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Navigation (Master and Seamen) Regulations
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Explain section STATUTORY RULES.
1924. No. 199.
REGULATIONS UNDER THE NAVIGATION ACT 1912-1920.
I, THE GOVERNOR-GENERAL in and over the Commonwealth of Australia, acting with the advice of the Federal Executive Council, hereby make the following Regulations under the Navigation Act 1912-1920, to come into operation forthwith.
Dated this seventeenth day of December, 1924.
FORSTER,
Governor-General.
By His Excellency’s Command,
H. E. PRATTEN,
Minister of State for Trade and Customs.
Navigation (Master and Seamen) Regulations.
Short title.
These Regulations may be cited as the Navigation (Master and Seamen) Regulations.
Application.
s. 10.
The provisions of these Regulations shall, unless the subject-matter requires a different application, apply only to British ships and to their owners, masters and crews.
General register of seamen.
s. 12.
A record of all persons serving in ships registered in Australia or regularly engaged in trading between or from Commonwealth ports, and entitled The General Register of Seamen, shall be compiled from official documents and returns and kept at the Mercantile Marine Office at the port of Sydney.
Indentures of apprenticeship.
s. 34.
Indentures of apprenticeship to the sea service made in Australia shall be in accordance with Form M. & S.—1.
Permit to sign articles.
s. 41.
(1) A Permit to sign Articles, in Form M. & S.—2, may be granted by a superintendent to a seaman who is not in possession of a discharge from the last ship in which he served, or engaged to serve, on payment by the seaman of a fee of two shillings and sixpence, and on his satisfying the superintendent—
(a) that he is qualified for the position he seeks;
(b) that he is not a deserter from, and does not belong to, any ship then in the port; and
(c) that his certificates of discharge are not at the time being withheld from him under the provisions of section 106a of the Act.
(2) A Permit to sign Articles shall not be required in the case of a person who has not previously served at sea.
Agreement with crew.
s 46. 49.
(1) Every agreement with a crew required by the Act to be entered into before a superintendent shall be in accordance with Form M. & S.—3.
Section 1 - Navigation (Master and Seamen) Regulations - Navigation (Master and Seamen) Regulations | Zoe Provided that in the case of a ship not registered in Australia, and having an agreement made out in accordance with the law of the place where the crew was engaged, single seamen may be signed on such original agreement in lieu of an agreement in the form prescribed by this regulation.
(2) In any case where, by reason of any charter or demise, or for any other reason, the navigation and management of a ship are controlled by some person other than the registered owner, the master shall declare, in the agreement, the name and address of the principal, and whether charterer or otherwise, for whom he is acting in engaging the crew.
Where a substitute is engaged to fill the place of a seaman who has failed to join, or whose services have, within twenty-four hours of the ship’s putting to sea, been lost by death, desertion or other unforeseen cause, and it has not been possible to make such engagement in the presence of a superintendent, the master, after signing on the substitute in the presence of a Customs officer or other witness, as required by section 48 of the Act, shall report the occurrence, in Form M. & S.—4 & 5, to the superintendent, in cases where the vessel is finally leaving Australia, at that port, or, in other cases, at the next port of call in Australia, and within twenty-four hours of the vessel’s arrival at that port.
The master of every British foreign-going ship shall, before finally leaving Australia, sign and send to the nearest superintendent, in Form M. & S.—4 & 5, a full and accurate statement of every change which has taken place in his crew since the last return to him by a superintendent of the agreement with the crew.
Fees, engagements, and discharges.
(1) The fee for engagements or discharges effected before a superintendent shall be, for each seaman engaged or discharged, two shillings.
(2) The master may deduct from the wages of a seaman, at the time of discharge, one half of the amount of the fees for the seaman’s engagement and discharge.
Certificates of discharge
(1) Certificates of discharge issued to seamen discharged in Australia in the presence of a superintendent shall be in accordance with Form M. & S.—6.
(2) When a seaman is engaged at any port, his last discharge, or if he has none, his Permit to Sign Articles, shall be stamped by the superintendent “Re-engaged at (showing name of port)”.
(1) Upon every discharge effected before a superintendent (excepting when the crew are discharged on the termination of the agreement) the master shall make and sign, in Form M. & S.—7, a report of the conduct, character, and qualifications of the seaman discharged.
(2) In cases where the crew are discharged on the termination of the agreement, report as to the conduct, character, and qualifications each seaman shall be made by the master in the form contained in the official log-book and headed “List of Crew and Report of Character.”
(1) Any allotment, in accordance with the provisions of the Act, of portion of the wages of a seaman engaged on a foreign-going ship shall be in accordance with Form M. & S.—8.
(2) An allotment to a Savings Bank shall be drawn in favour of the manager thereof for the time being.
At least twelve hours before a seaman is discharged, the master shall deliver to him in Form M. & S.—9, or M. & S.—9a, a full and true account of his wages and of all deductions to be made therefrom on any account whatever.
Final settlement of wages.
(1) The master of a foreign-going ship shall pay to each seaman, in account, at the time when he lawfully leaves the ship at the end his engagement, two pounds, or one fourth of the balance of wages due to him, whichever is least; and shall pay him the remainder of his wages within two clear days (exclusive of any Sunday or holiday) after he so leaves the ship.
(2) The master of an Australian-trade ship or of a limited coast-trade ship of 50 tons gross registered tonnage or upwards shall pay to each seaman, through or in the presence of a superintendent, within one clear day (exclusive of any Sunday or holiday) from the time the seaman lawfully leaves the ship at the end of his engagement, the balance of wages due to him.
(1) Where a seaman is discharged and a settlement of his wages effected before a superintendent, the master or owner and the seaman shall, in the presence of the superintendent, sign a mutual release of all claims in respect of the past engagement—
(a) in cases where a whole crew is being discharged on the termination of the agreement and the completed agreement is to be retained by the superintendent—in the column headed “Release” in the agreement; and
(b) in other cases both in that column and in Form M. & S.—10.
(2) A release in the form embodied in the agreement or in Form M. & S.—10, signed in accordance with sub-regulation (1) of this regulation, shall be deemed to be the prescribed release within the meaning of section 80 of the Navigation Act 1912-1920.
Voucher as to wages paid.
Upon any payment of wages being made before a superintendent, the latter shall, if required, give to the master a statement, in Form M. & S.—11, of the amount so paid.
Decision of questions by superintendents
(1) An application for the decision by a superintendent of any question between a master or owner and a seaman or apprentice shall be made in Form M. & S.—12, and the decision of the superintendent, or his refusal to decide the question, shall be recorded thereon.
(2) The form, so indorsed, shall be retained and filed by the superintendent as an official record.
(1) The following regulations for maintaining discipline are approved for insertion, at the joint will of the master and seaman, in agreements entered into in Australia:—
No. Offence. Amount of Fine. 1 Striking or assaulting any person on board or belonging to the ship (if not otherwise prosecuted) Five shilling 2 Bringing or having on board intoxicating liquors.......... Five shillings 3 Drunkenness—................................ First offence............................... Five shilling Second and for each subsequent offence............. Ten shillings 4 Taking on board and keeping possession of any firearms, knuckle-duster, loaded cane, slung shot, sword-stick, bowie-knife, dagger, or any other offensive weapon or offensive instrument, without the concurrence of the Master—for every day during which a seaman retains such weapon or instrument Five shillings 5 Insolent or contemptuous language or behaviour to the Master or Officers, or disobedience to lawful commands, if not otherwise dealt with according to law Five shillings 6 Absence without leave and without reasonable cause (if not otherwise dealt with according to law)—for each day on which such absence occurs Two days’ pay
(2) If, on account of subsequent good conduct, the master desires to reduce or remit any fine imposed on a member of his crew in accordance with the provisions of this regulation, he may, subject to the approval of the superintendent, make an entry in the official log to that effect, and upon the indorsement of the entry with the approval of the superintendent the fine shall thereupon he reduced or remitted accordingly.
(3) A fine imposed on a seaman under any of these Regulations, duly embodied in his agreement, shall be deducted by the master or owner from the seaman’s wages, and shall, at the time of his discharge, be paid to the superintendent in accordance with section 115 of the Navigation Act.
Wages, &c., of seamen left behind sick, &c., s. 130.
If the master of a foreign-going ship leaves a seaman or apprentice behind at any place in Australia, on the ground of his unfitness or inability to go to sea, he shall—
(a) in the case of a ship registered in Australia, or of other British ship proceeding on a voyage to terminate in Australia, deliver to the superintendent, in Form M & S.—1-3, a full and true account of the wages due to the seaman or apprentice, and shall pay such wages to the seaman or apprentice, or to the superintendent, as the case may be, as required by section 130 of the Navigation Act; or
(b) in the case of a British ship not registered in Australia, proceeding on a voyage to terminate outside Australia, deliver to the superintendent, in the British Board of Trade Form G.C.6, a full and true account of the wages due to the seaman or apprentice, and shall pay such wage to the seaman or apprentice, or to the superintendent, as under the provisions of the Merchant Shipping Act may be required; and
(c) in either case, deliver to the seaman or apprentice, or to the superintendent on his behalf, all effects (including, in the case of a seaman, any certificates of discharge held by the master) left by the seaman or apprentice on board the ship.
Search of ships. Signal to heave to.
(1) The master of a ship, when hailed by an officer of Customs and called upon to do so, or when signalled as prescribed in this regulation, shall immediately stop his ship and afford the officer, or any authorized officer of police, all necessary assistance to board and search the ship.
(2) The signal to be used for the purpose of this regulation shall, be, by day, the flag signal M N of the International Code, or the letter L of the Morse Code (..-.) communicated by long and short blasts of a whistle, and by night the burning of a blue light or flare, followed by the letter L of the Morse Code communicated by long and short blasts of a whistle or by Morse signalling lamp.
The master of every foreign-going or Australian-trade ship, arriving at a port in Australia from any place outside Australia, shall furnish to the superintendent at that port, within twenty-four hours of such arrival, a list of the crew of the ship in Form M. & S.—14.
Births, deaths and marriages.
(1) The master of every ship registered in Australia, and of every other ship (British or foreign) carrying passengers to Australia, shall record, in the case of a British ship in the official log book, the following particulars concerning every birth, death and marriage happening on board the ship:—
(a) As regards every birth—
Name (if any) and sex of child;
Name and surname, rank, profession, or occupation of the father;
Same and surname, and maiden surname, of the mother; and
Birthplace, nationality and last place of abode of the father and mother.
(b) As regards every death—
Bank, profession or occupation;
Birthplace, nationality, and last place of abode; and
(c) As regards every marriage—
Christian name and surname;
Rank, profession or occupation;
Bachelor, widower or divorcee;
Birthplace, nationality and last place of abode;
Names of parents, and rank, profession or occupation of father.
Christian name and maiden surname. (In the case of a widow or divorcee the Christian name, surname and maiden surname should be given);
Spinster, widow or divorcee;
Birthplace, nationality and last place of abode;
Names of parents, and rank, profession or occupation of father.
Name, permanent address and denomination of the officiating clergyman.
(2) Every entry in the official log regarding a birth, death or marriage occurring on board shall be signed by the master and an officer or some other member of the crew, and—
(a) in the case of a birth or death—by the medical officer on board (if any); and
(b) in the case of a marriage—by the clergyman who performed the marriage ceremony.
(3) The master, on arrival of the vessel at the first port of call in Australia after the occurrence, shall transmit to the nearest superintendent a return, in accordance with Form M. & S.—15, of the facts recorded by him in respect of any such birth, death or marriage.
Delivery of agreement, &c., to superintendent.
(1) Whenever a foreign-going ship arrives at any principal port in Australia, other than her final port of destination, the master shall, within forty-eight hours of her arrival, deliver to the superintendent the agreement with the crew and, if and when required by the superintendent, the official log-book of the ship.
(2) The following ports in Australia shall be principal ports for the purposes of this regulation and of section 167 of the Act, viz.:—
New South Wales.—Sydney, Newcastle.
Victoria.—Melbourne, Geelong.
Queensland.—Brisbane, Thursday Island, Cairns, Townsville Bowen, Mackay, Rockhampton, Gladstone, Bundaberg, Maryborough.
South Australia.—Port Adelaide, Port Pirie.
Northern Territory.—Darwin.
Western Australia. —Fremantle, Albany, Bunbury, Geraldton, Carnarvon, Point Samson (Roeburne), Port Hedland, Broome.
Tasmania.—Hobart, Launceston, Devonport, Burnie.
(3) The master of an Australian-trade or limited coast-trade ship, on each occasion on which a seaman is discharged during the currency of the agreement, shall produce the official log-book to the superintendent for his inspection.
(1) An official log-book, in Form M. & S.—16, shall be kept by the master of every ship other than a limited coast-trade ship of less than 50 tons gross registered tonnage or a river and bay ship:
Provided that in cases where the agreement with the crew has been entered into in the United Kingdom or in some British Possession other than Australia, an official log in the form approved by the British Board of Trade or by the Government of that British Possession may be used, during the currency of that agreement, in lieu of the official log provided for in this regulation.
(2) The master shall enter or cause to be entered in the official log the following matters:—
(a) Every conviction by a legal tribunal of a member of his crew, and the punishment inflicted;
(b) Every case in which a member of the crew is disrated (section 42), or is promoted, with the date of such disrating or promotion, the rating to which the seaman is reduced or promoted, and the rate of wages which he is to receive;
(c) A statement of the conduct, character, and qualifications of each member of his crew (section 67);
(d) Every offence for which punishment is inflicted on board, and the punishment inflicted;
(e) Every offence committed by a member of his crew for which it is intended to prosecute, or to enforce a forfeiture, or to exact a fine, together with such statement concerning the furnishing of a copy or reading over of that entry, and concerning the reply (if any) made to the charge as is required by section 111 of the Navigation Act;
(f) Every case of drunkenness or misconduct on the part of a certificated officer, whether the master wishes the case to be investigated or not;
(fa) Every case in which a stowaway is discovered on board with particulars as to his full name, age and birthplace, the place where he came aboard and where he is put ashore; also as to the proceedings (if any) taken against him and the penalty inflicted by the Court;
(g) Every case of illness or injury happening to a member of the crew, with the nature thereof, and the medical treatment adopted (if any). In cases of continued illness frequent entries should be made (daily if possible) showing the progress and treatment of the patient;
(h) Any case in which, where a daily allowance of anti-scorbutics is required by the Navigation Act or regulations to be issued, such issue is not made; also any refusal of a seaman or apprentice to take anti-scorbutics when served out (section 124);
(i) The name of every seaman or apprentice who ceases to be a member of the crew (otherwise than by death), with the place, time, manner, and cause thereof, together with a statement of the effects left on board by the seaman and of the amount due to the seaman on account of wages at the time of his so ceasing to be a member of the crew
(j) The wages due to any seaman who enters His Majesty’s naval service during the voyage;
(k) A description of the effects and a statement of the amount of money belonging to any seaman or apprentice who dies during the voyage, together with a statement of the sum due to the deceased for wages and of the amount of deductions (if any) to be made therefrom;
(l) In case of sale of any effects of a deceased seaman or apprentice, a description of each article sold, and the sum received for each (section 150);
(m) Every birth, death, or marriage taking place on board with, in each case, the particulars prescribed in regulation 22 of these Regulations (section 166);
(n) A list of the documents relating to the navigation of the ship and to the crew thereof received from the previous master (section 168);
(o) In the case of ships required by the Navigation Act or regulations to be divided into water-tight compartments, every occasion on which inspection and operation is made of the water-tight doors, side scuttles, valves, and other like contrivances, with an explicit record of any defects discovered (section 206);
(p) The draught of water and freeboard of the ship when leaving port (sections 222, 226);
(q) Every occasion on which collision, boat, or fire drill is practised on board the ship (section 235) or on which the life-saving and fire-extinguishing appliances on board the ship have been inspected for the purpose of seeing that those appliances are fit and ready for use;
(r) Every occasion on which a wireless call is received from a ship in distress, with, in cases where the master does not proceed to the assistance of the persons in distress, his reasons for not doing so (section 265);
(s) Every new danger to navigation observed; all messages or information received in regard to new dangers; and all messages and reports sent in regard to such dangers, with, in each case, the hour and minute and the position of the ship at the time (section 269a and Navigation (Distress Signals and Danger Calls Regulations).
(t) Every collision with another ship, or other matter required under section 268 of the Navigation Act to be reported, and the circumstances under which the same occurred, and
(u) any other matter or thing required by the Act or the regulations thereunder to be entered in the official log.
(1) An engine-room log-book, in a form approved by the Director of Navigation, shall be kept by the chief or only engineer of every steamship (other than a river and bay ship) of 50 tons gross registered tonnage or over.
(2) Entries shall be made in the engine-room log-book, in the manner prescribed in section 175 of the Navigation Act, in regard to the following matters:—
(a) Data indicating whether the machinery is working satisfactorily;
(b) Data showing whether the supply of fuel and essential stores is sufficient for the voyage;
(c) Orders and instructions received from the bridge (by engine-room telegraph or otherwise) and the movements of the engines or other action taken in response thereto, with date, time and remarks;
(d) Conditions, as to temperature and humidity, under which the crew are working in the engine-room, stokehold and bunkers; and
(e) Information as to fuel consumption, &c., necessary to be recorded as a guide to stokehold manning.
(3) All indicator cards taken shall be kept by the engineer and shall be produced to the surveyor if so required by him.
Investigation of deaths and accidents, s. 176.
The following ports in Australia shall be principal ports for the purposes of section 176 of the Act, viz.:—
New South Wales.—Sydney, Newcastle.
Queensland.—Brisbane, Townsville.
South Australia.—Port Adelaide.
Western Australia.—Fremantle.
Certificates of Service at Sea.
(1) Certificates showing the period and nature of a seaman’s service at sea, in respect of voyages terminating in Australia, may be issued by a superintendent in Form M. & S.—18.
(2) An application for a Certificate of Service at Sea shall be in Form M. & S,—19, and shall be accompanied by the proper fee, according to the following scale:—
For the first voyage for which certificate is required.....2s.; and
For each subsequent voyage .....................1s.
(1) Where a prescribed form contains, by way of note or otherwise, a clear indication or direction of any requirement as to—
(a) the number of copies of the document to be tendered (the words “in duplicate”, for example, being a sufficient indication of the number required);
(b) the nature or form of the information to be furnished; or
(c) any action, either by way of signing a form of declaration or otherwise, to be taken by the person concerned in the transaction in which the document is used,
the requirement so indicated shall be deemed to be prescribed.
(2) Any form approved by the British Board of Trade under the Merchant Skipping Act, or by any State authority under a State Act, and which is substantially in accordance with a form prescribed by these Regulations, may, if the Director of Navigation so approves, be used in lieu of that prescribed form.
The following charges shall be made for forms prescribed by these Regulations:—
Indenture of Apprenticeship (Form M. & S.—1; reg. 4), per set of two—original and duplicate s.5 d.0 Permit to Sign Articles (M. & S.—2; reg. 5) each ................. 2 6 Agreement with Crew (M & S.—3; reg. 6) per copy of—............ 8 pages....................................... 2 6 12 pages....................................... 3 6 16 pages....................................... 4 6 24 pages....................................... 5 6 36 pages....................................... 6 6
Note.—No charge is made for the Office Copy of an Agreement retained by the Superintendent, or for the Forecastle Copy (or copies) issued when an Agreement is first opened.
<table cellspacing="0" cellpadding="0" style="width:99.66%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Report of Changes in Crew (M. & S.—4 & 5; regs. 7 and 8)</span><span style="width:64.33pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.........</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Certificate of Discharge (M & S.—6; reg. 10).— Price included in fee of Two shillings charged for each seaman discharged (reg. 9).</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="text-align:right; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Report of Character (M. & S.—7; reg. 11)</span><span style="width:142.57pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.....................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Allotment Note (M. & S.—8; reg. 12)—per book of 25 forms</span><span style="width:57.31pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">........</span></p></td><td style="width:8.98%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; background-color:transparent"><span>1</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">0</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Account of Wages (M. & S.—9; and M. & S.—9</span><span class="BodytextSmallCaps0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">a;</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"> reg. 13)—</span><span style="width:55.79pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">........</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span style="width:328.3pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.................................................</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">(</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">a</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">) Account of Wages Form only (M. & S.—9)—per book of—</span></p></td></tr><tr style="height:1pt"><td style="width:83.72%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:35.45pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">25 forms</span><span style="width:253.64pt; font-family:'Lucida Console', monospace; display:inline-block">......................................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td></tr><tr style="height:1pt"><td style="width:83.72%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:35.45pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">50 forms</span><span style="width:253.44pt; font-family:'Lucida Console', monospace; display:inline-block">......................................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td></tr><tr style="height:1pt"><td style="width:83.72%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:35.45pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">100 forms</span><span style="width:247.94pt; font-family:'Lucida Console', monospace; display:inline-block">.....................................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">(b) Combined with Master’s Account Book (M. & S.—9</span><span class="BodytextSmallCaps0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">a),</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"> per book of—</span></p></td></tr><tr style="height:1pt"><td style="width:83.72%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:35.45pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">25 forms</span><span style="width:253.44pt; font-family:'Lucida Console', monospace; display:inline-block">......................................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td style="width:83.72%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:35.45pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">50 forms</span><span style="width:253.44pt; font-family:'Lucida Console', monospace; display:inline-block">......................................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td style="width:83.72%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:35.45pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">100 forms</span><span style="width:247.94pt; font-family:'Lucida Console', monospace; display:inline-block">.....................................</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Form of Release (M. & S.—10; reg. 15) each</span><span style="width:110.82pt; font-family:'Lucida Console', monospace; display:inline-block">................</span></p></td><td style="width:8.98%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; background-color:transparent"><span>1</span></p></td><td style="width:7.18%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">0</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Voucher for Payments by Master (M. & S.—11; reg. 16)</span><span style="width:60.4pt; font-family:'Lucida Console', monospace; display:inline-block">.........</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Submission of Question to Arbitration (M. & S.—12; reg. 17)</span><span style="width:37.75pt; font-family:'Lucida Console', monospace; display:inline-block">.....</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Account of Wages, &c., of Seaman Left Behind (M. & S.—13; reg. 19)</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:28.35pt; text-indent:-14.15pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">List of Crew, to be used when Agreement with Crew and Official Log-book are not available (M. & S.—14; reg. 21)</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:0pt"><td style="width:353.75pt"></td><td style="width:0.5pt"></td><td style="width:37.95pt"></td><td style="width:30.35pt"></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Return of Births, Deaths, and Marriages (M. </span><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">&</span><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">. </span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">S.—15 ; reg. 22)</span><span style="width:54.55pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">........</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Official log-book (M. & S.—16; reg. 24), per copy of—</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">20 pages, 40 men</span><span style="width:245.22pt; font-family:'Lucida Console', monospace; display:inline-block">....................................</span></p></td><td style="width:9.32%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:7.26%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">40 pages, 90 men</span><span style="width:245.22pt; font-family:'Lucida Console', monospace; display:inline-block">....................................</span></p></td><td style="width:9.32%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText41" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:7.26%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">50 pages, 120 men</span><span style="width:239.72pt; font-family:'Lucida Console', monospace; display:inline-block">....................................</span></p></td><td style="width:9.32%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td><td style="width:7.26%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">54 pages, 240 men</span><span style="width:239.72pt; font-family:'Lucida Console', monospace; display:inline-block">....................................</span></p></td><td style="width:9.32%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td><td style="width:7.26%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Certificate of Service at Sea (M. & S.—18)—According to the number of voyages certified to </span><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">vide </span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">reg. 27).</span><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:83.42%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Application for Certificate of Service at Sea (M. & S.19; reg. 27</span><span style="width:50.29pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.......</span></p></td><td colspan="2" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No charge</span></p></td></tr></tbody></table>
(1) When, for the convenience of the public, work in connexion with the engagement or discharge of seamen is performed on board ship, or any work is performed in a Mercantile Marine Office before or after official hours, the following charges shall be made for the services of the officers employed. These charges are in addition to the ordinary fees prescribed in these Regulations:—
(a) Work performed before or after official hours, ordinary working days—
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="4" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:3pt; margin-left:99.25pt; text-indent:-28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">(i) Discharge of seamen on board ship, at any one attendance of the officers—</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">£</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">s.</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">d.</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:42.55pt; text-indent:28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Thirty hands or under</span><span style="width:166.48pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.........................</span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">10</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:42.55pt; text-indent:28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Over 30 and not exceeding 60 hands</span><span style="width:101.42pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">...............</span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:42.55pt; text-indent:28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Over 60 hands</span><span style="width:197.95pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.............................</span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:3pt; margin-left:99.25pt; text-indent:-28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">(ii) Engagement of seamen on board ship, at any one attendance of the officers—</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">£</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">s.</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodytextItalic2" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">d.</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:42.55pt; text-indent:28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Thirty hands or under</span><span style="width:166.48pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.........................</span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">10</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:42.55pt; text-indent:28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Over 30 and not exceeding 60 hands</span><span style="width:101.42pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">...............</span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td style="width:79.8%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:42.55pt; text-indent:28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Over 60 hands</span><span style="width:197.95pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.............................</span></p></td><td style="width:7.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:6.6%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:6.08%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">0</span></p></td></tr><tr style="height:1pt"><td colspan="4" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:3pt; margin-left:99.25pt; text-indent:-28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">(iii) Discharge or engagement of seamen in a Mercantile Marine Office, on each occasion on which the officers are so employed in respect of any one ship—one-half of the above rates.</span></p></td></tr><tr style="height:37.95pt"><td colspan="4" style="padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:3pt; margin-left:99.25pt; text-indent:-28.35pt; text-align:justify; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="BodyText30" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">(iv) Clearance of agreements or similar work of a clerical nature performed in a Mercantile Marine Office (otherwise than in connexion with the engagement or discharge of seamen made at the same time)—for each officer engaged, per hour or part thereof, 3s.</span></p></td></tr></tbody></table>
(b) Work performed on Sundays and holidays—double the rates specified in paragraph (a) above.
(c) Work performed on board ship during official hours, on ordinary working days—double the rates specified in sub-paragraphs (i) and (ii) of paragraph (a) above.
(2) Where the services of an officer are required, otherwise than in a Mercantile Marine Office during ordinary official hours, there shall he charged, for each officer engaged, in addition to the charges specific in sub-regulation (1) of this regulation—
(a) When the service is required to be performed—
(i) on board ship, at any time; or
(ii) at a Mercantile Marine Office at any time outside ordinary official hours (other than immediately preceding, or immediately following on, such official hours), or on a Sunday or holiday,
for the time of the officer, in excess of a total of half an hour, necessarily occupied in travelling between the ship and the Mercantile Marine Office or his home, or between the Mercantile Marine Office and his home, as the circumstances of the case may require, an amount at the rate of Three shillings per hour or part of an hour; and
(b) When the service is required to be performed—
(i) on board ship, at any time; or
(ii) at a Mercantile Marine Office before or after official hours or on a Sunday or holiday,
for all waiting time, in excess of a total of half an hour, an amount at the rate of Three shillings per hour or part of an hour.
Services of Officers at places other than Mercantile Marine Offices.
When, for the convenience of the public, the attendance of an officer is required at any place outside a Mercantile Marine Office for purposes other than in connexion with the engagement or discharge of seamen or as a witness in a court of law, a charge of Five shillings per hour or part thereof shall be made for the services of each officer employed.
The Navigation (Master and Seamen) Regulations 1922, being Statutory Rules 1922, No. 34, as amended by Statutory Rules 1922, Nos. 72, 96, 131 and 184, and by Statutory Rules 1923, Nos. 7, 28, 83 and 120, are hereby repealed.
ISSUED UNDER THE NAVIGATION ACT 1912-1920.* Full Address.1 If there is a Surety his name is to be inserted here; but a Surety is not essential. If there is not one, the part relating to him should be struck out.2 This space is available for additional stipulations.3 See Note 1. Form M. & S.—1.INDENTURE OF APPRENTICESHIP TO THE SEA SERVICE.This Indenture, made the day of 19 between aged years, a native of , in the State of , now residing at* , of the first part, of* , in the State of of the second part, and1 of* , in the State of of the third part, witnesseth, That the said hereby voluntarily binds himself Apprentice unto the said , his Executors, Administrators, and Assigns, for the term of years from the date hereof: And the said Apprentice hereby covenants that, during such time, the said Apprentice will faithfully serve his said Master, his Executors, Administrators, and Assigns, and obey his and their lawful commands, and keep his and their secrets, and will, when required, give to him and them true accounts of his or their goods and money which may be committed to the charge, or come into the hands, of the said Apprentice ; and that the said Apprentice will not, during the said term, do any damage to his said Master, his Executors, Administrators, or Assigns, nor will he consent to any such damage being done by others, but will, if possible, prevent the same and give warning thereof; and will not embezzle or waste the goods of his Master, his Executors, Administrators, or Assigns, nor give or lend the same to others without his or their licence; nor absent himself from his or their service without leave; nor frequent Taverns or Alehouses, unless upon his or their business; nor play at unlawful games: In Consideration whereof, the said Master hereby covenants with the said Apprentice, that during the said term he, the said Master, his Executors, Administrators, and Assigns, will and shall use all proper means to teach the said Apprentice or cause him to be taught the business of a Seaman,2and the Master also agrees to provide the said Apprentice with sufficient Meat, Drink, Lodging, Washing, Medicine, and Medical and Surgical Assistance, and pay to the said Apprentice the sum of £ , in manner following (that is to say):—the said Apprentice providing for himself all wearing apparel and necessaries (except such as are hereinbefore specially agreed to be provided by the said Master): And IT is hereby agreed, that if at any time during the said term the said Master, his Executors, Administrators, or Assigns provide any necessary apparel for the said Apprentice he and they may deduct any sums properly expended thereon by him or them from the sums so agreed to be paid to the said Apprentice as aforesaid: And for the performance of the Agreements herein contained, each of them, the said and3 doth hereby bind himself, his Heirs, Executors, and Administrators unto the other of them, his Executors and Administrators, in the penal sum of £ ; and for the performance of the covenants on the part of the said Apprentice herein contained, the said , as surety, doth hereby bind himself, his Heirs, Executors, and Administrators unto the said , his Executors and Administrators, in the penal sum of £ : Provided, that notwithstanding the penal stipulations herein contained, any Court, Magistrate, or Justice of the Peace may exercise such jurisdiction in respect of the said Apprentice as he or they might have exercised if no such stipulations had been herein contained.In witness whereof the said parties have hereunto set their hands and seals, the day and year above written. Registered at the Port of t this day of , 19 .Signed Place of the Seal.Signed, sealed, and delivered in the presence of (Master.)Place of the Seal.Official Superintendent, Mercantile Marine Office, (Apprentice.)Place of the Seal.Stamp. Port of (Surety.)Note.—This Indenture must be executed in duplicate, and in the presence of a Superintendent. One copy will be recorded and retained by the Superintendent, and the other, duly indorsed, will be returned to the Master of the Apprentice.The Navigation Act further requires the Master to notify the Superintendent, as soon as practicable, of any assignment or cancellation of the Indenture, or the death or desertion of the Apprentice.
Commonwealth of Australia.
Navigation Act 1912-1920. No.
Navigation Act 1912-1920,
Sec. 41; Nav. (M. & S). Reg. 5.
Name of Seaman. Place and Year of Birth. Last Ship.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="3" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Particulars as to Last Ship.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Report of Character, Last Ship.</span></p></td></tr><tr style="height:1pt"><td style="width:17%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Date of Leaving.</span></p></td><td style="width:19.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:15.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Cause.</span></p></td><td style="width:17%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Efficiency as Boat-hand.</span></p></td><td style="width:17.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Ability.</span></p></td><td style="width:14.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Conduct.</span></p></td></tr><tr style="height:31.2pt"><td style="width:17%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
The above-named seaman, haying satisfied me that he is qualified for the position of , that he is not a deserter from, and does not belong to, any ship now in this port, and that his certificates of discharge are not being withheld from him under the provisions of section 106a of the Navigation Act 1912-1920, is hereby granted permission to engage as a seaman in the capacity named above and to sign Articles.
Fee, Two shillings and sixpence, received.
Signature of Seaman OfficialPort of Superintendent,Date, / / 19 . Stamp Mercantile Marine Office.
AGREEMENT AND ACCOUNT OF CREW
Australian Trade-Ship (not leaving the coast of Australia) or Limited Coast-Trade Ship.
Any Erasure, Interlineations, or Alteration, in this Agreement will be void unless made with the consent of the persons interested, and attested by some Superintendent of a Mercantile Marine Office, or Consular or other Proper Authority (Navigation Act, s. 55).
Issued under the Navigation Act 1912-1920. Nav. (M. & S.) Reg. 6.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:19.06%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Name of </span><span class="Bodytext55pt" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Ship.</span></p></td><td style="width:8.8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Official No.</span></p></td><td style="width:10%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Port No., and Date of Register.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Registered Tonnage.</span></p></td><td style="width:23.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Nominal Horse-power of Propelling Engines (if any).</span></p></td></tr><tr style="height:1pt"><td style="width:19.06%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Gross.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Net.</span></p></td><td style="width:23.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:23.55pt"><td style="width:19.06%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td style="width:23.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="4" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Registered Managing Owner or Manager.</span><span style="font-family:'Times New Roman', serif">†</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">No. of Seamen for whom Accommodation Is Certified.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">For Particulars as to Load-line see Page 2.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">N.H.P. of </span><span class="Bodytext6pt1" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">all</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline"> Engines in Engine-room (Navigation Act, Sch. 1.).</span></p></td></tr><tr style="height:1pt"><td style="width:19.06%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Name.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:11pt; letter-spacing:normal; vertical-align:baseline">Address (state No. of House, Street, and Town).</span></p></td></tr><tr style="height:16.55pt"><td style="width:19.06%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:11pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:80.85pt"></td><td style="width:37.3pt"></td><td style="width:42.4pt"></td><td style="width:15pt"></td><td style="width:72.1pt"></td><td style="width:10.75pt"></td><td style="width:32.3pt"></td><td style="width:27.8pt"></td><td style="width:4.85pt"></td><td style="width:100.65pt"></td></tr></tbody></table>
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The Several Persons whose names are hereto subscribed, and whose descriptions are contained herein, and of whom are Able Seamen and Ordinary Seamen, hereby agree to serve on board the said Ship in the several capacities expressed against their respective Names, on a Voyage from1
And the crew agree to conduct themselves in an orderly, faithful, honest, and sober manner, and to be at all times diligent in their respective duties, and to be obedient to the lawful commands of the said Master, or of any Person who shall lawfully succeed him, and of their Superior Officers, in everything relating to the said Ship and the stores and cargo thereof, whether on board, in boats, or on shore ; in consideration of which services to be duly performed, the said Master hereby agrees to pay to the said Crew as Wages the sums against their Names respectively expressed, and to supply them with Provisions according to the Scale on the other side hereof.
And it is hereby agreed that any Embezzlement or wilful or negligent Destruction of any part of the Ship’s Cargo or Stores shall be made good to the Owner out of the Wages of the Person guilty of the same.
And it is further agreed that if any Seaman enters himself to a capacity for which he is incompetent he is liable to be disrated.
And it is also agreed that the Regulations authorized by the Navigation (Master and Seamen) Regulations, which are printed herein and numbered2 are adopted by the parties hereto and shall be considered as embodied in this Agreement.2
And it is also agreed that if any Member of the Crew considers himself to be aggrieved by any breach of the Agreement or otherwise, he shall represent the same to the Master or Officer in charge of the Ship in a quiet and orderly manner, who shall thereupon take such steps as the case may require.
And it is also agreed that3
In witness whereof the said Parties have subscribed their Names herein on the days mentioned against their respective signatures,
<table cellspacing="0" cellpadding="0" style="width:200.36%; margin-right:9pt; margin-left:18pt; border-collapse:collapse; float:left"><tbody><tr style="height:1pt"><td rowspan="2" style="width:18.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:18pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Date of Commencement of Voyage.</span></p></td><td rowspan="2" style="width:15.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Port at which Voyage commenced.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-top:3pt; margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">These Columns to be filled up at the end of the Voyage or Termination of the Agreement,</span></p></td></tr><tr style="height:1pt"><td style="width:14.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Date of Termination of Voyage.</span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Port at which Voyage Terminated.</span></p></td><td style="width:17.8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Date of Delivery of Agreement to Superintendent.</span></p></td><td rowspan="2" style="width:19.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">I hereby declare to the truth of the Entries in this Agreement and Account of Crew, &c.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Master.</span></p></td></tr><tr style="height:1pt"><td style="width:18.32%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:8pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:8pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:8pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:8pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:8pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
†Note.—Under certain circumstances the name of the charterer or other person controlling the navigation and Management of the vessel is also to be given (see Navigation (Master and Seamen) Reg. 6).
1 Here is to be inserted the nature, and, as far as practicable, the duration of the intended voyage or engagement or fee maximum period and the places or parts of the world, if any, which are excluded.
2 Here are to be inserted the Numbers of any of the Regulations for preserving discipline authorized by the Navigation (Master and Seamen) Regulations, and printed on the third page hereof, which the parties agree to adopt.
3 Here any other stipulations may be inserted to which the parties agree, which are approved by the Superintendent, and which are not contrary to law.
(Ships registered in Australia and British Ships engaged in the Coasting Trade.)
Required by Section 117 of the Navigation Act 1912-1920 to be allowed and served out to the Crew during the Voyage except in Cases in which the Crew furnish their own Provisions.
Note.—The Scale agreed upon is in addition to the Lime and Lemon Juice and Sugar or other Anti-Scorbutics, in any case required under Section 124 of the Act.
[Here is set out the scale of Provisions, the conditions in applying scale and the list of Substitutes and Equivalents Schedule III. to the Navigation Act.]
LOAD-LINE AND DRAUGHT OF WATER.
* The centre of the disc is placed at feet inches below the deck-line marked under the provisions of the Merchant Shipping Act 1894.
* Position of Lines used in connexion with the Disc.
Maximum load-line in fresh water, feet inches above the centre of the disc.
Maximum load-line in winter, North Atlantic, feet inches below the centre of the disc.
Maximum load-line in fresh water, feet inches above the centre of the disc.
Maximum load-line in Indian summer, feet inches above the centre of the disc. Maximum load-line in summer, the centre of the disc.
Maximum load-line in winter, feet inches below the centre of the disc.
Maximum load-line in North Atlantic winter, feet inches below the centre of the disc.
* These particulars are to be taken from the certificate of approval of the position, or alteration of the position, of the disc, and the words which are not applicable should be erased.
Notes.—In the Northern Hemisphere the summer months are April to September inclusive, and the winter months October to March inclusive. In the Southern Hemisphere (elsewhere than in Australia) the summer and winter free-boards should be used during the corresponding or recognized summer and winter months respectively.
In the case of vessels entering, or loading in, any port in Australia the minimum freeboard allowed, for all seasons of the year, is as follows:—For steamships loaded with dead-weight cargo, the winter freeboard; for sailing ships so loaded, the winter North Atlantic freeboard; and for all vessels loaded with other cargo, the summer freeboard. A cargo is deemed to be a “dead-weight” cargo if it consists, to the extent of 85 per cent or more, of metalliferous ores, iron or steel rails or girders, pig-iron or any other homogeneous cargo with a specific gravity of 4 or over.
Form M. & S.—3—continued.
REGULATIONS FOR, MAINTAINING DISCIPLINE.
Sanctioned by the Navigation (Master and Seamen) Regulations.
These Regulations are distinct from, and in addition to those contained in the Act, and are sanctioned but not universally required by law. All or any of them may be adopted by agreement between a Master and his Crew, and hereupon the offences specified in such of them as are so adopted will be legally punishable by the appropriate fines or punishments. These Regulations, however, are not to apply to Certificated Officers.These Regulations are numbered, and the numbers of such of them as are adopted must be inserted in the space left for that purpose in the Agreement, page 1, and the following copy of these Regulations must be made to correspond with the Agreement by erasing such of the Regulations as are not adopted. The signature or initials of the Superintendent of a Mercantile Marine Office, or Consular or other Proper Authority before whom the Agreement is made, must be placed opposite such of the Regulations as are adopted.For the purpose of legally enforcing any of the following penalties, the same steps must be adopted as in the case of other offences punishable under the Act ; that is to say, a statement of the offence must, immediately after its commission, be entered in the Official Log Book by the Master, or under his directions, and must at the same time be attested to be true by the signatures of the Master and an officer or some other member of the Crew ; and a copy of such entry must be furnished, or the same must be read over to the offender, before the ship reaches any port, or departs from the port at which she is; and an entry that the same has been so furnished or read over, and of the reply, if any, of the offender, must be made and signed in the same manner as the entry of the offence. These entries must, upon discharge of the offender, be shown to the Superintendent before whom the offender is discharged; and, if he is satisfied that the offence is proved, and that the entries have been properly made, the fine must be deducted from the offender’s wages, and paid over to the Superintendent.If, in consequence of subsequent good conduct, the Master desires to remit or reduce any fine upon any member of his Crew which has been entered in the Official Log, he may, subject to the approval of the Superintendent, make an entry in the Official Log Book to that effect, and upon the indorsement of the entry with the approval of the Superintendent, the fine shall thereupon be remitted or reduced accordingly
No. Offence. Amount of Fine. Signature of Superintendent. 1 Striking or assaulting any person on board or belonging to the ship (if not otherwise prosecuted) Five shillings 2 Bringing or having on board intoxicating liquors............ Five shillings 3 Drunkenness—first offence.......................... Five shillings ,, second and for each subsequent offence........ Ten shillings 4 Taking on board and keeping possession of any firearms, knuckle-duster, loaded cane, slung shot, sword-stick, bowie-knife, dagger, or any other offensive weapon or offensive instrument without the concurrence of the Master—for every day during which a Seaman retains such weapon or instrument Five shillings 5 Insolent or contemptuous language or behaviour to the Master or Officers, or disobedience to lawful commands, if not otherwise dealt with according to law Five shillings 6 Absence without leave and without reasonable cause (if not otherwise dealt with according to law) for each day on which such absence occurs Two days’ pay
ACCOUNT OF APPRENTICES ON BOARD.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:21.7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surnames of the Apprentices at full length.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1.</span></p></td><td rowspan="2" style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2.</span></p></td><td rowspan="2" style="width:13.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nationality.* (If British, state Birthplace.)</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Registry of Indenture.</span></p></td><td rowspan="2" style="width:11.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Joining subsequent to commencement of this Agreement.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date, Place, and Cause of leaving this Ship, or of Death. If the Apprentice remains it should be stated.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">To be filled up by the Master.</span></p></td></tr><tr style="height:1pt"><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of. 4.</span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of. 5.</span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7.</span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8.</span></p></td><td style="width:10.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9.</span></p></td></tr><tr style="height:28.75pt"><td style="width:21.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
If a British Subject, state Town or Country of birth; and, if born in a Foreign Country, state if a natural-born British Subject or naturalized.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:102.8pt"><td rowspan="2" style="width:3.46%; height:102.8pt; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:102.8pt; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No.</span></p></div></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signatures of Crew.</span></p></td><td rowspan="2" style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nationality (if British, state</span><span class="BodytextBold" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> </span><span class="Bodytext6pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Birthplace.)</span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1) Port of Engagement Address, and (2) Home Address. N.B.</span><span class="BodytextBold0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">—</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Both to be inserted. The </span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">Home</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> Address is the one to which </span><span class="Bodytext6pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Communications should be made in the event of the Death of the Seaman.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ship in which he last served and Date of Discharge there- from.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Place of Signing this Agreement.</span></p></td><td rowspan="2" style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">In what Capacity engaged.†</span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No. of Certificate (it any) and No. of Reserve Commission or R.V. </span><span class="BodytextCandara1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2 </span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(if any).</span></p></td></tr><tr style="height:1pt"><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">State Name and Official No. or Port she belonged to.</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td><td style="width:16.38%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodyText50" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">10</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:3.46%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td rowspan="2" style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Master to sign first.</span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:10"><img src="image.006.png" width="11" height="17" alt="" style="margin-top:3.97pt; margin-left:44.22pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodyText21" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:11"><img src="image.007.png" width="11" height="22" alt="" style="margin-top:3.28pt; margin-left:43.38pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:12"><img src="image.008.png" width="11" height="22" alt="" style="margin-top:3.58pt; margin-left:43.72pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1) '</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2) ;</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:13"><img src="image.009.png" width="11" height="21" alt="" style="margin-top:1.88pt; margin-left:43.72pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodyText21" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:14"><img src="image.010.png" width="11" height="21" alt="" style="margin-top:2.72pt; margin-left:42.38pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:15"><img src="image.011.png" width="11" height="23" alt="" style="margin-top:1.52pt; margin-left:41.22pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:16"><img src="image.007.png" width="11" height="22" alt="" style="margin-top:1.83pt; margin-left:41.22pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:17"><img src="image.009.png" width="11" height="21" alt="" style="margin-top:1.62pt; margin-left:41.22pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:18"><img src="image.010.png" width="11" height="21" alt="" style="margin-top:2.42pt; margin-left:41.22pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2).</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:3.46%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodytextBold0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">-</span></p></td></tr></tbody></table>
* If a British Subject, state Town or Country of Birth, and if born in
† The capacities of Engineers not employed on the Propelling Engines and Boilers should be described here, and in the
not merely as Engineers. Boys should be described as
‡ If any Member of the Crew enters His Majesty’s Service, the Name of the King’s Ship into which he enters is to be
should be briefly stated, thus.
<table cellspacing="0" cellpadding="0" style="width:100.38%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="5" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">of Engagement.</span></p></td><td colspan="6" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Particulars of Discharge, &c. To be filled in by the Superintendent upon the Discharge, Death, or Desertion of any Member of the Crew.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">t</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Release.</span></p></td></tr><tr style="height:56.7pt"><td rowspan="2" style="width:7.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Hour at which he is to be on Board.</span></p></td><td colspan="3" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Wages per Calendar Month.</span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature or Initials of Official before whom the Seaman is engaged.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date, Place, and Cause of leaving this Ship, or of Death.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0.75pt; text-indent:-0.75pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Balance of Wages Paid on Discharge.</span></p></td><td rowspan="2" style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:8pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">We, the undersigned Members of the Crew of this Ship, do hereby release this Ship, and the Master and Owner or Owners thereof, from all Claims for Wages or otherwise in respect of this Agreement, except as stated hereunder; and I the Master, do hereby release the said undersigned Members of the Crew from all Claims in respect of the said Agreement. Signature of Crew (each to be on the Line on which he signed in Col. 1).</span></p></td><td rowspan="2" style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature or Initials of Official before whom the Balance of Wages was Paid and Release signed, and Date.</span></p></td><td rowspan="3" style="width:3.32%; height:56.7pt; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:56.7pt; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p style="text-align:left; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">Reference No.</span></p></div></td></tr><tr style="height:1pt"><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:right; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:17.45pt; text-indent:-17.45pt; text-align:right; widows:0; orphans:0; font-size:8pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:right; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:8pt; letter-spacing:normal; vertical-align:baseline">Cause</span><span style="font-family:'Times New Roman', serif">‡</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">11</span></p></td><td colspan="2" style="border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">12</span></p></td><td style="width:2.14%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">13</span></p></td><td style="width:6.62%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">14</span></p></td><td style="width:6.62%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">15</span></p></td><td style="width:7.12%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">16</span></p></td><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">17</span></p></td><td style="width:25.28%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">18</span></p></td><td style="width:15.58%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">19</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td></tr><tr style="height:1pt"><td style="width:7.1%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:1.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.32%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td></tr></tbody></table>
a foreign Country, state if a natural-born British Subject or naturalized.
Certificate of Discharge, as Engine-drivers, Donkeymen, Refrigerating Engineers, Electrical Engineers, or Winchmen, and Deck Boys, Cabin Boys, or as the case may be, not merely as Boys,
stated under the head of “Cause of leaving the Ship,” thus, “H.M.S. Revenge,” and the other causes of leaving the Ship.
“Discharged,” “Deserted,” Left Sick,” “Died.”
CERTIFICATES OR INDORSEMENTS MADE BY SUPERINTENDENTS
Form M. & S.—3—continued.
Issued under the Navigation Act 1912-1920. Nav. (M. & S.) Reg. 6. No.AGREEMENT AND ACCOUNT OF CREW.* Foreign-Going Ship or Australian-trade Ship trading to New Zealand or the Islands of the Pacific.Any Erasure, Interlineation, or Alteration in this Agreement will be void unless made with the consent of the persons interested, and attested by some Superintendent of a Mercantile Marine Office, or Consular or other Proper Authority, (Navigation Act, s. 55).
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:6.35pt"><td rowspan="2" style="width:20.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td rowspan="2" style="width:10%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official No.</span></p></td><td rowspan="2" style="width:11.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port No., and Date of Register.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:1.15pt; text-indent:-1.15pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Registered</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Tonnage.</span></p></td><td rowspan="2" style="width:19.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nominal Horse-power of Propelling Engines (if any).</span></p></td></tr><tr style="height:6.3pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:1.15pt; text-indent:-1.15pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Gross.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Net.</span></p></td></tr><tr style="height:13.95pt"><td style="width:20.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.85pt"><td colspan="4" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Registered Managing Owner or Manager.†</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0.85pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No. of Seamen for whom Accommodation is Certified.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">For Particulars as to Load-line see Page 2.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">N.H.P. of </span><span class="Bodytext6pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">all</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> Engines in Engine-room (Navigation Act, Sch. I.)</span></p></td></tr><tr style="height:1pt"><td style="width:20.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address (state No. of House, Street, and Town).</span></p></td></tr><tr style="height:14.15pt"><td style="width:20.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:85.65pt"></td><td style="width:42.4pt"></td><td style="width:49.6pt"></td><td style="width:21.55pt"></td><td style="width:49.35pt"></td><td style="width:16.05pt"></td><td style="width:32.55pt"></td><td style="width:29.35pt"></td><td style="width:12.8pt"></td><td style="width:84.7pt"></td></tr></tbody></table>
The Several Persons whose names are hereto subscribed, and whose descriptions are contained herein, and of whom are Able Seamen and Ordinary Seamen, hereby agree to serve on board the said Ship in the several capacities expressed against their respective Names, on a Voyage from1And the crew agree to conduct themselves in an orderly, faithful, honest, and sober manner, and to be at all times diligent in their respective duties, and to be obedient to the lawful commands of the said Master, or of any Person who shall lawfully succeed him, and of their Superior Officers, in everything relating to the said Ship and the stores and cargo thereof, whether on board, in boats, or on shore ; in consideration of which services to be duly performed, the said Master hereby agrees to pay to the said Crew as Wages the sums against their Names respectively expressed, and to supply them with Provisions according to the Scale on the other side hereof.And it is hereby agreed that any Embezzlement or wilful or negligent Destruction of any part of the Ship’s Cargo or Stores shall be made good to the Owner out of the Wages of the Person guilty of the same.And it is further agreed that if any Seaman enters himself in a capacity for which he is incompetent he is liable to be disrated.And it is also agreed that the Regulations authorized by the Navigation (Master and Seamen) Regulations, which are printed herein and numbered2are adopted by the parties hereto, and shall be considered as embodied in this Agreement.And it is also agreed that if any Member of the Crew considers himself to be aggrieved by any breach of the Agreement or otherwise, he shall represent the same to the Master or Officer in charge of the Ship in a quiet and orderly manner, who shall thereupon take such steps as the case may require.And it is also stipulated that allotments of part of wages shall be made as specified against the names of the respective seamen in the columns provided for that purpose. And it is also agreed that.In witness whereof the said Parties have subscribed their Names herein, on the days mentioned against their respective signatures.Signed by Master.on the day of . . 19 .
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:14.16%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Commencement of Voyage.</span></p></td><td rowspan="2" style="width:11.42%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port at which Voyage commenced.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">These Columns to be filled up at the end of the Voyage or Termination of the Agreement.</span></p></td></tr><tr style="height:1pt"><td style="width:15.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Termination of Voyage.</span></p></td><td style="width:13.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port at which Voyage Terminated.</span></p></td><td style="width:15.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Delivery of Agreement to Superintendent.</span></p></td><td rowspan="2" style="width:30.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:11.85pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">I hereby declare to the truth of the Entries in this Agreement and Account of Crew, &c.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Master.</span></p></td></tr><tr style="height:15.2pt"><td style="width:14.16%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.42%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
* Note.—“Foreign-going ship” includes every ship (other than an Australian-trade ship) employed in trading or going between places in Australia and places beyond Australia.
“Australian-trade ship “ includes every ship (other than a limited coast-trade ship or river and bay ship) employed in trading or going between places in Australia, and every ship employed in trading between (a) Australia and (b) territories under the authority of the Commonwealth, New Zealand, or the Islands of the Pacific.
† Note.—Under certain circumstances the name of the charterer or other person controlling the navigation and management of the vessel is also to be given (see Navigation (Master and Seamen) Reg. 6).
1 Here is to be inserted the nature, and, as far as practicable, the duration of the intended voyage or engagement, or the maximum period and the places or parts of the world, if any, which are excluded.
2 Here are to be inserted the Numbers of any of the Regulations for preserving discipline authorized by the Navigation (Master and Seamen) Regulations, and printed on the third page hereof, which the parties agree to adopt.
3 Here any other stipulations may be inserted to which the parties agree, which are approved by the Superintendent, and which are not contrary to law.
(Ships registered in Australia and British Ships engaged in the Coasting Trade.)
Required by section 117 of the Navigation Act 1912-1920 to be allowed and served out to the Crew during the Voyage, except in Cases in which the Crew furnish their own Provisions.
Note.—The Scale agreed upon is in addition to the Lime and Lemon Juice and Sugar, or other Anti-Scorbutics any case required under Section 124 of the Act.
Here is set out the Scale of Provisions, the conditions and exceptions in applying scale, and the list of Substitutes and Equivalents contained in Schedule III. to the Navigation Act.]
LOAD-LINE AND DRAUGHT OF WATER.
The centre of the disc is placed at feet inches below the deck-line marked under the provisions of the Merchant Shipping Act 1894.
* Position of Lines used in connexion with the Disc.
Maximum load-line in fresh water, feet inches above the centre of the disc.
Maximum load-line in winter, North Atlantic, feet inches below the centre of the disc.
Maximum load-line in fresh water, feet inches above the centre of the disc.
Maximum load-line in Indian summer, feet inches above the centre of the disc.
Maximum load-line in summer, the centre of the disc.
Maximum load-line in winter, feet inches below the centre of the disc.
Maximum load-line in North Atlantic winter, feet inches below the centre of the disc.
* These particulars are to be taken from the certificate of approval of the position, or alteration of the position, of the disc and the words which are not applicable should be erased.
Notes.—In the Northern Hemisphere, the summer months are April to September inclusive, and the winter months October to March inclusive. In the Southern Hemisphere (elsewhere than in Australia), the summer and winter freeboards should be used during the corresponding or recognized summer and winter months respectively.
In the case of vessels entering, or loading in, any port in Australia the minimum freeboard allowed, for all seasons of the year, is as follows:—For steam-ship loaded with dead weight cargo, the winter freeboard; for sailing ships so loaded, the winter North Atlantic freeboard and for all vessels loaded with other cargo, the summer freeboard. A cargo is deemed to be a “dead-weight” cargo if it consists, to the extent of 85 per cent. or more, of metalliferous ores, iron or steel rails or girders, pig-iron, or any other homogeneous cargo with a specific gravity of 4 or over.
The additional freeboard specified for the North Atlantic trades (winter North Atlantic freeboard) is to apply to vessels sailing to or from the Mediterranean or any United Kingdom or European port, which may sail to or from or call at, ports in British North America, or eastern ports in the United States north of Cape Hatte, as from October to March inclusive.
The reduced freeboard allowed for voyages in the fine weather season in the Indian Seas (Indian summer freeboard) only applies to vessels fading between the limits of Suez and Singapore.
The fine weather season in the Indian Seas is defined as prevailing east of Tuticorin from the 15th November to the 25th May, and west of Tuticorin from the 1st September to the 25th May.
REGULATIONS FOR MAINTAINING DISCIPLINE.
Sanctioned by the Navigation (Master and Seamen) Regulations.
These Regulations are distinct from, and in addition to, those contained in the Act, and are sanctioned but not universally required by law. All or any of them may be adopted by agreement between a Master and his Crew, and thereupon the offences specified in such of them as are so adopted will be legally punishable by the appropriate fines or punishments. These Regulations, however, are not to apply to Certificated Officers.
These Regulations are numbered, and the numbers of such of them as are adopted must be inserted in the space left for that purpose in the Agreement, page 1, and the following copy of these Regulations must be made to correspond with the Agreement by erasing such of the Regulations as are not adopted. The signature or initials of the Superintendent of a Mercantile Marine Office, or Consular or other Proper Authority before whom the Agreement is made, must be placed opposite such of the Regulations as are adopted.
For the purpose of legally enforcing any of the following penalties, the same steps must be adopted as in the case of other offences punishable under the Act ; that is to say, a statement of the offence must, immediately after its commission, be entered in the Official Log Book by the Master,
If, in consequence of subsequent good conduct, the Master desires to remit or reduce any fine upon any member of his Crew which has been entered in the Official Log, he may, subject to the approval of the Superintendent, make an entry in the Official Log Book to that effect, and upon the indorsement of the entry with the approval of the Superintendent, the fine shall thereupon be remitted or reduced accordingly.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:5.9%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No.</span></p></td><td rowspan="2" style="width:64.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Offence.</span></p></td><td style="width:14.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Fine.</span></p></td><td style="width:14.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of</span></p></td></tr><tr style="height:1pt"><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Superintendent.</span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:64.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Striking or assaulting any person on board or belonging to the ship (if not otherwise prosecuted)</span><span style="width:3.42pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:14.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:1.2pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Five shillings</span></p></td><td style="width:14.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:64.6%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Bringing or having on board intoxicating liquors .</span><span style="width:61.52pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">...........</span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:1.2pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Five shillings</span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><div style="width:100%; height:1pt; display:inline-block; overflow:visible"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:47"><img src="image.012.png" width="10" height="50" alt="" style="margin-top:1.38pt; margin-left:15.73pt; position:absolute"></span><span class="BodyText21" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></div></td><td style="width:64.6%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Drunkenness—first offence</span><span style="width:148.33pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">...........................</span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Five shillings</span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodyText21" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td style="width:64.6%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">,,</span><span style="width:243.55pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">............................................</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">second and for each subsequent offence</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ten shillings</span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodytextDavid" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:64.6%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Taking on board and keeping possession of any firearms, knuckle-duster, loaded cane, slung shot, sword-stick, bowie-knife, dagger, or any other offensive weapon or offensive instrument without the concurrence of the Master— for every day during which a Seaman retains such weapon or instrument</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-left:1.2pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Five shillings</span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td rowspan="2" style="width:64.6%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Insolent or contemptuous language or behaviour to the Master or Officers, or disobedience to lawful commands, if not otherwise dealt with according to law</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:1.2pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:bottom; background-color:#ffffff"><p style="margin-left:1.2pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Five shillings</span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.9%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td><td style="width:64.6%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-right:7.4pt; text-indent:-7.6pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Absence without leave and without reasonable cause (if not otherwise dealt with according to law) for each day on which such absence occurs</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p></td><td style="width:14.84%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:1.2pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Two days’ pay</span></p></td><td style="width:14.66%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
ACCOUNT OF APPRENTICES ON BOARD.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:22.34%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surnames of the Apprentices at full length.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1.</span></p></td><td rowspan="2" style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2.</span></p></td><td rowspan="2" style="width:13.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0.55pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nationality.* (If British, state Birthplace.)</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Registry of Indenture.</span></p></td><td rowspan="2" style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Joining subsequent to commencement of this Agreement.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date, Place, and Cause of leaving this Ship, or of Death. If the Apprentice remains it should be stated.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">To be filled up by the Master.</span></p></td></tr><tr style="height:1pt"><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of. 4.</span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of. 5.</span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7.</span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8.</span></p></td><td style="width:10.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9.</span></p></td></tr><tr style="height:1pt"><td style="width:22.34%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.34%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.34%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.34%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.34%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
* If a British Subject, state Town or Country of birth; and, if born in a Foreign Country, state if a natural-born British Subject or naturalized.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:5.54%; height:1pt; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:1pt; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></div></td><td colspan="10" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:6pt; margin-left:0pt; margin-bottom:6pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">Particulars</span></p></td></tr><tr style="height:1pt"><td rowspan="3" style="width:5.54%; height:1pt; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:1pt; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No.</span></p></div></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signatures of Crew.</span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:2.7pt; text-indent:-2.7pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">* Nationality (if British, state Birthplace).</span></p></td><td rowspan="2" style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)Port of Engagement Address, and (2) Home Address. N.B.—Both to be inserted. The </span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Home </span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address is the one to which Communications should be made in the event of the Death of the Seaman.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ship in which he last served, and Date of Discharge there-from.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Place of Signing this Agreement.</span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">In what Capacity engaged.†</span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No. of Certificate (if any) and No. of Reserve Commission or R.V. 2 (if any).</span></p></td></tr><tr style="height:1pt"><td style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">State Name and Official No. or Port she belonged to.</span></p></td><td style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:1pt"><td style="width:10.38%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">1</span></p></td><td style="width:5.96%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">2</span></p></td><td style="width:10.32%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">3</span></p></td><td style="width:14.74%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:5.68%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td style="width:8.14%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:18pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td><td style="width:5.68%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td><td style="width:6.14%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td><td style="width:16.44%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">9</span></p></td><td style="width:10.98%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">10</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Master to sign first.</span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:0"><img src="image.013.png" width="11" height="17" alt="" style="margin-top:4.43pt; margin-left:26.83pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:1"><img src="image.014.png" width="11" height="22" alt="" style="margin-top:2.97pt; margin-left:26.83pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td><td style="width:5.68%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.14%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">3</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:2"><img src="image.015.png" width="11" height="22" alt="" style="margin-top:2.47pt; margin-left:26.83pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:3"><img src="image.016.png" width="11" height="23" alt="" style="margin-top:1.17pt; margin-left:26.83pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext65pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:4"><img src="image.017.png" width="11" height="23" alt="" style="margin-top:1.12pt; margin-left:26.27pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">6</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:5"><img src="image.018.png" width="11" height="19" alt="" style="margin-top:1.27pt; margin-left:24.77pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">7</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:6"><img src="image.019.png" width="11" height="22" alt="" style="margin-top:0.77pt; margin-left:25.27pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">8</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:7"><img src="image.020.png" width="11" height="23" alt="" style="margin-top:0.82pt; margin-left:23.77pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:5.54%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">9</span></p></td><td rowspan="2" style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:8"><img src="image.021.png" width="11" height="25" alt="" style="margin-top:-0.43pt; margin-left:24.27pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(1)</span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(2)</span></p></td></tr><tr style="height:1pt"><td style="width:5.54%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext45pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">.</span></p></td></tr></tbody></table>
* If a British Subject, state Town or Country of Birth, and if born in
† The capacities of Engineers not employed on the Propelling Engines and Boilers should be described here, and in the
not merely as Engineers. Boys should be described as
‡ If any Member of the Crew, enters His Majesty’s Service, the Name of the King’s Ship into which he enters is to be
should be briefly stated, thus,
Form M. & S.—3—continued.
<table cellspacing="0" cellpadding="0" style="width:103.3%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="8" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">of Engagement.</span></p></td><td colspan="6" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Particulars of Discharge, &c. To be filled in by the Superintendent upon the Discharge, Death, or Desertion of any Member of the Crew.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Release.</span></p></td><td style="width:7.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:181.2pt"><td rowspan="2" style="width:7.7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:4.3pt; text-indent:-4.3pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Hour at which he is to be on Board.</span></p></td><td colspan="3" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Wages per Calendar Month.</span></p></td><td colspan="3" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Weekly or Monthly Allotment.</span></p></td><td rowspan="2" style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature or Initials of before whom the Seaman is engaged.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date, Place, and Cause of leaving this Ship, or of Death.</span></p></td><td colspan="3" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Balance of Wages Paid on Discharge</span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:4.9pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">We, the undersigned Members of the Crew of this Ship, do hereby release this Ship, and the Master and Owner or Owners thereof, from all Claims for Wages or otherwise in respect of this Agreement, except</span></p></td><td rowspan="2" style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature or Initials of Official before whom the Balance of Wages was Paid and Release signed, and Date.</span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:190.85pt"><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:11pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause</span><span style="font-family:'Times New Roman', serif">‡</span></p></td><td style="width:14.18%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">as stated hereunder ; and I, the Master, do hereby release the said undersigned Members of the Crew from all Claims in respect of the said Agreement. Signature of Crew (each to be on the Line on which he signed in Col. 1).</span></p></td><td style="width:7.64%; height:190.85pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:190.85pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">Reference No.</span></p></div></td></tr><tr style="height:10pt"><td style="width:7.7%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">11</span></p></td><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">12</span></p></td><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">13</span></p></td><td style="width:9.52%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">14</span></p></td><td style="width:6.82%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">15</span></p></td><td style="width:7.26%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">16</span></p></td><td style="width:7.94%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">17</span></p></td><td colspan="3" style="border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">18</span></p></td><td style="width:14.18%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">19</span></p></td><td style="width:9.74%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">20</span></p></td><td style="width:7.64%; height:10pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:10pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></div></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td></tr><tr style="height:1pt"><td style="width:7.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.7%; border:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:2.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.64%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
a foreign Country, state if a natural-born British Subject or naturalized.
Certificate of Discharge, as Engine-drivers, Donkeymen, Refrigerating Engineers, Electrical Engineers, or Winchmen, and Deck Boys, Cabin Boys, or as the case may he, not merely as Boys.
dated, under the head of “Cause of leaving the Ship,” thus, “H.M.S. Revenge,” and the other causes of leaving the Ship
“Discharged,” “Deserted,” “Left Sick,” “Died.”
The particulars of all Allotment Notes issued to Members of the Crew mentioned herein
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:9.72%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No.</span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Seaman by whom Allotment is made.</span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Allotment.</span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of First Payment.</span></p></td></tr><tr style="height:1pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:19"><img src="image.022.png" width="11" height="38" alt="" style="margin-top:3.97pt; margin-left:24.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">£</span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">s.</span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">d.</span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:27.3pt"><td style="width:9.72%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:34.7pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:20"><img src="image.023.png" width="11" height="33" alt="" style="margin-top:3.47pt; margin-left:24.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:35.2pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:21"><img src="image.024.png" width="11" height="37" alt="" style="margin-top:3.78pt; margin-left:24.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:35pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:22"><img src="image.025.png" width="11" height="35" alt="" style="margin-top:5.07pt; margin-left:24.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:34.85pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:23"><img src="image.025.png" width="11" height="35" alt="" style="margin-top:4.57pt; margin-left:24.12pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:34.6pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:24"><img src="image.024.png" width="11" height="37" alt="" style="margin-top:3.22pt; margin-left:22.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:28pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:25"><img src="image.026.png" width="11" height="31" alt="" style="margin-top:3.12pt; margin-left:22.48pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:27.7pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:26"><img src="image.027.png" width="11" height="27" alt="" style="margin-top:4.62pt; margin-left:22.48pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:28.1pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:27"><img src="image.028.png" width="11" height="31" alt="" style="margin-top:2.92pt; margin-left:22.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:27.8pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:28"><img src="image.029.png" width="11" height="30" alt="" style="margin-top:2.83pt; margin-left:22.48pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:28.2pt"><td style="width:9.72%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:29"><img src="image.030.png" width="11" height="29" alt="" style="margin-top:3.03pt; margin-left:22.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:27.2pt"><td style="width:9.72%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:30"><img src="image.031.png" width="11" height="29" alt="" style="margin-top:2.83pt; margin-left:24.98pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
* Note.—The Navigation Act (Sec. 70) provides for allotment of wages being made by seamen engaged on Foreign-
Form M. & S.—3—continued.
are to be inserted hereunder pursuant to Section 70 of the Navigation Act 1912—1920.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="4" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodytextDavid0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Period </span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">at which subsequent Payments are to be made</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Person to whom Payment is to be made.</span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Initials of Superintendent.</span></p></td></tr><tr style="height:1pt"><td style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name.</span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address.</span></p></td><td style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Relationship.</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; 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border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; 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border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; 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border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:16.4%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:17.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:18.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:24.88%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Going Ships for voyages calculated to exceed two months. In no other case can any allotment be stipulated for or permitted.
Form M. & S.—3—continued.
Or Indorsements made by Superintendents or by Consuls or other Proper Authorities.
Wages and Effects of Seamen left behind Abroad by Reason of Desertion, Neglect to Join, etc. (Section 28, Merchant Shipping Act 1906.)
Indorsement to be made by the Proper Officer on the Termination of the Voyage.
The wages and effects of seamen with the following reference numbers in this Agreement have been duly accounted for to me.
†Accounts of wages of seamen have not been delivered; those with reference Nos.
being exempted under Section 28 (12) (b), and those with reference Nos.
Image unavailable in extracted text under Section 28 (12) (c).
† These exemptions do not apply when the Master elects to deal with the accounts collectively.
Issued under the Navigation Act 1912-1920, ss. 48 and 52; Nav. (M. & S.) Regs. 7 and 8. Commonwealth of Australia.Navigation Act 1912-1920.Notice.—In all cases where changes occur in the Crew after the return to the Master by a Superintendent of the Agreement with the Crew, whether by death, desertion, engagement of substitutes, or other cause, a Report in this Form must be furnished to the Superintendent, in cases where the vessel is finally leaving Australia, at that port, and in other cases within 24 hours of arrival at the next port of call in Australia. Penalty for default, £5.
REPORT OF CHANGES IN CREW THAT HAVE TAKEN PLACE OTHERWISE THAN IN THE PRESENCE OF A SUPERINTENDENT.
Name of Ship. Official Number. Port of Registry.
Image unavailable in extracted text Name and Address of Registered (Managing) Owner.
Name and Address of Master and No. of his Certificate (if any).
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Mercantile Marine Office at which the Agreement was first opened, and the date.</span></p></td><td rowspan="2" style="width:45.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Description of Voyage or Employment.</span></p></td></tr><tr style="height:1pt"><td style="width:15.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:38.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:32.35pt"><td style="width:15.5%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:38.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:45.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
I hereby declare to the truth of the entries in this account of changes in crew.
Forwarded to the Superintendent, (where the Seamen were engaged) this day of 19 ,
Image unavailable in extracted text Signature of Superintendent, Mercantile Marine Office at Port where Form is first received.
Recorded and forwarded to the Superintendent, Mercantile Marine Office, George-street North, Sydney, this day of 19
Image unavailable in extracted text Signature of Superintendent at Port of Engagement.
Form M. & S.—4 and 5.—continued.
NOTICE.—The Discharges of men who fail to join, desert, or otherwise leave the ship, are to be returned with this Form. No entries or marks of any kind are to be made on the Discharges. A.—SEAMEN WHO HAVE FAILED TO JOIN, DESERTED, OR OTHERWISE LEFT THE SHIP WITHIN 24 HOURS OF THE SHIP PUTTING TO SEA.
<table cellspacing="0" cellpadding="0" style="width:101.22%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:11.06%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No. in Agreement.</span></p></td><td rowspan="2" style="width:6.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surname at Length.</span></p></td><td rowspan="2" style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td rowspan="2" style="width:7.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nationality. (If British state Birthplace.)</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Place of Signing Agreement.</span></p></td><td rowspan="2" style="width:8.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Rating, with No. of </span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">a</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">)</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> Certificate </span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">b</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">)</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> Dis. A.; (c) R.V. 2.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Particulars of Leaving the Ship.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Report of Character.</span></p></td><td rowspan="3" style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">If the last Discharge is not, forwarded with this Form, state the Reason.</span></p></td><td rowspan="3" style="width:8.16%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No. in Agreement</span></p></td></tr><tr style="height:47.5pt"><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:5.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:5.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:5.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause.</span></p></td><td style="width:7.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Efficiency as Boat-hand.</span></p></td><td style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ability.</span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Conduct.</span></p></td></tr><tr style="height:7pt"><td style="width:11.06%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.64%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">1</span></p></td><td style="width:5.08%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">2</span></p></td><td style="width:7.86%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">3</span></p></td><td style="width:4.86%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:5.2%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td style="width:8.6%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">6</span></p></td><td style="width:4.86%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td><td style="width:5.18%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td><td style="width:5.52%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td><td style="width:7.22%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">10</span></p></td><td style="width:5.96%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">11</span></p></td><td style="width:6.62%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">12</span></p></td></tr><tr style="height:20.5pt"><td style="width:11.06%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:41"><img src="image.036.png" width="17" height="21" alt="" style="margin-top:1.83pt; margin-left:55.97pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.16%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:44"><img src="image.037.png" width="13" height="21" alt="" style="margin-top:1.83pt; margin-left:1.58pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:20.8pt"><td style="width:11.06%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:42"><img src="image.036.png" width="17" height="21" alt="" style="margin-top:2.22pt; margin-left:55.97pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.16%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:45"><img src="image.037.png" width="13" height="21" alt="" style="margin-top:2.22pt; margin-left:1.58pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:21.15pt"><td style="width:11.06%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:43"><img src="image.036.png" width="17" height="21" alt="" style="margin-top:3.97pt; margin-left:55.97pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.86%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.16%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:46"><img src="image.037.png" width="13" height="21" alt="" style="margin-top:3.97pt; margin-left:1.58pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
B—DEATHS OF MEMBERS OF THE CREW.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Place of Death.</span></p></td><td rowspan="2" style="width:22.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surname of Deceased.</span></p></td><td rowspan="2" style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Sex.</span></p></td><td rowspan="2" style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td rowspan="2" style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Rating.</span></p></td><td rowspan="2" style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">†Nationality. (stating Birthplace).</span></p></td><td rowspan="2" style="width:22.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address of Next-of-Kin as recorded in Agreement.</span></p></td><td rowspan="2" style="width:18.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause of Death </span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">see footnotes*</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">)</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">.</span></p></td></tr><tr style="height:1pt"><td style="width:5.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:1pt"><td style="width:5.32%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">13</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">14</span></p></td><td style="width:22.78%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">15</span></p></td><td style="width:5.12%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">16</span></p></td><td style="width:5.12%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">17</span></p></td><td style="width:5.08%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">18</span></p></td><td style="width:7.46%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">19</span></p></td><td style="width:22.88%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">20</span></p></td><td style="width:18.78%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">21</span></p></td></tr><tr style="height:18.75pt"><td style="width:5.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:18.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt"></span></p></td></tr><tr style="height:21.1pt"><td style="width:5.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:18.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:20.75pt"><td style="width:5.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:18.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:20.35pt"><td style="width:5.32%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:18.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Form M. & S.—4 and. 5.—continued.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="3" style="width:5.8%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No. in Agreement.</span></p></td><td rowspan="2" style="width:7.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surname at Length.</span></p></td><td rowspan="2" style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td rowspan="2" style="width:7.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">† Nationality (stating Birthplace).</span></p></td><td rowspan="2" style="width:14.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address of Next of Kin.</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">———</span></p><p class="BodyText60" style="margin-right:2.15pt; margin-left:12.85pt; text-indent:-7.1pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">The Address is the one to which communications should be made in the event of the Death of the Seaman.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ship in which he last Served, and date of Discharge therefrom.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Place of Signing the Agreement.</span></p></td><td rowspan="2" style="width:9.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">‡Rating, with No. of</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">a</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">)</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> Certificate;</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">b</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">) Dis. A.;</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">c</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">) R.V. 2.</span></p></td><td rowspan="2" style="width:6.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of commencing Work.</span></p></td><td rowspan="2" style="width:6.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Wages per Calendar Month.</span></p></td><td rowspan="2" style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Weekly or Monthly Allotment.</span></p></td><td rowspan="2" style="width:6.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of Official or other Person before whom the Seaman is engaged.</span></p></td><td rowspan="2" style="width:5.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No. in Agreement.</span></p></td></tr><tr style="height:1pt"><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:9.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">State Name, Port of Registry, and Official No.</span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:3.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:1pt"><td style="width:7.4%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">22</span></p></td><td style="width:3.94%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">23</span></p></td><td style="width:7.48%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">24</span></p></td><td style="width:14.62%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">25</span></p></td><td style="width:3.94%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">26</span></p></td><td style="width:9.24%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">27</span></p></td><td style="width:3.94%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">28</span></p></td><td style="width:3.9%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">29</span></p></td><td style="width:9.82%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">30</span></p></td><td style="width:6.38%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">31</span></p></td><td style="width:6.3%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">32</span></p></td><td style="width:5.08%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">33</span></p></td><td style="width:6.26%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">34</span></p></td><td style="width:5.88%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:68.45pt"><td style="width:5.8%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:32"><img src="image.038.png" width="11" height="71" alt="" style="margin-top:7.18pt; margin-left:-7.88pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:34"><img src="image.039.png" width="119" height="2" alt="" style="margin-top:22.95pt; margin-left:4.4pt; position:absolute"></span><span style="height:0pt; text-align:left; display:block; position:relative; z-index:35"><img src="image.039.png" width="119" height="2" alt="" style="margin-top:45.35pt; margin-left:4.4pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:38"><img src="image.040.png" width="13" height="71" alt="" style="margin-top:7.18pt; margin-left:10.52pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:64.35pt"><td style="width:5.8%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:33"><img src="image.038.png" width="11" height="71" alt="" style="margin-top:5.32pt; margin-left:10.12pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.62%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:36"><img src="image.039.png" width="119" height="2" alt="" style="margin-top:24.65pt; margin-left:4.4pt; position:absolute"></span><span style="height:0pt; text-align:left; display:block; position:relative; z-index:37"><img src="image.039.png" width="119" height="2" alt="" style="margin-top:44.35pt; margin-left:4.4pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.24%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="height:0pt; text-align:left; display:block; position:relative; z-index:39"><img src="image.041.png" width="12" height="71" alt="" style="margin-top:5.32pt; margin-left:-4.38pt; position:absolute"></span><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
1. If the cause of death is from Disease, the name or nature of the same should be stated.
2. When the cause of death is Accidental, the circumstances attending the accident should be fully stated.
3. If at the time of an accidental death the vessel sustained any damage, loss of gear, cargo, &c., the nature of such damage or loss should be stated. If no damage or loss was sustained it should be so stated.
4. When the death is occasioned by any other cause, e.g., suicide, murder, &c., full particulars of the same should be stated.
† If a British Subject, state Town or Country of birth: and if born in a foreign country, state whether a natural-born British Subject, or naturalized.
‡ The capacities of Engineers not employed on the Propelling Engines and Boilers should be described here and in the Certificate of Discharge as Engine-drivers, Donkeymen, Refrigerating Engineers, Electrical Engineers, or Winchmen, and not merely as Engineers. Boys entirely employed in connexion with the work of Cooks and Stewards should be described as Cabin Boys, not merely as Boys.
CERTIFICATE OF DISCHARGE.
For Seamen Discharged before the Superintendent of a Mercantile Marine Office in the Commonwealth of Australia.
<table cellspacing="0" cellpadding="0" style="width:99.88%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="4" style="width:16.74%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:bottom; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><img src="image.001.jpeg" width="36" height="47" alt="C1924L00199-1.jpg"></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">Issued under the </span><span style="font-family:'Times New Roman', serif; font-style:italic">Navigation Act</span><span style="font-family:'Times New Roman', serif"> 1912-1920.</span></p></td><td style="width:18.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0.35pt; text-indent:0pt; text-align:justify; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official No.</span></p></td><td style="width:25.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td style="width:22.56%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reg. Tonnage.</span></p></td></tr><tr style="height:18.25pt"><td style="width:18.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.56%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0.35pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Horse-power of Engines (if any).</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Description of Voyage or Employment.</span></p></td></tr><tr style="height:23.65pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:70.9pt"></td><td style="width:77.15pt"></td><td style="width:64.45pt"></td><td style="width:8.15pt"></td><td style="width:107.3pt"></td><td style="width:95.55pt"></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:22.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Seaman.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place of Birth.</span></p></td><td style="width:24.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No. of R.N.R. or R.A.N.R.—Comm. or Cert.</span></p></td><td style="width:25.18%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity.—If Mate or Engineer, No. of Certificate (if any).</span></p></td></tr><tr style="height:26.05pt"><td style="width:22.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.18%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Engagement.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place of Engagement.</span></p></td><td style="width:24.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Discharge.</span></p></td><td style="width:25.18%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place of Discharge.</span></p></td></tr><tr style="height:24.4pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.94%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:25.18%; border:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:96.85pt"></td><td style="width:9.9pt"></td><td style="width:30.45pt"></td><td style="width:74.35pt"></td><td style="width:105.75pt"></td><td style="width:106.7pt"></td></tr></tbody></table>
I certify that the above particulars are correct and that the above-named Seaman was discharged accordingly, *and that the character described hereon is a true copy of the Report concerning the said Seaman.
Dated this day of 19 Authenticated by OFFICE SEAL Master. Signature of Superintendent. OR OFFICIAL STAMP
Image unavailable in extracted text
* If the Seaman does not require a Certificate of his character, obliterate the words appearing below, and score through the discs.
Certificate of character discs
Note.—Any Person who forges or fraudulently alters any Certificate or Report, or who makes use of any Certificate or Report which is forged or altered or does not belong to him, shall for each such offence be deemed guilty of an indictable offence, and may be fined or imprisoned.
N.B.—Should this Certificate come into the possession of any person to whom it does not belong, it should be handed to the Superintendent of the nearest Mercantile Marine Office, or be transmitted to the Director of Navigation, Melbourne.
Commonwealth of Australia.
Navigation Act 1912-1920.
Caution.—It is required by the Navigation Act and Regulations that the Master of a ship shall make and sign, in this Form, and shall forthwith deliver to the Superintendent, a report of the conduct, character, and qualifications of every seaman discharged before a Superintendent. The Act further provides that if any person knowingly makes a false Report of Character he shall be guilty of an indictable offence.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:17.35pt"><td colspan="3" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official Number.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td></tr><tr style="height:98.4pt"><td colspan="3" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:31.65pt"><td rowspan="2" style="width:4.3%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No.</span></p></td><td rowspan="2" style="width:27.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Seaman.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Report of Conduct, Character, and Qualifications.</span></p></td><td rowspan="2" style="width:13.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Initials of Master.</span></p></td><td rowspan="2" style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td></tr><tr style="height:1pt"><td style="width:14.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Efficiency as Boat-hand.</span></p></td><td style="width:9.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Conduct.</span></p></td><td style="width:9.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ability.</span></p></td></tr><tr style="height:97.6pt"><td style="width:4.3%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:27.08%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:18.2pt"></td><td style="width:114.8pt"></td><td style="width:35.7pt"></td><td style="width:22.75pt"></td><td style="width:59.55pt"></td><td style="width:39.35pt"></td><td style="width:39.85pt"></td><td style="width:59.3pt"></td><td style="width:34.5pt"></td></tr></tbody></table>
Commonwealth of Australia.
Navigation Act 1912-1920.
Issued under the Navigation Act and Nav. (M. & S.) Reg. 12. Note.—The Navigation Act provides (Section 71) a summary remedy for the recovery of the Payments named in this Note.SEAMAN’S ALLOTMENT NOTE.The Allotment can only be in favour of the Seaman’s Wife, Father, Mother Grandfather, Grandmother, Child, Grandchild, Brother, or Sister, or in favour of the Manager of a Savings Bank.
<table cellspacing="0" cellpadding="0" style="width:100.94%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:33.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">of Ship.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry and Official No. of Ship.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name and Address </span><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">of </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Managing Owner.</span></p></td></tr><tr style="height:18.35pt"><td style="width:33.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.65pt"><td style="width:33.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name of Seaman.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Surname.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Rating.</span></p></td></tr><tr style="height:20.9pt"><td style="width:33.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:14.15pt"><td colspan="6" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Relation(</span><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:6pt; letter-spacing:normal; vertical-align:super">1</span><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">) or Bank in whose Favour this Allotment Note is given.</span></p></td></tr><tr style="height:20.05pt"><td colspan="3" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name, Address, and Business or Occupation, or Name of Bank.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">What Degree of Relationship.</span></p></td></tr><tr style="height:1pt"><td colspan="3" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:17.65pt"><td colspan="6" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount and Particulars of Allotment (First and Subsequent Payments).</span></p></td></tr><tr style="height:1pt"><td style="width:33.6%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Pounds.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Shillings.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Pence.</span></p></td></tr><tr style="height:1pt"><td style="width:33.6%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Figures________________________</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Words_________________________</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">_______________________________</span></p><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">_______________________________</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">______________________________</span></p><p style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">______________________________</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address at which Payment is to be made.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of First Payment (</span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:6pt; letter-spacing:normal; vertical-align:super">2</span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">).</span></p></td><td style="width:24.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Period at which Subsequent Payments are to be made (</span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:6pt; letter-spacing:normal; vertical-align:super">3</span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">).</span></p></td></tr><tr style="height:20.25pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:143.8pt"></td><td style="width:54.8pt"></td><td style="width:76.25pt"></td><td style="width:12pt"></td><td style="width:38.25pt"></td><td style="width:102.9pt"></td></tr></tbody></table>
The seaman named above, having entered into an Agreement to serve in the above-mentioned Ship, and having required that a stipulation be inserted in the Agreement for the allotment of part of his wages by means of an Allotment Note, and such stipulation having been inserted pursuant to Section 70 of the Navigation Act 1912-1920, I, the undersigned, being the Master(4) of the said Ship, give this Allotment Note for the amount in favour of the (relative) (bank) named above, to the intent that the said (relative) (bank) shall be entitled to recover the sum so allotted in accordance with the provisions of Section 71 of the said Act.
To(The Person, Firm, or Company by whom payment is to be made.)Date / / 19. OFFICESTAMP Master. (4)Seaman.Witness. (6)
(1) In the case of a Wife the Marriage Certificate must be produced, if required, when payment is demanded. (2) Here insert date upon which first payment becomes due, whether weekly, fortnightly or monthly from date of the Agreement. (3) Here insert the period at which subsequent payments are to be made. (4) If the Owner or Agent gives the note, this must be altered accordingly. (6) This should be the Superintendent of a Mercantile Marine Office. The Office Stamp should be affixed, to show the place of issue.
[Back of Form M. & S.—8.]
Received on the Within Written Note.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:22.64%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Sum Received.</span></p></td><td style="width:57.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of Payee.</span></p></td></tr><tr style="height:10.85pt"><td style="width:22.64%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">£</span></p></td><td style="width:4.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">s.</span></p></td><td style="width:5.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0.2pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">d.</span></p></td><td style="width:57.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.2pt"><td style="width:22.64%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0.8pt; text-indent:-0.8pt; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:57.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Issued under the Navigation Act 1912-1920, Sec. 76: Nav. (M. & S.) Reg. 13. ACCOUNT OF WAGES.
<table cellspacing="0" cellpadding="0" style="width:102.32%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="5" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official No.</span></p></td></tr><tr style="height:19.95pt"><td colspan="5" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="3" rowspan="2" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Seaman.</span></p></td><td rowspan="2" style="width:14.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No. in Agreement.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date Wages Began.</span></p></td><td rowspan="2" style="width:13.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Wages Ceased.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total Period of Employment.</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Months.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Days.</span></p></td></tr><tr style="height:20.55pt"><td colspan="3" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.48%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:20.1pt"><td colspan="12" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:6pt; margin-left:17.85pt; margin-bottom:6pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Earnings.</span></p></td></tr><tr style="height:47.4pt"><td colspan="8" rowspan="2" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:18pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Months at £</span><span style="width:61.35pt; text-indent:0pt; display:inline-block"> </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">per month</span><span style="width:129.76pt; text-indent:0pt; display:inline-block"></span></p><p class="BodyText60" style="text-indent:18pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Days at</span><span style="width:77.11pt; text-indent:0pt; display:inline-block"> </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">per day</span><span style="width:139.76pt; text-indent:0pt; display:inline-block"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Overtime</span><span style="width:272.86pt; font-family:'Lucida Console', monospace; display:inline-block">..................................................</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Pay in lieu of leave not taken</span><span style="width:100.58pt; display:inline-block"> </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">days at</span><span style="width:76.06pt; display:inline-block"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Extras, viz.:—</span></p><p class="BodyText60" style="margin-top:6pt; margin-left:0pt; text-indent:113.4pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total Earnings</span><span style="width:128.11pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.......................</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="12" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-top:6pt; margin-left:17.85pt; margin-bottom:6pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Déductions, </span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">excluding Allotments.</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td colspan="6" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Particulars.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount.</span></p></td></tr><tr style="height:1pt"><td style="width:11.58%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="6" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:10.05pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Half Engagement and Discharge </span><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Fees</span><span style="width:53.4pt; font-family:'Lucida Console', monospace; display:inline-block">.........</span></p><p class="BodyText60" style="margin-left:10.05pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Fines</span></p><p class="BodyText60" style="margin-top:6pt; margin-left:9.9pt; margin-bottom:6pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cash Advances, Stores, &c., supplied (in order of </span><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">date)—</span></p><p class="BodyText60" style="margin-top:6pt; margin-left:9.9pt; margin-bottom:6pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cash on leaving Ship</span><span style="width:112.75pt; font-family:'Lucida Console', monospace; display:inline-block">....................</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="8" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total Deductions, exclusive of Allotments</span><span class="Bodytext55pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="8" rowspan="3" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total Earnings (as above)</span><span style="width:185.43pt; font-family:'Lucida Console', monospace; display:inline-block">..................................</span></p><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total Deductions, exclusive of Allotments (as above)</span><span style="width:85.95pt; font-family:'Lucida Console', monospace; display:inline-block">...............</span></p><p class="BodyText60" style="margin-top:6pt; margin-left:17.85pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Balance without deducting Allotments</span><span style="width:139.58pt; font-family:'Lucida Console', monospace; display:inline-block">.........................</span></p><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Allotments</span><span style="width:238.15pt; font-family:'Lucida Console', monospace; display:inline-block">...........................................</span></p><p class="BodyText60" style="text-indent:103.5pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Final Balance</span><span style="width:124.92pt; text-indent:0pt; font-family:'Lucida Console', monospace; font-variant:small-caps; display:inline-block">.......................</span><span class="Bodytext55pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> £</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:32.7pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:50.2pt"></td><td style="width:30.2pt"></td><td style="width:35.65pt"></td><td style="width:61.25pt"></td><td style="width:10.25pt"></td><td style="width:47.65pt"></td><td style="width:58.5pt"></td><td style="width:24.2pt"></td><td style="width:43.4pt"></td><td style="width:7.1pt"></td><td style="width:30.2pt"></td><td style="width:35.25pt"></td></tr></tbody></table>
The above Account of Earnings and of Deductions, exclusive of Allotments, is correct—
Note.—This Form when completed is the property of the Seaman whose name appears hereon.
Issued under the Navigation Act, Sec. 80; and Nav. (M. & S.) Reg. 15. RELEASE ON TERMINATION OF SERVICE.With. Note of Excepted Claims (if any).Port of
<table cellspacing="0" cellpadding="0" style="width:101.04%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:14.14%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td rowspan="2" style="width:11.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official Number.</span></p></td><td rowspan="2" style="width:14.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Master.</span></p></td><td rowspan="2" style="width:14.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Owner.</span></p></td><td rowspan="2" style="width:21.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Description of Agreement.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Commencement of Agreement.</span></p></td></tr><tr style="height:1pt"><td style="width:8.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:43.2pt"><td style="width:14.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.74%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
We, the undersigned members of the crew of the above-named Ship, do hereby release the said Ship, and the Master and Owner thereof, from all claims for wages or otherwise (except as stated hereunder) in respect of the above-mentioned Agreement. And I, the Master, do hereby release the said undersigned Members of the crew from all claims in respect of the said Agreement.
Note.—There are excepted from this Release any rights the seamen may have to benefits under Section 132 of the Navigation Act 1912-1920 (relating to Seamen left behind sick or injured, at a port in Australia, from a ship registered in Australia), and also the claims which are specified on the back hereof and which are identified by the signatures of the respective Seamen notifying such excepted claims.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:30.8pt"><td style="width:5.92%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Discharge Number.</span></p></td><td style="width:21.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of Seaman.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Balance of Wages Paid.</span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:9.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Discharge Number.</span></p></td><td style="width:21.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of Seaman.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Balance of Wages Paid.</span></p></td></tr><tr style="height:1pt"><td style="width:5.92%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.92%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.92%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5.92%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:4.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:3.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Note of Specified Claims excepted from and entered by the respective Seamen whose Signatures appear below, upon signing the Release on the front hereof.
Signature of Seaman. Claims Referred to Above. Initials of Superintendent.
I attest the execution, in my presence, of the above Release, subject to the exceptions referred to.
Issued under the Navigation Act, Sec. 80; and Nav. (M. & S.) Reg. 16. Commonwealth, of Australia.VOUCHER FOR PAYMENTS BY A MASTER.
Name of Ship. Official Number. Port of Registry. Name of Master. Description of Voyage. Date of Final Termination of Voyage.
I certify that the above-named Master has in my presence paid to the crew of the above-named Ship, in respect of the above-mentioned voyage, the sum of pounds shillings and pence.
Superintendent, Mercantile Marine Office.
Issued under the Navigation Act, Section 81; and Nav. (M. & S.) Reg. 17. Commonwealth of Australia.Navigation Act 1912-1920.
SUBMISSION OF QUESTION TO ARBITRATION OF SUPERINTENDENT.
* I,/we, the undersigned, hereby request that the Superintendent of the Mercantile Marine Office, shall decide the following question, as being a question between the *Master/Owner and a Seaman or Apprentice in respect of a voyage or engagement in the ship of Official No. , which terminated on / / 19
Amount of Wages (if any) involved, £ : :
(Signed) Master or* OwnerSeaman or* Seamen * Seaman or Seamen
*Strike out the words that are inapplicable.
*Refusal of Superintendent to Arbitrate.
I am of opinion that the question submitted is one that should be settled by a Court, and I accordingly refuse to decide it.
*Decision by Superintendent in Regard to Question Submitted.
*Note.—The Superintendent will complete one or other of the indorsements above, the other indorsement being struck through. After the parties to the dispute have been informed of the result the Form is to be retained by the Superintendent and filed as an official record.
In all cases where entries in the Official Log-book are produced in connexion with the settlement of the matter in dispute, a copy of the entries is to he made and attached hereto by the Superintendent.
Issued under the Navigation Act, sec. 130; and Nav. (M. & S.) Reg. 19. Commonwealth of Australia.Navigation Act 1912-1920.ACCOUNT OF WAGES AND EFFECTS
of a Seaman left behind on the Ground of unfitness or inability to proceed on the voyage.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:24.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name and Official Number of Ship.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Master.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Description of Voyage.</span></p></td></tr><tr style="height:1pt"><td style="width:24.68%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="5" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surname at Length.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Year of Birth.</span></p></td><td colspan="6" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nationality (stating birthplace).</span></p></td></tr><tr style="height:1pt"><td colspan="5" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="6" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext4pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Home </span><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Address as recorded in Agreement.</span></p></td><td colspan="3" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">In what Capacity engaged, No. of Certificate (if any), and No. of Reserve Commission of R.V. 2 (if any).</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount of Wages per Calendar Month.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date when Wages commenced and Place of signing the Agreement.</span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Discharge.</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext65pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" rowspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" rowspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" rowspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="3" rowspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" rowspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Creditor.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount</span><span class="Bodytext45pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt4" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Debtor.</span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext65pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Amount.</span></p></td></tr><tr style="height:1pt"><td colspan="2" style="border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Wages at £</span><span style="width:51.47pt; display:inline-block"> </span><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">per Month for</span><span style="width:2.06pt; display:inline-block"> </span><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">months</span><span style="width:9.5pt; display:inline-block"> </span><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">days</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Overtime</span><span style="width:86.51pt; font-family:'Lucida Console', monospace; display:inline-block">...............</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Pay in lieu of leave not taken days at</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Extras</span><span style="width:94.11pt; font-family:'Lucida Console', monospace; display:inline-block">.................</span></p></td><td rowspan="2" style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="2" style="width:5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" rowspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" rowspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Allotment</span></p></td><td rowspan="3" style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" rowspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="BodytextMSMincho" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">.</span></p></td><td rowspan="3" style="width:5.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:10.35pt"><td colspan="2" rowspan="3" style="border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:14.2pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total Earnings</span><span style="width:49.66pt; font-family:'Lucida Console', monospace; display:inline-block">.........</span></p><p class="BodyText60" style="margin-left:14.2pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Deductions as per Contra</span></p><p class="BodyText60" style="margin-left:14.2pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Balance due</span><span style="width:56.77pt; display:inline-block"> </span><span class="Bodytext7pt" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">£</span></p></td></tr><tr style="height:1pt"><td style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:7.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.26%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:104.65pt"></td><td style="width:22.65pt"></td><td style="width:30.25pt"></td><td style="width:21.2pt"></td><td style="width:21.9pt"></td><td style="width:9.25pt"></td><td style="width:44.75pt"></td><td style="width:10.2pt"></td><td style="width:50.1pt"></td><td style="width:28.75pt"></td><td style="width:30.8pt"></td><td style="width:9.75pt"></td><td style="width:16.2pt"></td><td style="width:23.55pt"></td></tr></tbody></table>
I declare the above account to be just and true.
(b) If illness, state nature of disease, and whether due to venereal disease, or the seaman’s wilful act, or default, or misbehaviour. If the result of injury in Service, state nature of accident and injury.
(c) Here state whether delivered to the seaman or the Officer.
I hereby certify that the above-named seaman was left at this port with my sanction on the ground of (a)
(b) and that I have examined the above account and compared it with the Agreement, the Master’s Book, and the Official Log-Book, and found it to be correct, and that the balance of wages, amounting to £ has been paid to me on account of the seaman,/the seaman, and the effects, together with the seaman’s discharge book (Dis. A),/discharges, have been delivered to (c) Signature of Superintendent
I hereby acknowledge the correctness of this account of wages, and the receipt of the above-mentioned balance of wages due to me.
Date / /192 Signature of Seaman
I hereby consent to the final settlement of my wages being left to the Superintendent, Mercantile Marine Office, Port of
Signature of Witness . Signature of Seaman
Issued under the Navigation Act 1912-1920, s. 165; and Nav. (M. & S.) Regns. Commonwealth of Australia.Navigation Act 1912-1920.LIST OF CREWNote: Particulars to be given in regard to the Master and all Officers, Seamen and Apprentices.To be delivered to the Superintendent, Mercantile Marine Office at the Vessel’s first port of call in Australia. Penalty £5.
<table cellspacing="0" cellpadding="0" style="width:102.32%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:23.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td rowspan="2" style="width:22.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td rowspan="2" style="width:22.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port Arrived From.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Commencement of Voyage.</span></p></td><td style="width:11.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:9.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td><td style="width:9.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:11.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Agents.</span></p></td></tr><tr style="height:39.1pt"><td style="width:23.32%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:15.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Full names.</span></p></td><td rowspan="2" style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Reference No. in Agreement.</span></p></td><td rowspan="2" style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nationality (Place of Birth).</span></p></td><td rowspan="2" style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Race.</span></p></td><td rowspan="2" style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity in which engaged.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place and date of Engagement.</span></p></td><td rowspan="2" style="width:13.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Remarks.</span></p></td></tr><tr style="height:14.6pt"><td style="width:13.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place.</span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date.</span></p></td></tr><tr style="height:56.65pt"><td style="width:15.5%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.92%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:7.55pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Master.</span></p></td><td style="width:13.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:13.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
I hereby certify that this List contains the names of all persons, constituting the Master, Officers, and crew of the ss. , now arrived at the Port of , and that to the best of my knowledge and belief the particulars furnished are true and correct.
Issued under the Navigation Act 1912-1920, S. 166; and Nav. (M. & S.) Reg. 22. Commonwealth of Australia.Navigation Act 1912-1920.RETURN OF BIRTHS, DEATHS, AND MARRIAGES.
To be furnished by the Master of a ship registered in Australia, or of any other ship (British or Foreign) carrying passengers to Australia.
Returns of Births and Deaths occurring on other British ships during the voyage to Australia, o whilst in Australian waters, are to be furnished in Board of Trade Form B. & D.I.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:21.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Vessel.</span></p></td><td rowspan="2" style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official Number.</span></p></td><td rowspan="2" style="width:22.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Registered Tonnage.</span></p></td><td rowspan="2" style="width:20.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Master.</span></p></td></tr><tr style="height:1pt"><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Gross.</span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Net.</span></p></td></tr><tr style="height:31pt"><td style="width:21.44%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Description of Voyage. Registered Owner.
Note.—It is important that the return on this form should be an exact copy of the entry in tabular form in the Official Log Book (if any).
Form M. & S.—15 (in Duplicate)—continued.
Name of Ship Official Number
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:7.16%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="10" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt1" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Births.</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:7.16%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Birth.</span></p></td><td rowspan="2" style="width:9.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name (if any) of Child.</span></p></td><td rowspan="2" style="width:6.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Sex.</span></p></td><td rowspan="2" style="width:9.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name and Surname of Father.</span></p></td><td rowspan="2" style="width:10.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Rank, Profession, or Occupation of Father.</span></p></td><td rowspan="2" style="width:9.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name and Surname of Mother.</span></p></td><td rowspan="2" style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Maiden Surname of Mother.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Father.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Mother.</span></p></td></tr><tr style="height:1pt"><td style="width:11.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Birthplace and Nationality.</span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Last Place of Abode.</span></p></td><td style="width:11.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Birthplace and Nationality.</span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Last Place of Abode.</span></p></td></tr><tr style="height:1pt"><td style="width:7.16%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td style="width:9.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.88%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.18%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:5%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Death.</span></p></td><td style="width:9.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place of Death.</span></p></td><td style="width:18.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name and Surname of Deceased.</span></p></td><td style="width:5.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Sex.</span></p></td><td style="width:5.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Age.</span></p></td><td style="width:16.46%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Rating or Rank, Profession or Occupation.*</span></p></td><td style="width:8.78%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Birthplace and Nationality.</span></p></td><td style="width:14.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Home Address as recorded in Agreement.</span></p></td><td style="width:16.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause of Death.</span></p></td></tr><tr style="height:1pt"><td style="width:5%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">10</span></p></td><td style="width:9.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:left; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Members of Crew</span><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">, </span><span class="Bodytext7pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">including Masters on European Agreement.</span></p></td><td style="width:14.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:5%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext45pt" style="font-family:'Times New Roman', serif; font-size:9pt; font-weight:normal; letter-spacing:normal; vertical-align:baseline">11</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">12</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">13</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">14</span></p><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">15</span></p></td><td style="width:9.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:18.28%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt3" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Persons who were not Members of the Grew,</span></p><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Last Place of Abode,</span></p><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:16.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Form M. & S.—15 (in Duplicate)—continued.
Date of Marriage. Christian and Surnames of Both Parties. Maiden Surname of Bride Age. Conjugal State.‡ Rank, Profession, or Occupation. Birthplace and Nationality. Last Place of Abode. Names of Parents. Profession or Occupation of Father. Name, Permanent Address, and Denomination of Officiating Clergyman. 161718
*In the case of an Infant or Child, the words “Son of” or “Daughter of,” followed by the name of the Father, and his profession, should be recorded in the column for “Kating or Rank, Profession, or Occupation.” In the case of an illegitimate child the full name of the Mother, instead of that of the Father, should be recorded.
† In the case of a Widow or Divorcee the Christian Name, Surname, and Maiden Surname should be given.
‡ e.g., Bachelor, Spinster, Widow, Widower, or Divorcee.
To be Filled in by the Master,
I hereby certify that the above Return is an exact copy of the facts recorded in the tabular form in the Official Log Book of the above-named Ship.
The following particulars respecting a deceased Member of the Crew should also be given, if known:—
Image unavailable in extracted text Number of Certificate of Competency
To be Filled in by the Superintendent to whom this Return is delivered.
Strike out words which do not apply.
The above Return, which is an exact copy of the facts recorded in the tabular form in the Official Log Book, was delivered to me this day of , 192 , at the port of
Additional Statement in case of Death
I have made inquiry into the death referred to, and reported the result on Form
* State whether correct and true.
I find that this Return of the particulars of the death is*
† State whether further inquiry is necessary or not.
‡ State whether received by the Officer, or left in charge of the Master.
The wages and effects of the Deceased have been‡
Form M. & S.—15 (in Duplicate)—continued.
Particulars of the Circumstances-which led to the Death.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="4" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:14.4pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">The Superintendent should also give the following particulars if the death occurred after the deceased had ceased to be a Member of the Crew:—</span></p></td></tr><tr style="height:1pt"><td style="width:28.38%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Leaving Ship.</span></p></td><td style="width:4.64%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place of Leaving Ship.</span></p></td><td style="width:52.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Cause of Leaving Ship. If an Injury, state the Nature and Cause of it.</span></p></td></tr><tr style="height:17.05pt"><td style="width:28.38%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Discharge</span></p></td><td rowspan="5" style="width:4.64%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="5" style="width:14.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td rowspan="5" style="width:52.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:20.1pt"><td style="width:28.38%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Desertion</span></p></td></tr><tr style="height:14.05pt"><td style="width:28.38%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Missing</span></p></td></tr><tr style="height:21.35pt"><td style="width:28.38%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Other Cause</span></p></td></tr><tr style="height:20.2pt"><td style="width:28.38%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Navigation Act 1912-1920,
Sec. 171; Nay. (M. & S.) Reg. 24
Foreign-going, Australian-trade, or Limited Coast-trade Ship.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:21.14%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship.</span></p></td><td rowspan="2" style="width:9.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official No.</span></p></td><td rowspan="2" style="width:18.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Registered Tonnage.</span></p></td><td rowspan="2" style="width:22.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Master.</span></p></td><td rowspan="2" style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No. of Certificate,</span></p></td></tr><tr style="height:16.15pt"><td style="width:9.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Gross.</span></p></td><td style="width:9.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Net</span></p></td></tr><tr style="height:49pt"><td style="width:21.14%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:18.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.44%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:22.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td style="width:27.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port at which and Date when Voyage commenced.</span></p></td><td style="width:44.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Nature of the Voyage or Employment.</span></p></td><td style="width:27.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port at which and Date when Voyage terminated.</span></p></td></tr><tr style="height:1pt"><td style="width:27.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:left; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">Port</span><span style="width:87.55pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">................</span><span style="width:5.45pt; text-indent:0pt; display:inline-block"></span></p></td><td rowspan="2" style="width:44.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:27.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:left; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">Port</span><span style="width:76.75pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">..............</span><span style="width:10.9pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">..</span></p></td></tr><tr style="height:1pt"><td style="width:27.88%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:-18pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date</span><span style="width:89.36pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">................</span><span style="width:1.65pt; text-indent:0pt; display:inline-block"></span></p></td><td style="width:27.3%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:left; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">Date</span><span style="width:74.76pt; text-indent:0pt; font-family:'Lucida Console', monospace; display:inline-block">.............</span><span style="width:16.25pt; text-indent:0pt; display:inline-block"></span></p></td></tr></tbody></table>
Delivered to the Superintendent of Mercantile Marine at the Port of..............
on..........day of... ..........19.
............... ............Master
................................Address.
Form M. & S.—1—continued,
LIST OF CREW AND REPORT OF CHARACTER.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:4.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">No.</span></p></td><td rowspan="2" style="width:21.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian and Surname at Length of each Member of the Crew.</span></p></td><td rowspan="2" style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity in which Engaged.</span></p></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Report of Conduct, Character, and Qualifications.</span></p></td><td rowspan="2" style="width:37.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:15.95pt; text-indent:-7.1pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">If there is any entry in the Log relating in any way to the Crew, the page pages in the Log where the entry is to</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"> </span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">be found should he written in this column opposite the man’s name.</span></p></td></tr><tr style="height:1pt"><td style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Efficiency</span></p><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">As Boat-hand.</span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">For Ability.</span></p></td><td style="width:8.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">For Conduct.</span></p></td></tr><tr style="height:12.9pt"><td style="width:4.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:21.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.95pt"><td style="width:4.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:21.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:12.6pt"><td style="width:4.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td><td style="width:21.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.15pt"><td style="width:4.44%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.98%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.38%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:37.14%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:justify; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
LOAD-LINE AND DRAUGHT OF WATER.
Position of the Load-line Disc and the Lines used in connexion with the Disc.
The Centre of the Disc is placed at feet inches below the deck-line marked under the provisions of the Commonwealth Navigation Act 1912-1920 and of the Merchant Shipping Act 1894.
Maximum load-line in Fresh Water feet inches above the centre of the disc.
Maximum load-line in Indian Summer feet inches above the centre of the disc.
Maximum load-line in Summer the centre of the disc.
Maximum load-line in Winter feet inches below the centre of the disc.
Maximum load-line in North Atlantic Winter feet inches below the centre of the disc.
The above particulars are to be taken from the Load-line Certificate. The words which are not applicable should be erased
Dates of Arrival at and Departure from each Port touched at, with the Free-board and Draught of Water upon every occasion of the Ship proceeding to Sea.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td colspan="6" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">From</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">To</span></p></td></tr><tr style="height:1pt"><td rowspan="2" style="width:10.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date and Hour of Departure.</span></p></td><td rowspan="2" style="width:21.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Dock, Wharf, Port or Harbour from which the Ship departs.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Draught of Water in salt water at time of proceeding to sea.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Free-board amidships corresponding to foregoing draught.</span></p></td><td rowspan="2" style="width:8.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Arrivai.</span></p></td><td rowspan="2" style="width:20.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Dock, Wharf, Port or Harbour.</span></p></td></tr><tr style="height:1pt"><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Forward.</span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Aft.</span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port.</span></p></td><td style="width:10.36%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Starboard.</span></p></td></tr><tr style="height:1pt"><td style="width:10.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">ft. in.</span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">ft. in.</span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">ft. in.</span></p></td><td style="width:10.36%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">ft. in.</span></p></td><td style="width:8.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:10.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.36%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:10.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.36%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:10.1%; border-top:0.75pt solid #000000; border-right:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.12pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.3%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.36%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:20.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
Notes.—In the Northern Hemisphere the Summer months are April to September inclusive, and the Winter months October to March, inclusive. In the Southern Hemisphere (elsewhere than in Australia) the Summer and Winter freeboards should be used during the corresponding or recognised Summer and Winter months respectively.
In the case of vessels entering, or loading, in any port in Australia, the minimum freeboard allowed, for all seasons of the year, is as follows:—For steam-ships loaded with dead weight cargo, the Winter freeboard; for sailing ships so loaded, the Winter North Atlantic freeboard; and for all vessels loaded with other cargo, the Summer free board. A cargo is deemed to be a “dead-weight” cargo if it consists to the extent of 85 per cent, or more of metalliferous ores, iron or steel rails or girders, pig iron or any other homogenous cargo with a special gravity of 4 or over.
The additional freeboard specified for the North Atlantic trades (Winter North Atlantic freeboard) is to apply to vessels sailing to, or from, the Mediterranean or any United Kingdom or European port, which may sail to, or from, or call at ports in British North America or Eastern ports in the United States, north of Cape Hatteras, from October to March, inclusive.
The reduced freeboard allowed for voyages in the Fine Weather Season in the Indian Seas (Indian Summer freeboard) only applies to vessels trading between the limits of Suez and Singapore.
The Fine Weather Season in the Indian Seas is defined as prevailing, east of Tuticorin, from the 15th November to the 25th May, and west of Tuticorin, from the 1st September to the 25th May.
Form M. & S.—16—continued.
MARRIAGES, BIRTHS, AND DEATHS
Of Members of the Crew, and other persons on board, which have occurred during the voyage.
Date of Marriage. Christian and Surnames of Both Parties. Maiden Surname of Bride.* Age. Conjugal State.î Rank, Profession or Occupation.
Birthplace and Nationality. Last Place of Abode. Names of Parents. Profession or Occupation of Father. Name, Permanent Address, and Denomination of Officiating Clergyman.
† In the case of a Widow or Divorcee the Christian Name, Surname, and Maiden surname should be given.
‡ e.g., Bachelor, Spinster, Widow, Widower, or Divorcee.
(Signed) ...........Officiating Clergyman.
.............Master or Officer in Command
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:22.35pt"><td colspan="7" style="border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Columns to be filled in by the</span></p></td></tr><tr style="height:1pt"><td style="width:8.18%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Birth.</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name (if any) of Child.</span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Sex.</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Kame and Surname of Father.</span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Hank, Profession, or Occupation of Father.</span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name and Surname of Mother.</span></p></td><td style="width:11.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Maiden Surname of Mother.</span></p></td></tr><tr style="height:1pt"><td style="width:8.18%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">1</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:8.18%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">2</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:8.18%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">3</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:8.18%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">4</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:8.18%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">5</span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.32%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.56%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:17.54%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.22%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:20.25pt"><td colspan="7" style="border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:right; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext7pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Columns to be filled in by the</span></p></td></tr><tr style="height:1pt"><td style="width:7.54%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Death.</span></p></td><td style="width:15.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place of Death.</span></p></td><td style="width:19.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Christian Name and Surname of Deceased.</span></p></td><td style="width:9.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Sex.</span></p></td><td style="width:8.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Age.</span></p></td><td style="width:15.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Rating, or Rank, Profession, or Occupation.*</span></p></td><td style="width:24.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Birthplace and Nationality</span></p></td></tr><tr style="height:24.55pt"><td style="width:7.54%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">6</span></p></td><td style="width:15.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Members of Crew, including</span></p></td></tr><tr style="height:21.25pt"><td style="width:7.54%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">7</span></p></td><td style="width:15.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:20.05pt"><td style="width:7.54%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">8</span></p></td><td style="width:15.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:14.55pt"><td style="width:7.54%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">9</span></p></td><td style="width:15.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Persons who were</span></p></td></tr><tr style="height:19.75pt"><td style="width:7.54%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">10</span></p></td><td style="width:15.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:19.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.34%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:15.04%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:24.68%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
In the case of an Infant or Child, the words “Son of” or “Daughter of,” followed by the name of the father and illegitimate child the full name of the mother
Form M. & S. 16—-continued.
RECORD OP BOAT MUSTERS, BOAT, COLLISION, EIRE AND ROCKET DRILLS AND OF EXAMINATION OF LIFE SAVING AND FIRE-EXTINGUISHING APPLIANCES AS REQUIRED BY REGULATION 5 OF THE NAVIGATION (COLLISION, BOAT AND EIRE DRILLS) REGULATIONS, MADE UNDER SECTIONS 235 AND 425 OF THE NAVIGATION ACT, OR (IN THE CASE OF BRITISH SHIPS TO WHICH THOSE REGULATIONS DO NOT APPLY) BY SECTION 9, OE THE MERCHANT SHIPPING ACT 1906.
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="3" style="width:6.04%; height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Master Drill or Examination.</span></p></div></td><td rowspan="3" style="width:7.1%; height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Place. (State whether at Sea or in port, giving name.)</span></p></div></td><td colspan="3" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Boat Musters.</span></p></td><td colspan="5" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Boat Drills.</span></p></td><td colspan="3" rowspan="3" style="height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">Here state Whether—</span></p><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">(</span><span style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic">a</span><span style="font-family:'Times New Roman', serif; font-size:9pt">) Fire Drill held;</span></p><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">(</span><span style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic">b</span><span style="font-family:'Times New Roman', serif; font-size:9pt">) Collision Drill held;</span></p><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; line-height:9pt; widows:0; orphans:0"><span style="font-family:'Times New Roman', serif; font-size:9pt">(</span><span style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic">c</span><span style="font-family:'Times New Roman', serif; font-size:9pt">) Rocket Drill held.</span></p></div></td><td rowspan="3" style="width:12%; height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:1pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Condition in which Life-saving and Fire-extinguishing Appliances were found.</span></p></div></td></tr><tr style="height:35.95pt"><td rowspan="2" style="width:5.9%; height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">* Number of boats swung out.</span></p></div></td><td rowspan="2" style="width:6.76%; height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">* Number of Boats cleared but not swung out.</span></p></div></td><td rowspan="2" style="width:6.82%; height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">* Total number of Crew attending Muster.</span></p></div></td><td rowspan="2" style="width:6.7%; height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:35.95pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span style="font-family:'Times New Roman', serif">* Number of Boats crow attending Muster.</span></p></div></td><td colspan="4" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Boats lowered into the water and Crews exercised at pulling the oars and boat handling.</span></p></td></tr><tr style="height:120.15pt"><td style="width:9.7%; height:120.15pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:120.15pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">* Number of Boats lowered.</span></p></div></td><td style="width:8.64%; height:120.15pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:120.15pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Time in Water.</span></p></div></td><td colspan="2" style="height:120.15pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:120.15pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Total number of Crew exercised</span></p></div></td></tr><tr style="height:13.2pt"><td style="width:6.04%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.64%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">a</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">)</span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">b</span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:normal; letter-spacing:normal; vertical-align:baseline">)</span></p></td><td style="width:6.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">(</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; font-style:italic; letter-spacing:normal; vertical-align:baseline">c</span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">)</span></p></td><td style="width:12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="margin-left:0pt; text-indent:0pt; text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.55pt"><td style="width:6.04%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.1%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:5.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.76%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.82%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.52%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.96%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.84%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:12%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:top; background-color:#ffffff"><p style="widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:0pt"><td style="width:25.65pt"></td><td style="width:30.1pt"></td><td style="width:25pt"></td><td style="width:28.65pt"></td><td style="width:28.9pt"></td><td style="width:28.4pt"></td><td style="width:41.15pt"></td><td style="width:36.65pt"></td><td style="width:0.35pt"></td><td style="width:40.35pt"></td><td style="width:29.5pt"></td><td style="width:29.5pt"></td><td style="width:29pt"></td><td style="width:50.8pt"></td></tr></tbody></table>
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:49.7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Remarks.</span></p></td><td rowspan="2" style="width:21.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Date of Entry.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of Master and Mate.</span></p></td></tr><tr style="height:1pt"><td style="width:14.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Master.</span></p></td><td style="width:14.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Mate.</span></p></td></tr><tr style="height:1pt"><td style="width:49.7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:1pt"><td style="width:49.7%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:21.58%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:14.7%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
*The distinguishing Letter and number of each boat to be entered in the column headed “Remarks.” Boats lowered into the water may be indicated by the letter L; those swung oat but not lowered, by S; and those cleared but not swung out, by C. Example.—L. P1, P2; S. P3, P4; C. S1, S2, indicating that the port life boats 1 and 2 were lowered into water and crews exercised; port boats 3 and 4 were swung out but not lowered, and starboard boats 1 and 2 were cleared but not swung out.
Date of the Occurrence entered, with Hour. Place of the Occurrence, or Situation by Latitude and Longitude at Sea. Date of Entry. Entries required by Act of Parliament. Amount of Fine or Forfeiture inflicted.
N.B.—Every entry in this Log Book required by the Act must be signed by the Master and by an Officer or some other member of the Crew, and every entry of illness, injury, or death must also be signed by the Surgeon or Medical Practitioner on board (if any) ; and every entry of wages due to, or of the sale of the effects of, any Seaman or Apprentice who has died must be signed by the Master and by an Officer and some other member of the Crew ; and every entry of wages due to any Seaman who enters His Majesty’s Service must be signed by the Master and by the Seaman or by the Officer authorized to receive the Seaman into such Service.
Note.—The Engine-room Log-book (late Form M. & S.—17) is now required to be in a form approved by the Director, vide regulation 25.
Nav. (M.& S.)Reg. 27. Commonwealth of Australia.Navigation Act 1912-1920.CERTIFICATE OF SERVICE AT SEA.Mercantile Marine Office,Port ofThis is to certify that (about years of age in 19 ) appears by the Official Records to have served, in the undermentioned vessels in the capacities, and during the respective periods, herein stated, viz.:—
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:37.6pt"><td rowspan="7" style="width:8.24%; height:37.6pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff; -moz-transform:rotate(180deg); -ms-transform:rotate(180deg); overflow:hidden; transform:rotate(180deg); -webkit-transform:rotate(180deg)"><div style="height:37.6pt; margin-right:auto; margin-left:auto; writing-mode:tb-rl; overflow:hidden"><p class="BodyText60" style="margin-right:5.65pt; margin-left:5.65pt; text-indent:0pt; text-align:left; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Signature of Seaman</span></p></div></td><td style="width:8.22%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Vessel’s Name</span></p></td><td style="width:8.4%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official Number.</span></p></td><td style="width:8.56%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port of Registry.</span></p></td><td style="width:6.5%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Tons,</span></p></td><td style="width:7.32%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Horse Power.</span></p></td><td style="width:8.44%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity in which he served.</span></p></td><td style="width:7.88%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">From—</span></p></td><td style="width:6.3%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">To—</span></p></td><td style="width:7%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Trade.</span></p></td><td style="width:6.1%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Conduct.</span></p></td><td style="width:7.74%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Ability.</span></p></td><td style="width:9.32%; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Efficiency</span></p><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">As Boathand.</span></p></td></tr><tr style="height:13.35pt"><td style="width:8.22%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.74%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:14.25pt"><td style="width:8.22%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.74%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:17.25pt"><td style="width:8.22%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.74%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.95pt"><td style="width:8.22%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.74%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.45pt"><td style="width:8.22%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.74%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:13.65pt"><td style="width:8.22%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.4%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.56%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.5%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.44%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.88%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.3%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:6.1%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.74%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:9.32%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
C1924L00199-2.jpg Superintendent.
Nav. (M. & S.) Reg. 27. Commonwealth of Australia.Navigation Act 1912-1920.APPLICATION FOR CERTIFICATE OF SERVICE AT SEA.
Name of Applicant in full. Year of Birth. Place of Birth. Address to which the Certificate is to be sent. No. of Certificate of Competency (if any). Purposes for which the undermentioned Services are required to be verified. 1. 2. 3. 4. 5. 6.
The Applicant above-named requests that the following statement of Services may be verified.*
<table cellspacing="0" cellpadding="0" style="width:100%; margin-left:18pt; border-collapse:collapse"><tbody><tr style="height:1pt"><td rowspan="2" style="width:11.2%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Ship (If a steam vessel, S.S. should be placed before the name.).</span></p></td><td rowspan="2" style="width:7.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Official Number if known.)</span></p></td><td rowspan="2" style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port Belonging to.</span></p></td><td rowspan="2" style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Tonnage.</span></p></td><td rowspan="2" style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Whether employed in Foreign or Coasting Trade.</span></p></td><td rowspan="2" style="width:11.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Name of Master.</span></p></td><td rowspan="2" style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Capacity of Applicant on Board.</span></p></td><td colspan="2" style="border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Period of Service </span><span class="Bodytext6pt2" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline"></span><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">to be verified.</span></p></td><td rowspan="2" style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; line-height:9pt; widows:0; orphans:0"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">Port in Australia at which discharged.</span></p></td></tr><tr style="height:1pt"><td style="width:8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">From (Year and Month.)</span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p class="BodyText60" style="margin-left:0pt; text-indent:0pt; widows:0; orphans:0; font-size:9pt; background-color:transparent"><span class="Bodytext6pt0" style="font-family:'Times New Roman', serif; font-size:9pt; letter-spacing:normal; vertical-align:baseline">To (Year and Month.)</span></p></td></tr><tr style="height:1pt"><td style="width:11.2%; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">7.</span></p></td><td style="width:7.9%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">8.</span></p></td><td style="width:11.72%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">9.</span></p></td><td style="width:8.2%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">10.</span></p></td><td style="width:11.66%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">11.</span></p></td><td style="width:11.6%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">12.</span></p></td><td style="width:11.66%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">13.</span></p></td><td style="width:8%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">14.</span></p></td><td style="width:8.06%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">15.</span></p></td><td style="width:10.02%; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif">16.</span></p></td></tr><tr style="height:13.35pt"><td style="width:11.2%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:12.85pt"><td style="width:11.2%; border-top:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr><tr style="height:14.45pt"><td style="width:11.2%; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.5pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:7.9%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.72%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.2%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.6%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:11.66%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:8.06%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td><td style="width:10.02%; border-top:0.75pt solid #000000; border-left:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:0.5pt; padding-left:0.12pt; vertical-align:middle; background-color:#ffffff"><p style="text-align:center; widows:0; orphans:0; font-size:9pt"><span style="font-family:'Times New Roman', serif"></span></p></td></tr></tbody></table>
* The superintendent should verity as much service as possible from Discharges in possession of Applicant.
Printed and Published for the Government of the Commonwealth of Australia by H. J. Green, Government Printer for the State of Victoria.