Prc-Mdo Form 5 Blank
Prc-Mdo Form 5 Blank
Prc-Mdo Form 5 Blank
01/11-04-2000
NOT FOR SALE Republic of the Philippines PROFESSIONAL REGULATION COMMISION Cagayan de Oro City BOARD OF MARINE DECK OFFICERS
had actually served under our SINGAPORE (State the Nationality of Vessel) 27735 gross tonnage
supervision on board
387775
This certifies further that the above-stated data are all true and that any false statement/s made
Mr. Marlon P. Trinidad / Fleet Head Name and Signature of Port Captain/ Personnel Mgr Magsaysay Maritime Corporation Name of Local Shipowner or Manning Agent Address: Antonio Bldg., 520 T.M. Kalaw Ermita, Manila Telephone Nos. 526-8888/526-9692/5269724
MasterSignature Above Printed Name Nationality : Kind of License : Registration No. : Date of Registration : Expiry Date :
SUBSCRIBED AND SWORN TO before me this_________day of _________________,2010, at _______________________. Doc. No. Page No. Book No. Series of :__________ :__________ :__________ :__________
NOTARY PUBLIC
Note: This form is good only for (1) Vessel. This form can be reproduced. Any erasure/ obliteration may be a ground for denial.
FOR SALE
under our
f Vessel)
ross tonnage
9 harge)
NOT FOR SALE Republic of the Philippines PROFESSIONAL REGULATION COMMISION Cagayan de Oro City BOARD OF MARINE DECK OFFICERS
had actually served under our SINGAPORE (State the Nationality of Vessel) 27735 gross tonnage
supervision on board
387776
This certifies further that the above-stated data are all true and that any false statement/s made
Mr. Marlon P. Trinidad / Fleet Head Name and Signature of Port Captain/ Personnel Mgr Magsaysay Maritime Corporation Name of Local Shipowner or Manning Agent Address: Antonio Bldg., 520 T.M. Kalaw Ermita, Manila Telephone Nos. 526-8888/526-9692/5269724
MasterSignature Above Printed Name Nationality : Kind of License : Registration No. : Date of Registration : Expiry Date :
SUBSCRIBED AND SWORN TO before me this_________day of _________________,2010, at _______________________. Doc. No. Page No. Book No. Series of :__________ :__________ :__________ :__________
NOTARY PUBLIC
Note: This form is good only for (1) Vessel. This form can be reproduced. Any erasure/ obliteration may be a ground for denial.
FOR SALE
under our
f Vessel)
ross tonnage
00 harge)
NOT FOR SALE Republic of the Philippines PROFESSIONAL REGULATION COMMISION Cagayan de Oro City BOARD OF MARINE DECK OFFICERS
had actually served under our , (Name of Vessel) (Type of Vessel) vessel of (Near Coastal/Seagoing) of (State the Nationality of Vessel) gross tonnage
supervision on board
from
to (Date of Embarkation)
(Date of Discharge)
This certifies further that the above-stated data are all true and that any false statement/s made
MasterSignature Above Printed Name Nationality : Kind of License : Registration No. : Date of Registration : Expiry Date :
Telephone Nos.
SUBSCRIBED AND SWORN TO before me this_________day of _________________,2010, at _______________________. Doc. No. Page No. Book No. Series of :__________ :__________ :__________ :__________
NOTARY PUBLIC
Note: This form is good only for (1) Vessel. This form can be reproduced. Any erasure/ obliteration may be a ground for denial.
OT FOR SALE
ed under our
ischarge)