REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF TRANSPORTATION

MARITIME INDUSTRY AUTHORITY

AD NO.: 05-00
Initial Issue Date: 09-08-2017
Revision Date: 00

FORM 5: INVENTORY OF TEACHING AIDS

Course :
Name of Maritime Training Institute :

Note: Substitute textbooks and videos can be Self- Pre-inspection

used provided they contain the same content of Inspection
Assessment evaluation
the required.
To be To be accomplished To be accomplished
accomplished by STCW Office by STCW Office
by MTI Evaluator Inspector
Quantity Number At Not Not
Items Complied Complied
Required Hand Complied Complied

Accomplished by : Date :
Name and Signature of
MTI’s Authorized Representative

Document Evaluator’s Comments:

Date of Evaluation
Document Evaluator’s Name & Signature

Inspector’s Comments:

Date of Evaluation
Inspector’s Name & Signature