MARITIME LABOUR COMPLIANCE

(Note: This Certificate shall have a Declaration of Maritime Labour Compliance attached)

Issued under the provisions of the
Navigation Act 2012, Section 44 and Article V and Title 5 of the

Maritime Labour Convention 2006

under the authority of the Government of Australia by the

Particulars of ship

Name of ship	IMO/Official Number	Port of Registry
Gross Tonnage1	Distinctive number or letters	Type of Ship
Name and address of the shipowner2	Date of Registry

This is to certify:

That this ship has been inspected and verified to be in compliance with the requirements of the Conventions, and the provisions of the attached Declaration of Maritime Labour Compliance.

That the seafarers’ working and living conditions specified in Appendix A5-I of the Convention were found to correspond to the abovementioned country’s national requirements implementing the Convention. These national requirements are summarized in the Declaration of Maritime Labour Compliance, Part I.

This certificate is valid until subject to inspections in accordance with the Standards A5.1.3 and A5.1.4 of the Convention.

This certificate is valid only when the Declaration of Maritime Labour Compliance issued at	on is attached.

Completion date of the inspection on which this Certificate is based was: .

Issued at:

………………	………………………	…………………………………………

(Place of issue of Certificate)	(Date of issue)	(Signature of authorised official issuing the certificate)

(seal or stamp of the authority, as appropriate)

Alex Schultz-Altmann

Manager, Ship Inspection and Registration, Operations

Endorsements for mandatory intermediate inspection and, if required, any additional inspections

This is to certify that the ship was inspected in accordance with Standards A5.1.3 and A5.1.4 of the Convention and that the seafarers’ working and living conditions specified in Appendix A5-1 of the Convention were found to correspond to the above-mentioned country’s national requirements implementing the Convention.

Intermediate inspection (to be completed between the second and third anniversary dates):

Issued at:

………………	………………………	…………………………………………

(Place of issue)	(Date of issue)	(Signature of authorised officer)

____________________________________________________________________________________________________________

Additional endorsements (if required)

This is to certify that the ship was the subject of an additional inspection for the purpose of verifying that the ship continued to be in compliance with the national requirements implementing the Convention, as required by Standard A3.1, paragraph 3, of the Convention (re-registration or substantial alteration of accommodation) or for other reasons.

Additional inspection (if required):

………………	………………………	…………………………………………

(Place of issue)	(Date of issue)	(Signature of authorised officer)

Additional inspection (if required):

………………	………………………	…………………………………………

(Place of issue)	(Date of issue)	(Signature of authorised officer)

Additional inspection (if required):

………………	………………………	…………………………………………

(Place of issue)	(Date of issue)	(Signature of authorised officer)

____________________________________________________________________________________________________________

Extension after renewal inspection (if required):

This is to certify that, following a renewal inspection, the ship was found to continue to be in compliance with national laws and regulations or other measures implementing the requirements of this Convention, and that the present certificate is hereby extended, in accordance with paragraph 4 of Standard A5.1.3, until (not more than five months after the expiry date of the existing certificate) to allow for the new certificate to be issued to and made available on board the ship.

Completion date of the renewal inspection on which this extension is based was:

Issued at:

………………	………………………	…………………………………………

(Place)	(Date)	(Signature of authorised officer)

____________________________________________________________________________________________________________

Endorsement to extend the validity of the certificate until

This certificate shall be accepted as valid until

Issued at:

………………	………………………	…………………………………………

(Place of issue)	(Date of issue)	(Signature of authorised officer)

____________________________________________________________________________________________________________