10-04-03 SIGN OFF Forms

SIGNING OFF CREW MEMBER

VACCATION, END OF CONTRACT

(Company logo)

VESSELS NAME

TO:                             

FROM:                     

E-MAIL on board:  

DATE:                      

Full name____________________________Nationality_________________________

Department__________________________ Position or Rank____________________

Date - beginning of contract_______________________________________________

Requested Date to sign off_________________________________________________

Reason (please be as specific as possible)_____________________________________

This is the confirmation, that the crewmember received all the regular company payments (ITF confirm).

The company is responsible to arrange and pay the home transfer to the home airport or to the home train station.

Crew member’s signature_________________________________________________

Head of Department’s signature____________________________________________

                                                           (please indicate name & position)

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MEDICAL - LEAVE

(Company logo)

VESSELS NAME

TO:                           

FROM:                     

E-MAIL on board:  

DATE:                      

This request must be filled in and signed from a Doctor!

The Employer “must” have the Doctors original documentation, otherwise he will not have the support from the ship insurance.

Full name____________________________Nationality_________________________

Department__________________________ Position or Rank____________________

Date - beginning of contract_______________________________________________

Requested Date to sign off_________________________________________________

Reason (please be as specific as possible)_____________________________________

Crew member’s signature_________________________________________________

Head of Department’s signature____________________________________________

                                                           (please indicate name & position)

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SIGNING OFF CREW MEMBER

VACCATION, END OF CONTRACT

(Company logo)

VESSELS NAME

TO:                             

FROM:                     

E-MAIL on board:  

DATE:                      

Full name____________________________Nationality_________________________

Department__________________________ Position or Rank____________________

Date - beginning of contract_______________________________________________

Requested Date to sign off_________________________________________________

Reason (please be as specific as possible)_____________________________________

This is the confirmation, that the crewmember received all the regular company payments (ITF confirm).

The company is responsible to arrange and pay the home transfer to the home airport or to the home train station.

Crew member’s signature_________________________________________________

Head of Department’s signature____________________________________________

                                                           (please indicate name & position)

*********************************************************************************************************************

COMPASSIONATE LEAVE

(Company logo)

VESSELS NAME

TO:                           

FROM:                     

E-MAIL on board:

DATE:                      

Full name____________________________Nationality_________________________

Department__________________________ Position or Rank____________________

Date - beginning of contract_______________________________________________

Date to sign off___________________________________________________________

This is the confirmation, that the Employer has received all the payments during the whole contract in a serious and fair way like from ITF required.

The Employee must pay the HOMEFLIGHT                        YES…………………NO

The Employee must pay the flight of the Replacement        YES…………………NO

The Employee will get the leave payment                              YES…………………NO

I understand that all repatriation expenses will be deducted from wages or other amounts due to me. (except the company take over all the costs or a part of the expenses spontaneous)

Crew member’s signature_________________________________________________

Head of Department’s signature____________________________________________

                                                           (please indicate name & position)

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RESIGNATION

(Company logo)

VESSELS NAME

TO:                           

FROM:                     

E-MAIL on board:  

DATE:                      

This resignation form must be filled out 14 days before the crew member wants to leave the vessel. The crew member must pay all the expenses from his own pocket. The company has to arrange the home flight and the transfer to the airport ect. Furhter the company will handle all the important questions with the authorities which are necessary for the disembarkation.

If the resignation form was not filled out minimum 14 days before, in that case the company can keep the money also for the coming replacement!

Full name____________________________Nationality_________________________

Department__________________________ Position or Rank____________________

Date - beginning of contract_______________________________________________

Requested Date to sign off_________________________________________________

Reason (please be as specific as possible)_____________________________________

I understand that all expenses will be deducted from wages or other amounts due to me.

Crew member’s signature_________________________________________________

Head of Department’s signature____________________________________________

                                                           (please indicate name & position)

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