SEA SERVICE CERTIFICATE

Owners / Company Name: ________________________________________

Owners / Company Address: _________________________________________________________ Name of the Candidate: _______________________
__________________________________________________________________________________
Owners Telephone: ____________________ Date of Birth: ____________________________
Owners Email Id: ________________________
(To be issued by the employer)

Nature of
Ship’s Port of Registration Total Sea Vessel Laid Total Leave Total Vessel Laid Rank Duties
Number
BHP Leave Taken Net Sea Service
Name Registry Service up Period Taken Up Period Worked I / R / N

❶ ❷ ❸
❶-(❷+❸)
from to from to from to

DD- DD- DD- DD- DD- DD-

Y
MM MM- MM- MM- MM- MM- YY MM DD YY MM DD MM DD
Y
-YY YY YY YY YY YY

TOTAL NET SEA SERVICE

Total net sea service in words –
Report as to Conduct: ___________________________ Report as to Sobriety: _______________________ Report as to Ability: _______________________

I hereby certify that the above service particulars are based on the employer's office record.
Rubber
stamp of
company
Date of issue: _________________________ Authorized signatory of the
Place: _______________________ company with rubber stamp

Note:
1. Nature of duties I / R / N – Ito be mentioned for in-charge of the engine room watch, R on regular watch and if none, N to be reported.