses of any nature whatsoever which may
be brought or preferred against me or which I may sustain or incur arising out of or in connection with making the
remittance into the abovementioned account(s) or for any reason whatsoever in connection therewith; and

(c) Authorised to debit the amount of any third party negotiable instrument returned by the Beneficiary's bank and
your bank charges incurred by you in connection with your acceding to this arrangement at my request.

Name: Heydarov Zaur Date: 28.03.2021