CERTIFICATE NO.

_______________

This is to certify that _____________________________________________________________

Date of birth __________________ CDC No. _______________ Passport No._____________

COC No._______________________ INDOS No. _______________________________________

Has successfully completed training in;

BASIC SAFETY TRAINING IN

PERSONAL SURVIVAL TECHNIQUES
FIRE PREVENTION & FIRE FIGHTING
ELEMENTARY FIRST AID; AND
PERSONAL SAFETY & SOCIAL RESPONSIBILITIES

FROM __________________ TO _________________

This course is approved by LIBERIA MARITIME AUTHORITY and meets the requirements
laid down in regulation VI/1, Section A-VI/1 paragraph 2.1, Table A-VI/1-1,
Table A-VI/1-2, Table A-VI/1-3 and Table A-VI/1-4 of the STCW convention and code 2010.

This certificate is issued under the LIBERIA MARITIME AUTHORITY.