II SÉRIE-A — NÚMERO 83 32

Name of duly authorized official

Date of birth of the holder of the certificate ……………

Signature of the holder of the certificate …….................

Photograph of the holder of the certificate

The validity of this certificate is hereby extended until ………………………………………..

(Official seal) ………………………..…….…………………….

Signature of duly authorized official

Date of revalidation ……………………. ………………….….……………………………

Name of duly authorized official

The validity of this certificate is hereby extended until ………………………………………..

(Official seal) …………………….……….…………………….

Signature of duly authorized official

Date of revalidation ……………………. ………………………..…………………………

Name of duly authorized official

Appendix 2

The form used to attest the issue of a certificate shall be as shown hereunder, provided that the words «or

until the date of expiry of any extension of the validity of this endorsement as may be shown overleaf» appearing

on the front of the form and the provisions for recording extension of the validity appearing on the back of the

form shall be omitted where the endorsement is required to be replaced upon its expiry.

(Official Seal)

(Country)

Endorsement attesting the issue of a certificate under the provisions of the International Convention on

Standards of Training, Certification and Watchkeeping for Fishing Vessel Personnel, 1995

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

and has been found competent to serve as specified below, 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:

The lawful holder of this endorsement may serve in the following capacity or capacities specified in the

applicable safe manning requirements of the Administration:

Capacity Limitations applying (if any)