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_______________________________________________________________________________________________

FORM OF TESTIMONIAL FOR SEA-SERVICE


(For Ministry of Surface Transport Examination purpose only)

I, certify that the following is a full and true statement of sea service performed by Mr. NAME
CDC No: XXXXXXX under my supervision in VESSEL NAME Off.No.XXXX/IMO NO: XXXXXXX Port of
Registry: XXXXX
Period of service
From

To

Rank of Officer and


actual seniority on
watch

Type of Main Engines and Boiler,


Single or Twin Screw KW

Nature of duties(for
appropriate
description see
below)

ME MAKE / MODEL / TYPE, MCR KW AT


MCR RPM, VESSEL PROPULSION TYPE,
BOILER & ECONOMIZER DETAILS WITH
CAPACITIES , GENERATOR DETAILS,
CARGO GEAR DETAILS

DD/MMM/Y DD/MMM/Y
YYY
YYY

RANK

EXAMPLE(BULK CARRIER): HITACHI B&W


6L60MC SINGLE SCREW, 11700 BHO@111
RPM ON HF MANOEUVRING FORCED
CIRCULATION FIN TYPE EXHAUST GAS
ECONOMISER DC 071414 WITH 510
SQ.MTR HEATING SURFACE VERTICLE
WATER TUBE BOILER TYPE AQ 3 WORKING
PR. 7 KG/CM2, YANMAR 6GLET AUX
ENGINES RUNNING IN IFO 4 X 780 KW
ELECTRO HYDRAULIC CRANES
HAGGLUNDS TYPE K 2524

IV (a)

During the whole period stated above he was on articles of agreement.


No. of days actual spent at sea: XXX DAYS (IN WORDS )

Reports as to:
Ability
: VERY GOOD
Conduct : VERY GOOD
Sobriety : STRICTLY SOBER

___________________________
Sign. Of Master or Engr. Supt.

___________________________
Sign. Of Chief Engineer Officer.

(Name Of Master or Engr. Supt.)

(Name Of Chief Engineer Officer)


Dated

at_

__________________________________________________________________________________________________________
DESCRIPTION OF DUTIES
I

On fitters work either by day or regular watch.


a)
Within Main Engine and Boiler Spaces.
b)
Out side Main Engine and Boiler Spaces.
c)
On refrigerating or other machinery not
essential to the propulsion of the vessel
d)
On Auxiliary Engines separated from main
propelling units, but worked in conjunction
therewith
II On regular watch on Main Engines as
a)
Senior in full charge.
b)
First Assistant
c)
Second Assistant
III On Regular watch on Main Boiler
a)
In-charge of all stoke holds.
b)
In-charge of section or one stoke hold only
c)
As boiler room Assistant

IV On regular watch on Main Engines and Boilers Simultaneously.


a) Senior in full charge
b) First Assistant
c) Second Assistant.
In ships where watches are kept on other than tradition
system of not less that eight out of each twenty four
hours, a brief description of the duration and frequency
of the watches should be given.
Mention of periods on day work or on fitters work watch
should be made. This is particularly applicable to vessels that
1. Have a centralized control room
2. Are fully or partly automated
3. Have arrangements such as the engine room is
unmanned for Some part of the twenty four hours.

NOTE: It is recommended that this form should be used when the Engineer is reported on or when the Chief
Engineer leaves the ship.

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FITNESS FOR DUTY


Drug and Alcohol Abuse

1
0

REPORT______________________________________________________________________
_______________________________________________________________________________________________
VOYAGE PLANNING
General
Watch-keeping Arrangements

1
0

REPORT_______N/A_____________________________________________________________________
_______________________________________________________________________________________________
WATCH-KEEPING AT SEA
Protection of Marine Environment
Taking over the Watch
Performing the Engineering Watch
Watch-keeping in different
conditions/Areas
Restricted Visibility
Coastal and Congested waters
Ship at Anchor

1
0

REPORT__________N/A
_______________________________________________________________________________________________
WATCH-KEEPING IN PORT
Taking over the Engineering
Watch
Performing the Engineering
Watch
Protection of Marine
Environment

1
0

REPORT_______N/A______________________________________________________________________
_______________________________________________________________________________________________
Signature of Chief Engineer____XXXXXXXXXXXX___NAME

Certificate of Competency No. __XXXXXXXX__


ISSUING
AUTHORITY____D.G.SHIPPING,_GOVT. OF INDIA_____
NOTE: In the boxes above, please circle or tick the marks given by you out of 10 against each
heading.
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