(Official Seal)
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(COUNTRY)
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ENDORSEMENT ATTESTING THE ISSUE OF A
CERTIFICATE UNDER THE PROVISIONS OF THE
INTERNATIONAL CONVENTION ON STANDARDS OF TRAINING,
CERTIFICATION AND WATCHKEEPING FOR SEAFARERS, 1978,
AS AMENDED
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The Government of
...
certifies that certificate
No.
..
has been issued to
.. who has been found duly
qualified in accordance with the provisions of regulation
.
of the above Convention, as amended, and has been found competent to
perform the following functions, at the levels specified, subject to
any limitations indicated until
. or until the date of expiry
of any extension of the validity of this endorsement as may be shown
overleaf:
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FUNCTION
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LEVEL
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LIMITATIONS APPLYING (IF ANY)
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The
lawful holder of this endorsement may serve in the following capacity
or capacities specified in the applicable safe manning requirements of
the Administration:
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CAPACITY
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LIMITATIONS APPLYING (IF ANY)
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Endorsement No.
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issued on
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(Official Seal)
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Signature of duly authorized official
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Name of duly authorized official
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The
original of this endorsement must be kept available in accordance with
regulation I/2, paragraph 11 of the Convention
while its holder is serving on a ship.
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Date of birth of the holder of the certificate
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Signature of the holder of the certificate
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Photograph of the holder of the certificate
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The validity of this endorsement is hereby extended until
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(Official Seal)
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..............................................................................
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Signature of duly authorized official
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Date of revalidation
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Name of duly authorized official
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The validity of this endorsement is hereby extended until
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(Official Seal)
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Signature of the authorized official
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Date of revalidation
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Name of duly authorized official
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