PRC-MDO Form No.

5
Rev.01/11-04-2000
NOT FOR SALE

Republic of the Philippines

PROFESSIONAL REGULATION COMMISSION
Manila

BOARD OF MARINE DECK OFFICERS

CERTIFICATE OF SEA SERVICE

(All Statements herein are subject to verification)

TO THE BOARD OF MARINE DECK OFFICERS:

ALBERT C. PRTUGAL
THIS CERTIFIES that ___________________________________________ had actually served under
our
SS TRINITY GLORY LNG CARRIER PANAMA
supervision on board __________________________,___________________of_____________________________
(Name of Vessel) (Type of Vessel) (State the
Nationality of Vessel)
40203-09
with Registry No.:_____________which
SEAGOING 111,126
is a______________________ vessel of _______________ gross tonnage
(Near Coastal/ Seagoing)

0 1O O1 18 MARCH 2009 to _____________________

for a period of _______________________________from_______________________ 19 JANUARY 2010
(No. of Years) (Months) (Days) (Date of Embarkation) (Date of
Discharge)

ORDINARY SEAMAN
as______________________.
(Position Held)

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

19
Issued this_____________day JANUARY 10 PYONGTAEK, KOREA
of_______________20_____at_____________________________
SEAL OF COMPANY SEAL OF VESSEL

_　 CAPT. DENIS VOCUVIK_

Mr. Michaelangelo Malana Master - Signature Above Printed Name
___________________________________________ Nationality : __COATIAN______
Name and Signature of Port Captain/ Personnel Kind of License : MASTER MARINER___
Mgr. Registration No. : _ __ ________
OSM Maritime Services Date of Registration :　 __
____________________________________________ Expiry Date :　 ___
VNP Bldg. 479 Pedro Gil St.
Name of Local Shipowner or Manning Agent
Ermita, Manila
Address: ____________________________________
____________________________________
(02) 523-8871
Telephone Nos. ______________________________

SUBSCRIBED AND SWORN TO before me this______ day of___________________, 20____,

at_________________.

Doc. No. :___________

Page No. :___________
________________
Book No. :___________
NOTARY PUBLIC
Series of :___________

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