THE REPUBLIC OF LIBERIA Marine Notice

LIBERIA MARITIME AUTHORITY

MLC-005
Office of Rev. 07/20
Deputy Commissioner
of Maritime Affairs

TO: ALL SHIPOWNERS, OPERATORS, MASTERS AND OFFICERS OF

MERCHANT SHIPS AND AUTHORIZED CLASSIFICATION
SOCIETIES

SUBJECT: Health and safety protection, accident prevention, medical care, welfare and
social security protection of seafarers under the Maritime Labour
Convention (MLC), 2006

Reference: (a) Maritime Labour Convention (MLC), 2006, as amended

(b) Amendments of 2014 to MLC, 2006
(c) Amendments of 2016 to MLC, 2006
(d) ILO ‘Accident Prevention on Board Ship at Sea and in Port’
(e) ILO Guidelines for implementing the occupational safety and health
provisions of MLC, 2006
(f) IMO Resolution MSC.255 (84): Casualty Investigation Code
(g) MSC-MEPC.2/Circ.3: Guidelines on the basic elements of a shipboard
occupational health and safety programme
(h) WHO ‘International Medical Guide for Ships’
(i) WHO ‘Quantification Addendum, International Medical Guide for Ships’
(j) IMO ‘Medical First Aid Guide for Use in Accidents Involving Dangerous
Goods’, 2010 edition (MFAG)
(k) ITU ‘List IV- List of Coast Stations and Special Service Stations’
(l) Liberian Maritime Law (RLM-107) Articles: 257, 258, 336A
(m) Liberian Maritime Regulations (RLM 108) Regulations: 2.66(2),
9.257, 9.258, 10.292, 10.296, 10.336(5), (11), (12a), (12b), (12c), (12d)
(n) Requirements for Marine Investigations and Hearings (RLM-260)
(o) Requirements for Merchant Marine Personnel (RLM-118)
(p) Liberian Marine Notices: MLC-001, MLC-002, MLC-003, MLC-004,
MLC-006, INS-001, INS-004, INT-001, ISM-001

Supersedes: Marine Notice MLC-005, dated 04/18

The following changes have been included:

1 of 13
Inquiries concerning the subject of this Notice should be directed to the Office of the Deputy Commissioner, Republic of
Liberia, the Liberian International Ship & Corporate Registry, 22980 Indian Creek Drive., Suite 200, Dulles, VA 20166,
USA. The most current version of all Marine Notices are available in the Online Library at: http://www.liscr.com
 a. Added consultation with shipowners’ and seafarers’ organizations for
determining potentially hazardous work for young seafarers in paragraph
3.3.5;
b. Added new paragraphs 3.3.11, 3.3.12 and 3.3.13 regarding reporting and risk
evaluation in relation to occupational safety and health.

PURPOSE:
This notice sets forth the Administration’s requirements, to ensure that seafarers’ work
environment on board ships promotes occupational safety and health; to protect the health of
seafarers and ensure their prompt access to medical care on board ship and ashore; to ensure that
seafarer’s are protected from the financial consequences of sickness, injury or death occurring in
connection with their employment; to ensure that measures are taken with a view to providing
seafarers with access to social security protection; and to ensure that seafarer’s working on board
a ship have access to shore-based facilities and services to secure their health and well-being under
the Maritime Labour Convention (MLC), 2006.

1. APPLICABILITY:

This notice applies to all ships and seafarers serving on board these ships to which MLC,
2006 applies.

2. DEFINITIONS:

2.1 Contractual claim: Any claim which relates to death or long-term disability of
seafarers due to an occupational injury, illness or hazard as set out in national law,
the seafarers’ employment agreement or collective agreement.

Refer to MLC-001 for other definitions.

3. REQUIREMENTS
These requirements are supplemental to DMLC-I, the Maritime Law (RLM-107), Maritime
Regulations (RLM-108) and Marine Notices contained in the Combined Publication Folder
(RLM-300).

3.1 Medical care on board ship and ashore

3.1.1 Shipowners shall ensure that seafarers working on board their ships have
prompt access to the necessary medicine, medical equipment and facilities
for diagnosis and treatment, and to medical and occupational health
protection information and expertise, which is generally comparable to that
provided to workers ashore.

3.1.2 Shipowners shall ensure that seafarers are given the right to visit a qualified
medical doctor or dentist without delay in ports of call, where practicable.

3.1.3 Health protection and medical care, including essential dental care, shall be
provided free of charge to seafarers while the seafarer is on board ship or
landed in a foreign port.

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 3.1.4 Shipowners shall adopt programs of a preventive character such as health
promotion and health education on board their ships.

3.1.5 Shipowners shall use the standard medical report form or forms provided for
in the Annex to the current edition of the WHO ‘International Medical Guide
for ships’, for use by the master and relevant medical personnel onshore and
on-board. The form, when completed and its contents shall be kept
confidential and shall only be used to facilitate the treatment of seafarers.
Other medical report forms may be accepted provided the necessary
information is included.

3.1.6 Every ship shall maintain a medical log for recording all medical treatment
on-board and onshore.

3.1.7 All ships shall carry a medicine chest and medical equipment that complies
with the requirements in the current edition of the WHO ‘International
Medical Guide for Ships and Quantification Addendum’, references (g) and
(h), and bearing in mind the number of persons on board and the nature and
duration of the voyage. The Administration will accept a medicine chest and
medical equipment that meets a similar national standard provided the
inventories are effectively equivalent to the WHO standards.

3.1.7.1 The Quantification Addendum contains recommended

quantities, indications and dosing for 55 medicines listed in the
International Medical Guide for Ships 3rd edition.

3.1.7.2 The quantities are based on three types of ships:

a) ocean-going ships with crews of 25-40 and no doctor

(Category A);

b) coastal ships with crews of up to 25 that travel no more than

24 hours from a port of call (Category B); and

c) small boats and private craft with crews of 15 or less, and

usually travelling no more than a few hours from a port of call
(Category C).

3.1.7.3 These quantities have been updated to reflect the decrease of

crew numbers on most ships and calculated for voyages of one
month. The Quantification Addendum to the International
Medical Guide for Ships provides essential guidance to all
those who involved in the procurement, purchasing, stock
maintenance and use of medicines to promote and protect the
health of seafarers worldwide.

3.1.7.4 Every ship shall maintain a list of medicines and medical

equipment carried on board. In addition, the master is required
to maintain a register of controlled medicines and this register

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 shall be maintained on board for a period of two (2) years from
the date of the last entry.

3.1.8 The medicines & medical equipment shall be inspected at regular intervals,
not exceeding 12 months, by the designated medical officer on board or a
pharmacist, who shall ensure that the quantities, labelling, expiry dates and
conditions of storage of all medicines and directions for their use are checked
and all equipment functioning as required.

3.1.9 All ships carrying 100 or more persons and ordinarily engaged on
international voyages of more than 3 days duration shall carry a qualified
medical doctor.

3.1.10 On ships which do not carry a medical doctor, there shall be at least one
seafarer on board who is in charge of medical care and administering
medicine as part of their regular duties or at least one seafarer on board
competent to provide medical first aid; such persons shall have completed
the relevant training required by the STCW 1978, as amended.

3.1.11 All ships shall carry on board the current edition of the WHO publication
‘International Medical Guide for Ships and Quantification Addendum’ and
for those ships carrying dangerous cargoes, in addition shall carry the
‘Medical First Aid Guide’ for use in accidents involving dangerous cargoes.

3.1.12 Ships carrying dangerous goods not listed in the most recent edition of the
Medical First Aid Guide (MFAG), reference (i) for use in accidents
involving dangerous cargoes, shall carry ‘Material Safety Data Sheets’
available for these cargoes.

3.1.13 All ships shall carry a complete and up-to-date list of radio stations through
which medical advice can be obtained; and, if equipped with a system of
satellite communication, carry an up-to-date and complete list of coast earth
stations through which medical advice can be obtained.

Such publications shall include, but not be limited to: the current editions of
the ITU publication ‘List IV-List of coast stations and special service
stations’, reference (j); the ‘Admiralty List of Radio Signals Vol.1; and the
‘International Code of Signals’.

3.1.14 The seafarer’s responsible for medical care or first aid care should be
instructed in the use of the current editions of the International Medical
Guide, the medical section of the International Code of Signals and the
radio/satellite communication system.

3.1.15 Disposal of medicines and medical supplies:

Medicines and medical supplies shall be disposed of properly in accordance

with all applicable local and national laws and regulations of the State in
which disposal is occurring and any applicable international requirements.

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 3.1.15.1 Expired non-controlled medicines and medical supplies should
be:

a) returned to the supplier, where possible; or

b) sent to an approved shore-side contractor for disposal.

If disposable under 3.1.15.1 is not possible, expired non-controlled

medicines and medical supplies may be incinerated at sea as domestic waste
(category C in accordance with MARPOL Annex V), but only where a ship
has in place a written waste disposal policy and program that includes
incineration at appropriate temperatures by exclusively authorized
persons.

Records of such incinerated non-controlled medicines and medical supplies

shall be kept as part of the medical log.

3.1.15.2 Expired controlled medicines and medical supplies should be:

a) returned to a person who may lawfully supply them, such as

a qualified medical practitioner or registered pharmacist; or

b) disposed at sea through incineration as domestic waste

(category C in accordance with MARPOL Annex V). If the
medicines are in ampoules, the ampoules should be first
crushed in cloth before everything is incinerated. If should
be noted that for the glass ampoules to evaporate the
incinerator temperature should be between 850 degrees
Celsius and 1100 degrees Celsius; or

c) disposed ashore after encapsulation in accordance with the

requirements of the local authorities.

Whichever method of disposing of controlled medicines is utilized, all the

following conditions shall be met:

a) the method utilized shall be properly implemented;

b) the entire process from unpacking throughout the final

destruction of the controlled medicine shall be witnessed by
at least two (2) persons; and

b) the information (name/quantities/ strength/expiry date)

shall be written in the controlled medicines register and
shall be signed by the master and the two (2) witnesses after
destruction.

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 3.2 Shipowners’ liability

3.2.1 Shipowners shall be liable to bear the costs for seafarers working on their
ships in respect of:

a) sickness and injury of the seafarers occurring between the date of

commencing duty and the date upon which they are deemed duly
repatriated, or arising from their employment between these dates; and

b) Sickness and injury while off the ship pursuant to an actual mission
assigned to the seafarer, by the master or by the authority of the master.

Where the sickness or injury results in incapacity for work the shipowner
shall be liable:

a) To pay full wages as long as the sick or injured seafarers remain on

board or until the seafarers have been repatriated in accordance with this
Convention; and
b) To pay at least one-third of the basic wages from the time when the
seafarers are repatriated or landed until their recovery.

Liberian regulations limit the liability of the shipowner to pay one-third of

the basic wages in respect of a seafarer no longer on board to a period which
shall not be less than 16 weeks from the day of injury or the commencement
of the sickness.

However, this does not prohibit the seafarer’s employment agreement or any
applicable collective agreement from limiting the shipowners’ liability to
more favorable terms and conditions for the seafarers, than those
provided for above.

The seafarers’ employment agreement or any applicable collective

agreement shall contain the information on the Shipowners’ liability to bear
the costs in respect of sickness and injury.

3.2.2 Shipowners shall provide annually to the Administration, evidence of

financial security to assure compensation in the event of the death or long-
term disability of seafarers due to an occupational injury, illness or hazard.

The seafarers’ employment agreement or any applicable collective

agreement shall contain the information on the shipowners’ liability to
provide such compensation.

3.2.2.1 The contractual compensation, where set out in the seafarer’s

employment agreement and without prejudice to subparagraph
3.2.2.4, shall be paid in full and without delay.

3.2.2.2 There shall be no pressure to accept a payment less than the

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 contractual amount.

3.2.2.3 Where the nature of the long-term disability of a seafarer makes it

difficult to assess the full compensation to which the seafarer may
be entitled, an interim payment or payments shall be made to the
seafarer so as to avoid undue hardship.

3.2.2.4 In accordance with Regulation 4.2, paragraph 2, the seafarer shall

receive payment without prejudice to other legal rights, but such
payment may be offset by the shipowner against any damages
resulting from any other claim made by the seafarer against the
shipowner and arising from the same incident.

3.2.2.5 The claim for contractual compensation may be brought directly by

the seafarer concerned, or their next of kin, or a representative of the
seafarer or designated beneficiary.

3.2.2.6 Beginning 18 January, 2017, each ship shall carry on board a

certificate or other documentary evidence of financial security
issued by a financial security provider acceptable to the
Administration. A copy shall be posted in a conspicuous place on
board where it is available to the seafarers. Where more than one
financial security provider provides cover, the document provided
by each provider shall be carried on board.

3.2.2.7 The financial security shall not cease before the end of the period of
validity of the financial security unless the financial security
provider has given prior notification of at least 30 days to the
Administration.

3.2.2.8 The financial security shall provide for the payment of all
contractual claims covered by it which arise during the period for
which the document is valid.

3.2.3 The certificate or other documentary evidence of financial security shall

contain the information listed in the Annex I. It shall be in English or
accompanied by an English translation. The Administration may accept a
certificate or other documentary evidence of financial security issued to the
shipowner, which could be the owner, if the owner is the one on whose behalf
financial security is provided by a financial security provider acceptable to
the Administration. The Administration may also accept a certificate or other
documentary evidence of financial security issued to the crewing manager
by a financial security provider acceptable to the Administration, provided
the declaration of maritime labour compliance (DMLC) Part I addresses
measures which are substantially equivalent to these provisions, while
ensuring that the shipowner implements these measures in the DMLC Part
II.

3.2.3.1 Seafarers shall receive prior notification if a shipowner’s financial

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 security is to be cancelled or terminated.

3.2.3.2 The Administration shall be notified by the provider of the financial

security if a shipowner’s financial security is cancelled or
terminated.

3.2.3.3 Parties to the payment of a contractual claim may use the Model
Receipt and Release Form set out in the Annex I.

3.2.4 Shipowners shall be liable to defray the expense of medical care, including
medical treatment and the supply of necessary medicines and therapeutic
appliances, and board and lodging away from home until the sick or injured
seafarer has recovered, or until there is a declaration of permanent
incapacity.

Liberian regulations limit the liability of the shipowner to defray the expense
of medical care and board and lodging to a period which shall not be less
than 16 weeks, from the day of the injury or the commencement of the
sickness.

However, this does not prohibit the seafarers’ employment agreement or any
applicable collective agreement from limiting the shipowners’ liability to
more favorable conditions for the seafarers than those provided for above.

The seafarers’ employment agreement or any applicable collective

agreement shall contain the information on the shipowners’ liability to defray
these expenses.

3.2.5 Shipowners shall be liable to pay the cost of burial expenses in the case of
death occurring on board or in the case of death occurring ashore, if at the
time the seafarer was entitled to medical care and maintenance.

3.2.6 Liberian regulations exclude the shipowner from liability in the following
circumstances:

a) injury incurred otherwise than in the service of the ship;

b) injury or sickness which resulted from a willful act, default or
misconduct of the seafarer; injury or sickness which developed from a
condition that was intentionally concealed from the shipowner
(employer) at or prior to engagement under the Shipping Articles
(seafarers employment agreement);
c) death due to a willful act of the seafarer; death which developed directly
from a condition that was intentionally concealed from the shipowner
(employer) at or prior to his engagement under the Shipping Articles
(seafarers’ employment agreement);
d) if the seafarer refused medical treatment for such sickness or injury or
was denied such treatment because of misconduct or default;

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 e) if at the time of engagement, the seafarer refused to be medically
examined; or
f) if death was caused directly by war or an act of war, declared or
undeclared. But this clause shall not apply if at the time of the act the
vessel had entered a known zone of international hostility for the
purpose of trade.

3.2.7 Shipowners are exempted from the liability to defray the expense of medical
care and board and lodging and burial expenses in so far as such liability is
assumed by the public authorities.

3.2.8 Shipowners or their representatives shall take measures for safeguarding

property left on board by sick, injured or deceased seafarers and for returning
it to their next of kin.

3.3 Health and safety protection and accident prevention

3.3.1 Shipowners shall adopt and effectively implement and promote an

occupational safety and health policy on board their ships.

3.3.2 Shipowners shall take reasonable precautions to prevent occupational

accidents, injuries and diseases on board ship, including measures to reduce
and prevent the risk of exposure to harmful levels of noise and vibration and
other ambient factors and chemicals as well as the risk of injury or disease
that may arise from the use of equipment and machinery on board ships.

3.3.3 Shipowners shall adopt, effectively implement and promote an occupational

health and safety programme taking into account the ILO code of practice
entitled ‘Accident prevention on board ship at sea and in port’, reference
(d); the ILO Guidelines for implementing the occupational safety and health
provisions of the Maritime Labour Convention, 2006, reference (e); the
MSC-MEPC.2/Circ.3 entitled ‘Guidelines on the basic elements of a
shipboard occupational health and safety programme’, reference (g); the
IMO Resolution MEPC.255(84) entitled ‘Casualty Investigation Code’,
reference (f); International Guidance on eliminating shipboard harassment
and bullying; or other international standards and guidelines and codes of
practice for the following, but not limited to:

a) hazard identification and risk evaluation taking account of appropriate

statistical information from the shipowners’ fleet and general accident
and casualty statistics provided by the Administration;
b) initial vessel orientation or familiarization, covering shipowners’ safety
policy, emergency procedures, access and egress, fire protection, job
hazards, and information on hazardous materials before beginning
work;
c) periodic health and safety training and instruction of seafarers, including
bringing to their attention information concerning particular hazards,

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 which may include audiovisual material, display of posters, articles and
periodicals;
d) periodic safety inspections at least once every three (3) months or more
frequently if there have been substantial changes in the conditions of
work;
e) reporting and correcting hazardous conditions and unsafe practices;
f) investigation and reporting of on-board occupational accidents and
injuries while ensuring the protection of seafarers’ personal data;
g) prevention of occupational accidents, injuries and diseases on board
ship, and for continuous improvement in occupational safety and health
protection, involving seafarers’ representatives and all other persons
concerned in their implementation, taking account of preventive
measures, including engineering and design control, substitution of
processes and procedures and procedures for collective and individual
tasks, and the use of personal protective equipment;
h) fire-prevention and fire-fighting;
i) handling anchors, chains and mooring lines;
j) the effects of drugs and alcohol abuse and dependency;
k) responding to accidents and emergencies;
l) loading & unloading equipment;
m) working on deck, below deck and in machinery spaces;
n) work involving electrical equipment, working at heights/overside & in
enclosed spaces;
o) safe access to ship;
p) safe movement about the ship;
q) dangerous cargo & ballast;
r) HIV/AIDS protection and prevention;
s) harassment and bullying; and
t) potentially hazardous work for young seafarers under the age of 18 years
undertaken only under appropriate supervision and instruction.

3.3.4 Additionally, the shipowner should ensure that the implications for health
and safety are taken into account, particularly in the following areas:

a) emergency and accident response;

b) the effects of drug and alcohol dependency;
c) HIV/AIDS protection and prevention; and
d) harassment and bullying

3.3.5 The Administration has determined after consultation with the shipowners’
and seafarers’ organizations, the following types of work involving the
activities below are potentially hazardous and likely to jeopardize the health

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 and safety of young seafarers under the age of 18 years. When assigning
potentially hazardous work to young seafarers under the age of 18 years, the
shipowner should consider, in particular, work involving the activities
below, but not limited to;

a) the lifting, moving or carrying of heavy loads or objects;

b) entry into boilers, tanks and cofferdams;
c) exposure to harmful noise and vibration levels;
d) operating hoisting and other power machinery and tools, or acting as
signalers to operators of such equipment;
e) handling mooring or towlines or anchoring equipment;
f) rigging;
g) work aloft or on deck in heavy weather;
h) night watch duties;
i) servicing of electrical equipment;
j) exposure to potentially harmful materials, or harmful physical agents
such as dangerous or toxic substances and ionizing radiations;
k) the cleaning of catering machinery; and
l) the handling or taking charge of ship’s boats.

3.3.6 Each ship with five or more seafarers shall establish a safety and health
committee.

3.3.7 Safety and health committee meetings shall be held at least once every
month.

3.3.8 Record keeping documenting the effectiveness of the health & safety
programme for as long as necessary in light of their intended use.

3.3.9 Shipowners shall ensure that the issues raised by the safety committee and
safety inspections are addressed in a timely manner.

3.3.10 The occupational health and safety programme in 3.3.3 above shall also
specify:

a) The duties & responsibilities of the ship owner to comply with the safety
and health policy and programme;
b) The duties & responsibilities of the master to comply with the safety
and health policy and programme;
c) The duties & responsibilities of the master or a person designated by the
master, or both, to take specific responsibility for the implementation of
and compliance with the ship’s occupational safety and health policy
and programme;

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 d) The duties & responsibilities of the seafarers to comply with the safety
and health policy and programme; and
e) The authority of the appointed or elected safety representative to
participate in meetings of the safety & health committee, to have access
to all parts of the ship, to participate in investigation of accidents,
incidents and near-misses, to have access to all necessary
documentation, including investigation reports, past reports of safety &
health committee meetings.
3.3.11 In accordance with Liberian Maritime Regulations RLM-108, shipowners
shall report occupational accidents, injuries and diseases, taking into account
the requirements in chapter 9 of Liberian Maritime Regulations RLM-108.

3.3.12 Shipowners conducting risk evaluation in relation to management of

occupational safety and health shall refer to appropriate statistical
information from their ships and to the statistics of injuries and
deaths provided in the annual report published by the Administration
on the Liberian Registry website:
http://www.liscr.com/maritime/mlc2006-annual-report

3.3.13 The standards for occupational safety and health protection and accident
prevention on Liberian registered ships are reviewed regularly by the
Administration in consultation with the representatives of the shipowners’
and seafarers’ organizations to facilitate continuous improvement in
occupational safety and health policies and programmes and to provide a safe
occupational environment for seafarers on ships that fly its flag.

3.4 Access to shore-based welfare facilities

Seafarers shall be granted shore leave, taking due account of the operational
requirements of their positions, to access shore-based welfare facilities.

3.5 Social security

3.5.1 Countries and territories that are party to MLC, 2006, will ensure the
implementation of the convention requirements relating to social security
protection for seafarers that are nationals or are resident or are otherwise
domiciled in its territory. MLC Regulation 4.5 requires that social security
protection include at least three of the following branches: medical care,
sickness benefit, unemployment benefit, old-age benefit, employment injury
benefit, family benefit, maternity benefit, invalidity benefit and survivors’
benefit, complementing the protection provided for under MLC Regulation
4.1, on Medical care on board ship and ashore and Regulation 4.2, on
shipowners’ liability and under other titles of this Convention.

3.5.2 Shipowners that employ seafarers on board theirs ships that are from a
country or territory that is not a party to MLC, 2006, must ensure the
seafarers are provided with the health and social security protection benefits

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 required under MLC Regulation 4.5, as noted in 3.5.1 above, during the
period of employment with the shipowner.

3.5.3 The Convention provides for arrangements to be developed through bilateral

and multilateral agreements or contribution-based systems, and through
private insurance schemes or in CBA’s or in a combination of these.

3.5.4 The seafarers’ employment agreement or applicable CBA should identify

how the various branches of social security protection will be provided to
the seafarers as well as any other relevant information at the disposal of the
ship owner, such as statutory deductions from the seafarers' wages and ship
owners' contributions which may be made in accordance with the
requirements of identified authorized bodies pursuant to relevant national
social security schemes.

3.5.5 Where the seafarers’ employment agreement or applicable CBA provides

for any of the branches of social security through a mandatory contributory
system, such contributions shall be made as required and properly
recorded.

* * * * *

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 ANNEX I

Evidence of financial security under Regulation 4.2

The certificate or other documentary evidence of financial security required under subparagraph
3.2.2.7 shall include the following information:

(a) name of the ship;

(b) port of registry of the ship;
(c) call sign of the ship;
(d) IMO number of the ship;
(e) name and address of the provider or providers of the financial security;
(f) contact details of the persons or entity responsible for handling seafarers’ contractual claims;
(g) name of the shipowner/crewing manager on whose behalf financial security has been
provided;
(h) period of validity of the financial security; and
(i) an attestation from the financial security provider that the financial security meets the
requirements of Standard A4.2.1.
 ANNEX II

Model Receipt and Release Form referred to in subparagraph 3.2.2.13

Ship (name, port of registry and IMO number):.……………………….……..…….………….…

Incident (date and place): ………………………….………………………………...……..……....

Seafarer/legal heir and/or dependant: …………………………………………….………...……..

Shipowner: …………………………………………………………………..…………...…….….

I, [Seafarer] [Seafarer’s legal heir and/or dependant]* hereby acknowledge receipt of the sum of
[currency and amount] in satisfaction of the Shipowner’s obligation to pay contractual
compensation for personal injury and/or death under the terms and conditions of [my] [the
Seafarer’s]* employment and I hereby release the Shipowner from their obligations under the
said terms and conditions.

The payment is made without admission of liability of any claims and is accepted without
prejudice to [my] [the Seafarer’s legal heir and/or dependant’s]* right to pursue any claim at law
in respect of negligence, tort, breach of statutory duty or any other legal redress available and
arising out of the above incident.
Dated: ……………………………………………………………………….………………….…

Seafarer/legal heir and/or dependent: ………………………………………………………..……

Signed: …………………..……