INTEGRATED SAFETY MANAGEMENT SYSTEM OC-13

Version: 1-00
MLC DECLARATION FORM Issued: 01.03.2019
Pages: 1 of 1

Yes No
All items contained in my employment contract have been
1.
explained to me and I am aware of them.
A full sample agreement incorporating all terms and conditions to
2. apply (including the CBA) has been provided to me prior to
entering the agreement.
I was given adequate time to review the contract and seek advice
3.
on the terms and conditions in the agreement
I freely entered into the agreement with a sufficient understanding
4.
of my rights and responsibilities.
I was given an original set of my Seafarers Employment
5.
Agreement, which I must carry with me on board.
No fees or other charges for my recruitment or placement or for
6. providing employment to me have incurred directly or indirectly,
in whole or in part.
No joining advances or any other exploitation incurred with regard
7.
to the employment.
The company’s Complaint procedure has been explained to me and
8. I am fully aware of the process to be followed and the record to be
used.
The terms and conditions of employment and any particular
9. conditions applicable to the job for which I am engaged have been
explained to me.

 By ticking the YES box you indicate that the documented statement is correct.
 By ticking the NO box you indicate that the documented statement is NOT correct.
 If any statement is answered NO you may enter your remarks below.

Remarks:

Seafarer’s Name Rank Vessel to join