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Ref No : 204401/5 ID 204401
EMPLOYMENT OFFER
Dear Mr. IVAN YEREBAKAN,
Marlow Navigation Netherlands B.V. is pleased to offer you employment on board. The details of the proposed engagement are specified in section 1.
Your Seafarer Employment Agreement shall be prepared closer to the actual date of your embarkation. In the meantime, you are kindly requested to
review and confirm acceptance of this Employment Offer via your manning agent. Additionally, in order to enable us prepare your Employment
Agreement for this assignment you are kindly requested to:
1. Review all information in sections 4 and 5 and revert with updates / corrections as appropriate.
2. Review the list of missing documentation in section 6 and provide copies as appropriate. In case certain documents are not in your possession
yet, please indicate when you expect to have them on hand.
Note: The original documentation as specified in sections 5 & 6 must be taken on board.
3. Review and acknowledge open Training Needs (and proposed actions to address these shortcomings) as specified in section 7 (if applicable).
4. Confirm your acceptance of the Employment Offer in writing to your Manning Agency.
5. In preparation for the below proposed assignment during COVID times, you are required to view the following video:
https://cutt.ly/Marlow-Covid
For your own safety and the safety of others, all instructions mentioned in the above video must be strictly complied with, specifically, self-
quarantine for at least 14 days prior your departure, (with the exception of any essential actions for the issuance/renewal of documents
required for joining such as medicals etc), checking and recording your temperature daily and then submitting the form to your agent/crew
manager at the time of S.E.A issuance prior dispatch/travel to the airport etc.
Disclaimer: This is only a provisional offer for employment and not the Employment Agreement itself and therefore is of no value. Although all
efforts will be made to ensure your joining as offered, the Company reserves the right to amend this offer in part or full, or cancel it completely due to
unforeseen circumstances beyond the Company's control. In such case however, you will be notified of the changes or cancellation immediately.
1. Vessel & Proposed Seafarer Employment Agreement Details

Vessel Name: AS FATIMA Vessel Type: CONT Vessel Subtype: 2ND IMO No: 9437191
GENERATION
Rank: ECAD Port (tentative):PIRAEUS, Date(tentative): 15.07.2021 SEA Duration: SIX MONTHS
ATHENS
Vessel Flag: PMD Salary Splitup: 205+59.20(1.48x40)+SA152+8DS(54.80)=471 USD
SEA Type: ITF / VER.DI / IMEC-IBF Union Agreement: VER.DI/ITF BERLIN IMEC IBF GMP CBA 2019-2022
SEA Remarks:
2. Generic / Employment-specific Information

Working Clothes: YES Working Clothes Remarks: None
Laid up Agreement required: N Induction Checklist required: N
3. Crew Superintendent Details
Superintendent DAVE FRANKEN Office Tel: Mobile: Email: N3@marlownavigation.nl
4. Seafarer Personal Details
Family Status: SINGLE No. of Children: 0 Telephone: Mobile: 380-96-5123147
Email: erebakanv300@gmail.com Main Airport: ODESSA Alternative Airport:
Home Address: 3a, Kvitkovyy Lane, Izmail, UKRAINE 68600
Seafarer is requested to complete and return the consent form in order to update his records and proceed with employment. S.E.A. cannot
be issued without the form consent / data
5. Seafarer Personal Documentation

The following documents (as per our database records) have been reviewed and are considered as acceptable / required for the proposed assignment.
Originals are to be hand carried on board accordingly:
Documentation Name Doc No. Nat. Issued Expiry Applied I Remarks

Passport FX547320 UKR 02.10.2019 02.10.2029 Y
Passport Photo (Colour) N/A UKR 23.02.2021 23.02.2026 Y
Seamans Book (National) AB670171 UKR 22.10.2020 22.10.2025 Y
Advanced Fire Fighting CERT 257238 UKR 04.02.2021 04.02.2026 Y
Basic Safety Training COURSE (4 parts) 18400 UKR 09.10.2019 09.10.2024 Y
Prof. in Surv. Craft & Rescue Boats 257236 UKR 04.02.2021 04.02.2026 Y
CERT (other than fast rescue boats)
Printed on : 07.07.2021 Page: 1 of 5

6. Missing Seafarer Personal Documentation / Action required by Seafarer
To complete your documentation process, the following documentation is awaited from your end. In case you cannot arrange the same due to any
reason, please inform your Manning Agent immediately, in order to avoid any delays in your embarkation:
Documentation Name Doc No. Nat. Issued Expiry Applied I Remarks
Security Awareness Training CERT N/A UKR Unlimited N
(with designated duties)
I = Electronic Image of Doc/Lic in the database (yes or no)

Version 8 CDA-00-060
12/06/2019 Private Medicines Declaration
Approved by: Agreed by: Issued by:
Page 1 of 2 Director Crewing QMR J. Managing Director
FORM 1: Declaration of Medicines taken on board
PRIVATE MEDICINES DECLARATION FORM

Name YEREBAKAN IVAN Agency MN UKR
Rank ECAD Joining Date 15.07.2021
Vessel AS FATIMA Port PIRAEUS, ATHENS
To be filled in the case you are taking prescribed or non-prescribed medicines on board.
Please hand this form over to the Master upon embarkation.
It is for your own interest to disclose such information to the Master:

a. To avoid that you are treated with other medicines that might conflict with your prescribed medicines presently being taken.
b. To ensure that all drugs/medicines are correctly declared to customs (to avoid any unnecessary fines).
c. To be aware prior taking the D&A test in case your medicines interfere with the results of the test.
No. Name of prescribed medicine Quantity Dose Frequency Duration
Please make sure you attach/hand carry all prescriptions with this form (in case you are required to show
them to the customs authorities).
No. Name of non-prescribed medicine Quantity Dose Frequency Duration
Additional Comments:
Why are you taking the medicine as specified (optional):
Specify any medicines that cause you an allergic reaction:
I hereby confirm that the above information is correct and accurate. Additionally, I confirm that sufficient quantities of medication
are available for the duration of my assignment (including possible extensions for operational reasons). I am also aware that taking
drugs/medicines on board which are not declared in this form may result in fines and I hereby agree to cover all associated costs
directly incurred due to non-disclosure.
Seafarers signature:
Reviewed by Name Date Comments Signature

Doctor
Agency

Version 8 CDA-00-060
12/06/2019 Private Medicines Declaration
Approved by: Agreed by: Issued by:
Page 2 of 2 Director Crewing QMR J. Managing Director
FORM 2: Declaration in case no medicines are being taken on board
PRIVATE MEDICINES DECLARATION FORM

Name YEREBAKAN IVAN Agency MN UKR
Rank ECAD Joining Date 15.07.2021
Vessel AS FATIMA Port PIRAEUS, ATHENS
I hereby declare that no medicines of any kind are being taken on board. I am also aware that taking drugs / medicines on board which
are not declared in this form may result in fines and I hereby agree to cover all associated costs directly incurred due to non-disclosure.
Seafarers signature:
Please hand this form over to the Master upon embarkation.

Ver 1 (April 2020)
DAILY CREW TEMPERATURE CHECK RECORDS FOR SELF QUARANTINE
Name of Seafarer: Mr. YEREBAKAN IVAN
Marlow ID: 204401
I confirm that the information below is an accurate record of my body temperature.
Signature:
Date: 07.07.2021
Day Date Check 1 Check 2

Temp Time Temp Time
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
Note 1. Please record temperatures in Celsius
Note 2: Completed / signed form to be submitted to agent or crew manager together with the 'Covid-19 Pre Departure Check Self
Declaration Statement'

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Ref No : 204401/5 ID 204401

1. Vessel & Proposed Seafarer Employment Agreement Details

2. Generic / Employment-specific Information

5. Seafarer Personal Documentation

Documentation Name Doc No. Nat. Issued Expiry Applied I Remarks

Printed on : 07.07.2021 Page: 1 of 5

Printed on : 07.07.2021 Page: 2 of 5

FORM 1: Declaration of Medicines taken on board

PRIVATE MEDICINES DECLARATION FORM

It is for your own interest to disclose such information to the Master:

No. Name of prescribed medicine Quantity Dose Frequency Duration

Specify any medicines that cause you an allergic reaction:

Reviewed by Name Date Comments Signature

Printed on : 07.07.2021 Page: 3 of 5

FORM 2: Declaration in case no medicines are being taken on board

PRIVATE MEDICINES DECLARATION FORM

Please hand this form over to the Master upon embarkation.

Printed on : 07.07.2021 Page: 4 of 5

DAILY CREW TEMPERATURE CHECK RECORDS FOR SELF QUARANTINE

Name of Seafarer: Mr. YEREBAKAN IVAN

Marlow ID: 204401

I confirm that the information below is an accurate record of my body temperature.

Day Date Check 1 Check 2

Note 1. Please record temperatures in Celsius

Printed on : 07.07.2021 Page: 5 of 5

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