1044-(182)

II SÉRIE-A — NÚMERO 44

The validity of this endorsement is hereby extended until ... (Official seal.)

Hate of revalidation ,.. (17).

" VER DIÁRIO ORIGINAL"

(signature of duly authorized official)

(name of duly authorized official)

The validity of this endorsement is hereby extended until ... (Official seal.)

Date of revalidation ... (17).

(signature of duly authorized official)

(name of duly authorized official)

2 — An endorsement attesting the recognition of a certificate may be attached to and form part of the certificate endorsed, or may be issued as a separate document (see STCW, regulation 1/2, paragraph 6). All entries made in the form are required to be in Roman characters and Arabic figures (see STCW, regulation 1/2, paragraph 8). The spaces numbered (1) to (17) in the form which follows the text hereunder are intended to be completed as indicated in paragraph 1 above, except in respect of the following spaces:

(2), where the number assigned by the Party which issued the certificate being recognized should be entered;

. (3), where the name entered should be the same as that appearing in the certificate being recognized;

(4), where the name of the Party which issued the certificate being recognized should be entered;

(9), where the capacity or capacities entered in column (9) should be selected, as appropriate, from those specified in the safe applicable manning requirements of the Administration which is recognizing the certificate;

(11), where the number entered in space (11) should be unique to the endorsement both for reference and for location in the register of endorsements; and

(12), where the date of original issue of the endorsement should be entered.

3 — When replacing a certificate or endorsement which has been lost or destroyed, Parties should issue the replacement under a new number, to avoid confusion with the document to be replaced.

(Official seal)

" VER DIÁRIO ORIGINAL"

(Country)

Endorsement attesting the recognition of a certificate under the

provisions of the International Convention on Standards o> Training, Certification and Watchkeeplng for Seafarers, 1978, as amended In 1995.

The Government of ... (1) certifies that certificate no. ... (2) issued to ... (3) by or on behalf of the Government of ... (4) is duty recognized in accordance with the provisions of regulation i/\0 of the above Convention, as amended, and the lawful holder is authorized to perform the following functions, at the levels specified, subject to any limitations indicated until ... (5) or until the date of expiry of any extension of the validity of this endorsement as may be shown overleaf:

(fiJFunctlon (7) Levei (8) UmiuiiorB applying

The lawful holder of this endorsement may serve in the following capacity or capacities specified in the applicable safe manning requirements of the Administration:

" VER DIÁRIO ORIGINAL"

(9)Capacity (10) Limitalions app)ying(if any)

Endorsement no. ... (11) issued on ... (12). (Official seal.)

............................(13)

(signature of duly authorized official)

(name of duly authorized official)

The original of this endorsement must be kept available in accordance with regulation 1/2, paragraph 9, of the Convention while serving on a ship.

Date of birth of the holder of the certificate ... (14). ... (signature of the holder of the certificate) (15). (Photograph of the holder of the certificate.)

(16)