Merchant Shipping Act, 1951 (Act No. 57 of 1951)RegulationsMerchant Shipping (Seamen's Documents) Regulations, 2000AnnexesAnnex 3 : Report by Master in terms of Section 113(4) of Act 57 of 1951 |
ANNEX 3
(Regulation 6)
REPUBLIC OF SOUTH AFRICA
SOUTH AFRICAN MARITIME SAFETY AUTHORITY
REPORT BY MASTER IN TERMS OF SECTION 113(4) OF ACT 57 OF 1951
Remarks:
| (1) | When a seaman is discharged and the master declines to express an opinion on the conduct, character and ability of the seaman, the master shall complete this form in duplicate and hand it to the proper officer, who shall retain one copy and forward the other copy to the South African Maritime Safety Authority, P.O. Box 13186 Hatfield 0028, Republic of South Africa. |
| (2) | In Division D the master shall merely record that he or she declines to express an opinion on the aforesaid features. If the seaman desires it, a copy of this report shall be handed to him or her, or the master's statement shall be endorsed in the seaman's record book. |
| (3) | This form must be signed by the master. |
A. DESCRIPTION OF SEAMAN
Surname (in block letters) |
First names (in block letters) |
Date, place and country of birth |
Rank |
No. of record book |
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B. DETAILS OF SHIP
Name of ship |
Port of registry |
Official number |
Gross tonnage |
*Power |
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C. DETAILS OF ENGAGEMENT AND DISCHARGE OF SEAMAN
Port of engagement |
Date of engagement |
Description of voyage or employment |
Port of discharge |
Date of discharge |
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D. STATEMENT BY MASTER
| .......................................................................................................................................... |
| .......................................................................................................................................... |
| .......................................................................................................................................... |
| Port where from complete ............................................................................................. |
Date................................................. |
................................................................... |
Signature of master |
E. STATEMENT BY SEAMAN
| .......................................................................................................................................... |
| .......................................................................................................................................... |
| .......................................................................................................................................... |
| Port where statement made ............................................................................................ |
Date................................................. |
................................................................... |
Signature of seaman |
F. REPORT BY PROPER OFFICER
| .......................................................................................................................................... |
| .......................................................................................................................................... |
| .......................................................................................................................................... |
| Port ................................................................................................................................ |
................................................................... |
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Signature of proper officer |
OFFICIAL DATE STAMP
| * | In the case of a radio officer, the type of radio installation on the ship must also be inserted. |