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MLC 001 - MLC Declaration Form

Mal ознакомление

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Sergei Mazur
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156 views1 page

MLC 001 - MLC Declaration Form

Mal ознакомление

Uploaded by

Sergei Mazur
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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MLC 2006 Compliance Booklet – Liberian Flagged Vessels

Roswell Navigation Corp.


Form MLC-001: MLC Declaration

Yes No
All items contained in my employment contract have been
1.
explained to me and I am aware of them.
All the certificates/documents that I have furnished are
2.
genuine.
A full sample agreement incorporating all terms and
3. conditions to apply (including the CBA) has been provided to
me prior to entering the agreement.
I was given adequate time to review the contract and seek
4.
advice on the terms and conditions in the agreement
I freely entered into the agreement with a sufficient
5.
understanding of my rights and responsibilities.
I was given an original set of my Seafarers Employment
6.
Agreement, which I must carry with me on board.
No fees or other charges for my recruitment or placement or
7. for providing employment to me have incurred directly or
indirectly, in whole or in part.
No joining advances or any other exploitation incurred with
8.
regard to the employment.
The company’s Complaint procedure has been explained to
9. me and I am fully aware of the process to be followed and
the record to be used.
The terms and conditions of employment and any particular
10. conditions applicable to the job for which I am engaged have
been explained to me.

 By ticking the YES box you indicate that the documented statement is correct.
 By ticking the NO box you indicate that the documented statement is NOT correct.
 If any statement is answered NO you may enter your remarks below.

Remarks:

Seafarer’s Name Rank Vessel to join

Seafarer’s Signature

Issue No.: 02 Date: 30.11.2019 Rev. No: 00 Date: 00.00.0000 Page 1 Developed By: DPA Authorized By: MD

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