for any harm, inconvenience, expense, and damage relevant to or arising from the same, Including, but

not limited to, airfare and travel accommodations, legal fees, and penalties/fines.
4. The Parties understand and agree that this Undertaking/Promissory Note and their obligations herein
are separate and distinct from the obligations arising from the Seafarer's employment contract, that it is
not intended as a guarantee for the Seafarer's performance under the employment contract or for the
Seafarer's repatriation, and that this Undertaking/Promissory Note is made solely for the purposes stated
herein.

The Parties each acknowledge that they have read this Undertaking/Promissory Note and understand .5
all of its terms, and that this Undertaking/Promissory Note is being executed knowingly and voluntarily,
.without duress, and with full knowledge of its legal significance

IN WHEREOF, we have hereunto set our hands this day of 20

Manila, Philippines.

MAKER (WIFE/FATHER/GUARDIAN) CO-MAKER (MOTHER/GUARDIAN)

SEAFARER

WITNESSES

Fleet HR Director/Branch Manager Fleet HR Manager/ Fleet HR Officer/Branch

Officer

ACKNOWLEDGMENT

BEFORE ME, a duly commissioned Notary Public in and for City of Manila, Philippines, personally
appeared the following:

Name Government ID & ID Number Issue Date/Validity

known to me and to me known to be the same persons who executed the foregoing instrument, an
Undertaking/Promissory Note, and acknowledged to me that the same is their own free and voluntary act
and deed.
WITNESS MY HAND AND SEAL this day of ,20 in Manila, Philippines.

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