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Stödig Ship Management
MAN/SOM/ENG-0733
Approved: Revision 03 / 31.12.2019

Manuals • Ship Operation Manual • Engine Instruction

Bunkering instruction - Dry Cargo vessels (CSR)
1. PURPOSE
The purpose of this procedure is to describe guidelines for bunkering of fuel and lube oil.
2. SCOPE
This procedure applies to the dry cargo and survey vessels.
3. RESPONSIBILITY
The Chief Engineer has the overall responsibility for the bunkering operations and is responsible for filling in the check lists.
The Master is responsible to verify that the checklist(s) has been completed (for dry cargo vessels the verification can be done by either the Master
or the Chief Engineer).
The Officer of the watch is responsible for moorings to the pier, barges etc., and for ensuring that bunker hoses and their equipment do not become
snagged or fouled in any way.
4. DEFINITIONS
Fuel / lube oil: Ref. definition in the Stödig bunker specifications.
5. DESCRIPTION
5.1 Preparation
Chief Engineer is responsible to prepare a bunkering plan stating:
In which order the tanks are to be filled.
The level in the tank after bunkering.
The pumping rate.
Agreement between vessel and supplier about shore stop or ship stop when bunkering is completed.
Written agreement concerning bunker transfer shall be made between the vessel and terminal or between vessel and vessel.
5.1.1 Fuel oil Bunker Delivery Note (BDN)
Before the bunkering starts the supplier must pass over to the ship a Bunker Delivery Note (BDN) declaring fuel conformity to IMO Regulation
Annex VI.
The BDN shall be signed by suppliers representative and contain specific information as follows:
Name and IMO no. of receiving vessel.
Bunkering Port.
Date of commencement of bunkering.
Name, address and telephone number of fuel oil supplier.
Product name.
Quantity MT.
Density at 15 `C.
Sulfur content %.
A declaration signed and certified by the fuel oil supplier`s representative that the fuel oil supplied is in conformity with the applicable paragraph
of regulation 14.1 or 14.4 and regulation 18.3 of MARPOL Annex VI
Example of text for suppliers`s declaration:
I certify that the fuel oil supplied is in conformity with regulation 18.3 of MARPOL Annex VI and that the sulfur content does not
exceed:
-0,5% m/m (delete appropriate) as per the limit value in regulation 14.1 of MARPOL Annex VI; except for ships using "equivalent"
compliance mechanisms.
-0,10% m/m as per the limit value in regulation 14.4 of MARPOL Annex VI: or
-the purchaser`s specified limit value of _______ (% m/m)
If BDN parameters is not in accordance to requested / ordered fuel oil quality, the fuel oil shall not be taken onboard.
The BDN shall be retained onboard for a period of three (3) years after oil has been delivered onboard.
 5.1.2 Fuel oil sampling
All fuel oil taken onboard has to be sampled at our vessels bunker manifold.. A continuous drip sample has to be taken during the bunkering into a
container and then distributed to sample bottles at completion.
The supplier will as well hand over samples taken by them, make sure to witness where and when those samples are taken before you sign
those documents connected to it.
If a bunker surveyor is used, this person might be our representative.

5.2 Accomplishment of bunkering

The bunkering shall be carried out in accordance to the actual bunker check-list.
When the tank is 80 % full, the bunkering rate should be reduced if required.
Commencement and completion of bunkering operation shall be reported to the Officer of the watch.
Time of completion shall be recorded in the engine log book.
After completion of bunkering operation, blank flanges must be fitted and fully bolted. Tank filling valves shall be closed.
In case of any accidents or spills, the Master shall be informed without delay in order to inform local authority (Ref. CM/SOPEP/SMPEP).
5.2.1 Watchman
During bunkering, one person shall be standby at the bunkering connection responsible to monitor unauthorised access to the vessel and pollution.
In case of emergency he shall stop the flow immediately.
The contact between the Officer in charge of the bunkering and bunkering watch shall be via UHF/VHF.
5.3 Check lists
The Stödig Bunker Check-list shall be completed and adhered to.
5.4 Records
All bunkering operations shall be recorded in:
Engine Log Book records shall contain: start and stop times, quantity bunkered, type of bunker and sulphur content (if applicable).
Oil Record Book Part 1 records shall follow the Guidance for the recording of operations in the Oil Record Book Part 1 - Machinery
space operations(ref. IMO MEPC.1/Circ.736/Rev.2).
Bunker quantity received: Both BDN quantity and measured quantity shall be recorded in both log books. If there is a deviation between BDN
and measured quantity more than 2% - a letter of protest has to be issued. (use vessels experience factor as well if mentioned level is outside
your experience)

References

Type Title Number

QA Document Bunkering permit - Dry Cargo (CSR) BFT/WPS/WPS-1710

QADocument Letter Of Protest - shortage of bunker BFT/TMA/TMA-2320

Attachment IMO-MEPC.1-Circ.736-Rev.2.pdf N/A

Exported by: Helge Hals/SSM @ 2023-01-20T10:42:13.246+01:00

 E

4 ALBERT EMBANKMENT
LONDON SE1 7SR
Telephone: +44 (0)20 7735 7611 Fax: +44 (0)20 7587 3210

MEPC.1/Circ.736/Rev.2
6 October 2011

GUIDANCE FOR THE RECORDING OF OPERATIONS IN THE OIL RECORD BOOK

PART I – MACHINERY SPACE OPERATIONS (ALL SHIPS)

1 The Marine Environment Protection Committee, at its sixty-second session,

(11 to 15 July 2011), approved a revised text of the Guidance for recording of operations in the
Oil Record Book Part I – Machinery space operations (all ships) (MEPC 62/24, paragraph 7.23),
set out in the annex.

2 The Guidance is intended to facilitate compliance with MARPOL requirements

on board ships by providing advice to crews on how to record the various operations in the Oil
Record Book by using the correct codes and item numbers in order to ensure a more uniform
port State control procedure.

3 Administrations of Parties to MARPOL are invited to encourage implementation of the

annexed Guidance for use aboard ships flying their flags and to disseminate it among all
stakeholders including ship operators, surveyors and port State control officers.

4 This circular revokes MEPC.1/Circ.736/Rev.1.

***

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Annex, page 1

ANNEX

GUIDANCE FOR RECORDING OF OPERATIONS IN THE OIL RECORD BOOK

PART I – MACHINERY SPACE OPERATIONS (ALL SHIPS)

General Guidance

 This guidance only includes sections C to I.

 Operations should be recorded in chronological order as they have been executed
on board.
 Dates should be entered in dd-MONTH-yyyy format, e.g. 16-MAR-2009.
 Incineration or landing ashore of oily garbage and used filters should be recorded in the
Garbage Record Book only.
 All Entries are to be made and signed by the officer or officers in charge of the operations
concerned and each completed page shall be signed by the master of the ship.
 Do not leave any full lines empty between successive entries.
 If a wrong entry has been recorded in the Oil Record Book (ORB), it should immediately
be struck through with a single line in such a way that the wrong entry is still legible.
The wrong entry should be signed and dated, with the new corrected entry following.
 Tank nomenclature should be recorded as per the format noted within the International
Oil Pollution Prevention Certificate (IOPPC).
 Recording of quantities retained in bilge water holding tanks listed under section 3.3 of
the IOPPC is voluntary and not required by the Convention.
 The recording of general maintenance of items pertaining to the OWS remains voluntary
and is not required to be recorded in the ORB.

Usage of code C.11: Collection of oil residues (sludge)

Example #1

Weekly inventory of oil residues (sludge) tanks (tank listed under item 3.1 in the Supplement to
the IOPPC)

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 11.1 [Name of sec 3.1 Tank & Designation]
11.2 xx m3
11.3 xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy
dd-MONTH-yyyy C 11.1 [Name of sec 3.1 Tank & Designation]
11.2 xx m3
11.3 xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

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Annex, page 2

Example #2

Recording of oil residue (sludge) collected by manual operation in oil residue (sludge) tank (tank
listed under item 3.1 in the Supplement to the IOPPC)*

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 11.1 [Name of sec 3.1 Tank & Designation]
11.2 xx m3
11.3 xx m3
11.4 xx m3 collected from [identification of source]
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: Operator initiated manual collection where oil residue (sludge) is transferred (transfer
with a pump) into the oil residue (sludge) tank(s). Examples of such operations could
be:

1.
Collection of oil residue (sludge) from fuel oil separator drain tanks.
2.
Collection of oil residue (sludge) by draining engine sump tanks.
3.
Adding fuel oil to an oil residue (sludge) tank (all content of a sludge tank is
considered sludge).
4. Collection of sludge from bilge water holding tanks – in this case a disposal
entry for bilge water is also needed.
_______________
*
Use of Code Item Number C 11.4 only becomes applicable in accordance with MARPOL Annex I amendments
which enter into force on 1 January 2011 (resolution MEPC.187(59)).

Usage of code C.12: Disposal or Transfer of oil residues (sludge)

Example #3

Disposal of oil residue (sludge) via shore connection

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 12.1 xx m3 sludge from [Name of sec 3.1 Tank & Designation],
xx m3 retained,
to "identity or name of sludge receiver, i.e. barge, tank truck or
shore facility" during port stay (Name of Port)
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: Ships' masters should obtain from the operator of the reception facilities, which includes
barges and tank trucks, a receipt or certificate detailing the quantity of oil residue
(sludge) transferred, together with the time and date of the transfer. This receipt or
certificate, if attached to the Oil Record Book Part I, may aid the master of the ship in
proving that his ship was not involved in an alleged pollution incident. The receipt or
certificate should be kept together with the Oil Record Book Part I.

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Example #4

Draining of water (disposal) from an oil residue (sludge) tank listed under item 3.1 in the
Supplement to the IOPPC, to a bilge water holding tank listed under item 3.3 in the Supplement
to the IOPPC

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 12.2 xx m3 water drained from [Name of sec 3.1 Tank & Designation]
xx m3 retained,
to [Name of sec 3.3 Tank & Designation] retained in tank(s)
xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: Collection of bilge water need not to be accounted for, so only one entry is required.
Capacity of sludge tanks should not be recorded for C.12.x entries.

Example #5

Transfer from one oil residue (sludge) tank to another oil residue (sludge) tank, both listed under
item 3.1 in the Supplement to the IOPPC

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 12.2 xx m3 sludge transferred from [Name of sec 3.1 Tank &
Designation], xx m3 retained,
to [Name of sec 3.1 Tank & Designation] retained in tank(s)
xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #6

Incineration of oil residue (sludge) in Incinerator

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 12.3 xx m3 sludge from [Name of sec 3.1 or 3.2.3 Tank &
Designation], xx m3 retained,
Burned in Incinerator for xx hours
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #7

Burning of oil residue (sludge) in Boiler

Item
Date Code Record of operation and signature of officer in charge
No.
dd-MONTH-yyyy C 12.4 xx m3 sludge from [Name of sec 3.1 Tank & Designation],
xx m3 retained,
Burned in Boiler for xx hours
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

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Annex, page 4

Example #8

Evaporation of water (disposal) from an oil residue (sludge) tank listed under items 3.1 in the
Supplement to the IOPPC

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 12.4 xx m3 water evaporated from [Name of sec 3.1 Tank &
Designation], xx m3 retained.
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #9

Regeneration of fuel oil from oil residue (sludge)*

Item
Date Code Record of operation and signature of officer in charge
No.
dd-MONTH-yyyy C 12.4 xx m3 sludge disposed by regeneration of x m3 fuel in [Fuel Tank
& Designation] and x m3 of water in [Name of sec 3.3 Tank &
Designation]
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy
_______________
*
Only permitted if mentioned as an approved means of disposal in the IOPPC Supplement.

Usage of code D: Non-automatic starting of discharge overboard, transfer or disposal

otherwise of bilge water which has accumulated in machinery spaces

Example #10

Pumping of bilge water from engine-room bilge wells to a tank listed under item 3.3 in the
Supplement to the IOPPC
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy D 13 xx m3 bilge water from engine-room bilge wells,
14 Start: hh:mm, stop: hh:mm
To [Name of sec 3.3 Tank & Designation], retained in tank(s)
15.3 xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #11

Transfer of bilge water between tanks listed in item 3.3 in the Supplement to the IOPPC
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy D 13 xx m3 bilge water from, [Name of sec 3.3 Tank & Designation], xx
m3 retained,
14 Start: hh:mm, stop: hh:mm
To [Name of sec 3.3 Tank & Designation], retained in tank(s)
15.3 xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

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Annex, page 5

Example #12

Pumping of bilge water overboard from tank listed in item 3.3 in the Supplement to the IOPPC
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy D 13 xx m3 bilge water from [Name of sec 3.3 Tank & Designation]
Capacity xx m3, xx m3 retained
14 Start: hh:mm, stop: hh:mm
15.1 Through 15 ppm equipment overboard
Position start: xx deg xx min N/S, xx deg xx min E/W
Position stop: xx deg xx min N/S, xx deg xx min E/W
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #13

Disposal of bilge water from tank listed in item 3.3 in the Supplement to the IOPPC to oil residue
(sludge) tank listed in item 3.1 in the Supplement to the IOPPC
Item
Date Code Record of operation and signature of officer in charge
No.
x m3 bilge water from [Name of sec 3.3 Tank & Designation],
dd-MONTH-yyyy D 13 now xx m3
14 Start: hh:mm stop:, hh:mm
Collected in [Name of sec 3.1 Tank & Designation] retained in
15.3 tank(s) xx m3
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: A code C.11.4 recording may be required if this operation is a manual operator initiated
operation.

Usage of code E: Automatic starting of discharge overboard, transfer or disposal

otherwise of bilge water which has accumulated in machinery spaces

Example #14

Pumping of bilge water overboard via 15 ppm equipment from tank listed in item 3.3 in the
Supplement to the IOPPC or from engine-room bilge wells
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy E 16 Pump start hh:mm at xx deg xx min N/S, xx deg xx min E/W from
[Name of sec 3.3 Tank & Designation]
18 Stop hh:mm
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

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Annex, page 6

Example #15

Transfer of bilge water from engine-room bilge wells to a tank listed under item 3.3 in the
Supplement to the IOPPC
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy E 17 Transfer start hh:mm to
[Name of sec 3.3 Tank & Designation]
18 Stop hh:mm
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Usage of code F: Condition of oil filtering equipment

Example #16

Failure of Oily Filtering Equipment, Oil Content Meter or stopping device

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy F 19 hh:mm
20 hh:mm (might be unknown – if spare parts has been ordered)
21 [Reason for Failure, if known]
signed: (Officer-in-charge, Name & Rank dd-MONTH-yyyy

Note: The condition of the oil filtering equipment also covers the alarm and automatic
stopping devices, if applicable.

A code 'I' entry should also be made indicating that the overboard valve was sealed
shut due to non working Oil Filtering Equipment or Oil Content Meter.
On the date where the system is functional again, a new entry, using
code F 19 / 20 / 21 should be made where F 19 is the date and time of the initial failure
and F 20 is the time the system is functional again.

Example #16bis

When proper operation of the Oily Filtering Equipment, Oil Content Meter or stopping device is
restored
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy F 19 hh:mm (the same time as in example 16)
20 hh:mm (the time the system is functional)
21 [Reason for Failure, if known]
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: The condition of the oil filtering equipment also covers the alarm and automatic
stopping devices, if applicable.
A code 'I' entry should also be made indicating that the overboard valve was unsealed
since the operation of the Oil Filtering Equipment or Oil Content Meter has been
restored.

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Annex, page 7

Usage of code G: Accidental or other exceptional discharges of oil

Example #17
Accidental Pollution
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy G 22 hh:mm
23 Place or Position: xx deg xx min
24 Type and Quantity of oily residue (if known)
25 Circumstances of the discharge
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: If failure of Oil Filtering Equipment or Oil Content Meter related equipment is involved,
appropriate (F) entry is to be made in ORB.
Relevant sections of the SOPEP (SMPEP) are to be used to combat oil spills at sea.
Examples of Circumstances of discharge include, but are not limited to:
1. Oil Content Meter failure.
2. Fuel tank overflow.
3. Ruptured bunkering hose/flange.
4. Fuel tank leakage (due to collision or grounding).

Usage of code H: Bunkering of fuel or bulk lubricating oil

Example #18
Bunkering of Fuel oil
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy H 26.1 [Name of Port]
26.2 Start dd-MONTH-yyyy-hh:mm Stop dd-MONTH-yyyy-hh:mm
26.3 xxxx MT of ISO-xxxxx HFO x.x % S bunkered in tanks:
aaaa MT added to [Tank Name & Designation] now containing
bbbb MT
cccc MT added to [Tank Name & Designation] now containing
dddd MT
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #19
Bunkering of Bulk Lubricating oil
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy H 26.1 [Name of Port]
26.2 Start dd-MONTH-yyyy-hh:mm Stop dd-MONTH-yyyy-hh:mm
26.4 xx MT [Type of Oil] bunkered in tanks:
xx MT added to [Tank Name & Designation] now containing xx
MT
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

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Annex, page 8

Note: Separate entries required for each grade of fuel oils and lubricating oils respectively to
ensure transparency.
This entry is not required if lubricating oils are delivered onboard in packaged form
(55 gallon drum, etc.).

Usage of code I: Additional operational procedures and general remarks

Example #20

Pumping oily bilge water from a Cargo Hold bilge holding tank to a tank listed under item 3.3 in
the Supplement to the IOPPC
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy I xx m3 oily bilge water from Cargo Hold bilge holding tank
to [Name of sec 3.3 Tank & Designation]
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: Any collection and transfer of oily bilge water into the engine-room bilge holding tank(s)
from a cargo hold bilge holding tank(s) should be recorded using code (I)

Example #21

Entry pertaining to an earlier missed operational entry

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy (1) I Entry pertaining to an earlier missed operational entry
xx m3 sludge transferred from [Name of sec. 3.1 Tank and
dd-MONTH-yyyy (2) C 12.2 Designation], xx m3 retained
to [Name of sec 3.1 Tank & Designation], retained in tank(s) xx
m3
signed (1): (Officer-in-charge, Name & Rank) dd-MONTH-yyyy
signed (2): (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: Date (1) to be the date of the original operation.

Date (2) to be the current date i.e. the date the entry is made.
Signed (1) Signature of Officer making I entry
Signed (2) Signature of Officer making missed entry

Example #22

De-bunkering of Fuel oil

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy I xxxx MT of ISO-xxxxx HFO x.x % S de-bunkered from tanks:
xxxx MT removed from [Tank Name & Designation] now
containing xxx MT
De-bunkered to "identity or name of receiver i.e. barge, tank
truck or shore facility" in "Name of Port"
Start dd-MONTH-yyyy; hh:mm Stop dd-MONTH-yyyy; hh:mm
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy
Note: Include receipt & certificate from receiver for amount & type of fuel oil de-bunkered.

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Tankers with slop tanks

Example #23

Transfer of sludge from engine-room oil residue (sludge) tank to deck/cargo slop tank
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy C 12.4 xx m3 sludge from [Name of sec 3.1 Tank & Designation],
xx m3 retained,
Transferred to Deck Slop Tank [designation]
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #24

Transfer of bilge water from tank listed in item 3.3 in the Supplement to the IOPPC to deck/cargo
slop tank
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy D 13 xx m3 bilge water from [Name of sec 3.3 Tank & Designation]
Capacity xx m3, xx m3 retained
14 Start: hh:mm, stop: hh:mm
15.3 Transferred to Deck Slop Tank [designation]
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Note: Requires this method listed in the IOPP Supplement under item 3.2.3.
If non-oil-cargo related oily residues are transferred to slop tanks of oil tankers, the
discharge of such residues should be in compliance with Regulation 34. (UI 22.1.1 for
Regulation 15).
Requires an entry in the Oil Record Book – Part II using code (J).
If sludge or bilge water is transferred from multiple tanks in engine-room a separate
entry must be made in ORB Parts I & II for each transfer.

General Guidance – Additional Voluntary Recordings

Example #25

Voluntary declaration of quantities retained in bilge water holding tanks ref. MEPC.1/Circ.640 –
record weekly
Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy I Weekly Inventory of Bilge Water Tanks (listed under item 3.3)
[Name of sec 3.3 Tank & Designation]
capacity xx m3, xx m3 retained
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

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Annex, page 10

Example #26

Optional sealing of MARPOL Annex I related valve and/or equipment

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy I Overboard valve [Valve Number] from 15 ppm bilge water
separator unit sealed
seal No.: xxxxxxx,
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

Example #27

Breaking of optional seal on MARPOL Annex I related valve and/or equipment

Item
Date Code Record of operations/signature of officer in charge
No.
dd-MONTH-yyyy I Overboard valve [Valve Number] from 15 ppm bilge water
separator unit unsealed
for normal operation of 15 ppm unit
seal No.: xxxxxxx
signed: (Officer-in-charge, Name & Rank) dd-MONTH-yyyy

___________

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