You are on page 1of 2

Republic of the Philippines

Office of the President


COMMISIION ON HIGHER EDUCATION

Department of Transportation and Communications

MARITIME INDUSTRY AUTHORITY

CERTIFICATE OF SEA SERVICE

Sir / Madam :

This is to certify that JOHN MARK G. SUSADA holder of SIRB No. C0928783 has been
employed by this company with the following sea going service/s:

Name of Type Route Gross KW Registry Period Covered Position / Total


Vessel (Foreign / Tonnage Power From To Rank Sea
Domestic) Y/M/D Y/M/D service
Y-M-D
THE CARGO / DOMESTIC 759 2,060 BATANGAS 2018 2019 DECK 1 YEAR
PEGASUS PASSENGER JUNE JUNE CADET 4 DAYS
26 30

This further certifies that the above-stated data are true and that any false statement/s made herein
shall be ground for criminal prosecution.

Issued this 14TH day of OCTOBER 2019 at MANILA, PHILIPPINES .

COMPANY SEAL
President / Duly Authorized Person
Signature above Printed Name

SUBSCRIBED AND SWORN to before me this day of , 20 ,

Doc No. :
Page No. :
Book No. :
Series of : Notary Public

Note:
This form is good only for one (1) vessel. This form can be reproduced. Any erasure / obliteration may be a ground for denial.

Republic of the Philippines


Office of the President
COMMISIION ON HIGHER EDUCATION

Department of Transportation and Communications

MARITIME INDUSTRY AUTHORITY

CERTIFICATE OF SEA SERVICE

This certifies that ______ JOHN MARK G. SUSADA _______ had actually served under
our Supervision onboard ______M/V THE PEGASUS______, ______CARGO / PASSENGER_____
(Name of Vessel) (Type of Vessel)
Of ____BATANGAS_____ with Registry No. _04-0003714_, __DOMESTIC __ vessel
(Vessel Nationality) (Near Coastal/Seagoing)
Of _____2,060______ KW and _____759_____ Gross tonnage for a period of
____1 YEAR 4 DAYS____ from _____JUNE 26, 2018____ to ____JUNE 30, 2019____
No. of (Years) (Months) (Days) (Date of Embarkation) (Date of Discharge)
as ___DECK CADET________
(Position Held)

This further certifies that the above-stated data are true and that any false and that any false
statement/s made herein shall be ground for criminal prosecution.

Issued this ___________________ day of __________________ at ________________________


___________________________.

SEAL OF VESSEL

____CAPT. ARIEL F. ORNUM_____


Master-Signature above Printed Name
Nationality :_____FILIPINO _____
Kind of License :_____MARINA LICENSE ______
Registration No. :_____SRN – S605140000______
Date of Registration :_____NOVEMBER 28, 2017____
Expiry Date :_____NOVEMBER 28, 2022____

Note:
This form is good only for (1) vessel. This form can be reproduced. Any erasure/obliteration may be ground for
denial.

You might also like