The Application for the Issue of a Barbados Seaman S

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Barbados Maritime

Declaration of Authenticity

The application for the issue of a Barbados Seaman’s

Endorsement and/or a Seaman’s Record Book is hereby made on behalf of

…………………………………………………………………………………

Seaman’s Name

I/We do declare that this application along with the supporting documentation has been presented in original to the undersigned and has been confirmed as being authentic.

I/We have signed and stamped this Declaration as confirmation of the above

….…………………………………………………………………………………

Registered Ship Owner/ Ship Manager/Crewing Agency Dated

This Declaration may only be signed and stamped by a representative of the Ship Owning Company or Ship Management Company duly noted in the Ships Register against the vessel which the officer is to join

Where either of the two noted companies has given prior advice to the Registry that a Crewing Agency has been engaged and is operating in compliance with the company’s ISM system & MLC 2006 requirements.

Penalties

Where a company provides to BMSR a Declaration of Authenticity for a certificate which later proves to be counterfeit the following fines will be imposed by BMSR:

· First occasion the company signing will be liable to a fine of USD $1000.00

· Second occasion the company signing will be liable to a fine of USD $5000.00

· Third occasion or if the previous noted fines remain unpaid for 30 days; BMSR will immediately cease to process applications for Officer Endorsements from that Company.

If the company signing is a Crewing Agency, the fine will then be applied to the ship Owning/Managing company, which nominated the Crewing Agency.

A fine of USD $500.00 will also be applied to the ship Owning/Managing company if an officer is on-board a vessel without a valid Barbados certificate.

BARBADOS

Application for a Seafarer’s Endorsement Document

and/or a Seaman’s Record Book

PART I. APPLICANT DETAILS

1. Last name (family name)

First Name (given name )

Middle initial

2. Date of birth

dd-mm-yyyy / 3. Place of birth
(City & Country)

4. Permanent address (street, city, country)

5. Citizenship

6. Gender M/F

PART II. DESCRIPTION OF HIGHEST GRADE BARBADOS ENDORSEMENT AND FOREIGN CERTIFICATE OF

COMPETENCY/PROFICIENCY NOW HELD

(A) Barbados /

Grade of Certificate (Master, Chief Eng., 2nd Eng. etc.)

Certificate No.

Date issued

dd-mm-yyyy

/ Date of expiry
dd-mm-yyyy /

Issuing Country

/ / / BARBADOS
(B) Foreign / / / /

PART III. ELIGIBILITY BASIS ON WHICH APPLICATION IS MADE

(1) I hereby apply for the issuance of a Barbados Endorsement Document in a grade equivalent to my foreign CoC or CoP described in Part ll (b) above. Applicants for engineer endorsement document must indicate mode of propulsion qualified for and desired (e.g. Steam, Motor or Steam & Motor) (Tick box if relevant)

(2) I hereby apply for a Seaman’s Record Book (n.b. tick box if relevant) /

PART IV. AFFIDAVIT OF APPLICANT Endorsement cannot be issued unless signed by the applicant below

I hereby affirm that all the information provided by me in this application and the supporting documents and proofs are true and correct to the best of my knowledge and belief, also that no certificate issued to me previously by any Government has ever been revoked or suspended, or if revoked or suspended, a full explanation of the circumstances is attached and made part of this application.

Signature of applicant: (sign inside of the box) Date:

Sponsor details: Ship Owner / Technical Manager / Crewing Agent (please circle)

Sponsor Name: Sponsor Signature:
Company Name:
Company Address:
Company Tel: Email Address:
(If the endorsement certificate/Seaman’s Record book is to be sent to a different address from the above , then please notify us via email)

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PART V. SEA SERVICE
List one year’s sea service in the last five years to establish eligibility for the seaman’s endorsement document requested. If you list service aboard a Barbados flag vessel in an officer capacity, you must detail the Barbados officer endorsement document held in Part II (a)
Name of Vessel / Flag / Name of Managing Operator / Capacity in which served / Period of Service / Total Service
From / to
Day / Month / Year / Day / Month / Year / Years / Months / Days
PART VI. Applicants for GMDSS Endorsement must read and sign this declaration.
By affixing my signature below, I acknowledge that I am obliged to ensure and maintain the secrecy of all telecommunications of which I may gain knowledge in the course of my services and that I am likewise obliged not to reveal the existence of the contents of any correspondence to anyone other than the addressee. My signature further acknowledges that , if I should breach these obligations, my Endorsement Document issued on the strength of this application may be suspended or revoked.

(sign inside of the box) / PART VII Applicants for Officer’s Endorsement at the Management level must sign this declaration.
I hereby affirm that in accordance with the Regulation 4 of the Shipping (Safe Manning, Watch keeping and Hours of Work) Regulations 2000, on boarding the Barbadian ship I will review Part II and IV of the Shipping Act kept onboard, to ensure that I become familiar with the national maritime legislation of Barbados relevant to the functions to be performed by me, for which I have applied for an endorsement.

(sign inside of the box)

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Items Required to Receive an Officer’s Endorsement

And/or a Seaman’s Record Book and/or Certificate of Proficiency

APPLICATION / ENCLOSED
(Yes/No) / INITIAL
Application Rev. 01-16 (pages 1 to 4), with signatures in parts IV and also in parts VI and VII if applicable.
Proof of one year total sea service in the last five years, must be shown in Part V of the application.
One clear coloured passport sized photograph, taken within the last 5 years.
A clear copy of the Certificate of Competency or Certificate of Proficiency issued in accordance with STCW 2010 (as amended) by an Administration with whom BMSR has an agreement to recognise such Certificates.
A clear copy of the GMDSS issued in accordance with STCW 78 (as amended) by an Administration with whom BMSR has an agreement to recognise such Certificates.
A clear copy of the STCW SSO certificate, issued by an Administration with whom BMSR recognises.
A clear copy of the applicant’s ID e.g. passport, Seaman’s book etc. showing expiry date.
A clear copy of the applicant’s medical certificate, which must have a minimum period of three months till expiry. The medical must be issued in accordance with STCW Regulation I/9.
Previous Endorsements/GMDSS, which are still valid, must be returned to BMSR offices. In cases where the previous Endorsement/GMDSS has been lost or damaged, a statement to this effect is required from the Owner/Manager or recognised Crewing Agent.
Payment for CoC/CoP Endorsement.
Payment for GMDSS Endorsement.
Payment for SSO Endorsement.
Payment for Seaman’s Record Book
Name of the Vessel that applicant will be joining:

GENERAL INFORMATION AND INSTRUCTIONS

1. Please read all instructions carefully

Enter all required information either by typing or printing legibly. This application may be rejected or approval delayed if you fail to complete the application correctly or submit the required proofs, etc.

2. Documents to be filed with application

The following documents, letter, and proofs must be submitted with this application.

a) One (1) photographs – facial front view of applicant passport size, taken within not more than a five year period preceding application with applicant’s passport or seaman’s book. Photographs must be in colour

b) Medical examination report. All applicants are required to submit a medical examination report on a medical form completed by a licensed physician. The applicant should retain the original of the Medical form as evidence of physical qualification while serving onboard a Barbados flag vessel. This medical examination must be carried out not more than 12 months prior to the date of making the application and have a minimum of three months validity remaining. The medical certificate must be issued and meet the standards prescribed by STCW Regulations I/9.

c) The owner/manager/ authorised crewing agents must recommend the applicant for a Barbadian endorsement document by signing the application document.

d) Proof of sea service: Applicants for officer endorsement documents based on an acceptable national officer’s certificate must submit at least one (1) years total sea service in the last five (5) years (or employment ashore directly related to the operation of the vessels e.g. Port Captain, Port Engineer). For seamen issued with CoP (certificate of proficiency) the CoP must be issued by an STCW compliant administration with which Barbados has an agreement under STCW Reg 110.

e) Proof of foreign seaman’s certificate. The foreign certificate of competency or certificate of proficiency issued by his national administration must have a valid STCW 78 (as amended) endorsement and be issued by a country recognised by Barbados. A Barbados endorsement can only have the same validity as the accompanying CoC or CoP,

f) The original foreign certificate must be submitted to the owner/manager or manning agent acting on behalf of the owner/manager, who must make a clear photocopy and endorse the said copy as a true copy of the original presented. This is to be forwarded to the Barbados Ship Registry with the application.

g) All documents not presented in the English language must have a certified English translation attached and enclosed with the application.

h) Proof of foreign training certificates – radar simulator training, advanced firefighting training, GMDSS certification, first aid training, advanced medical training, survival craft/rescue boat training and automatic radar plotting aids (ARPA) training, submit one copy of foreign certificate, if national officer certificate does not require this training. See Para. 6. for Training Requirements.

i) Application must be accompanied by a signed and stamped Declaration of Authenticity in all cases.

j) Check List.

4. Schedule of Fees

Barbados Seaman’s Endorsement and/or Seaman’s Record Book Refer to Rate Card for current year

Replacement of lost/damaged Endorsement Same price as an Endorsement

Fine - for seaman on vessel without Barbados certificate Issued by the Principal Registrar

Payment must be made by bank transfer or credit card facility, details of which can be provided on request by the Barbados Maritime Ships’ Registry.

5. Age and Citizenship Requirements

Applicants for Endorsement Documents as officer in charge of a navigational watch, officer in charge of an engineering watch and GMDSS Operator must be at least 18 years of age, as must Deck and Engineering Watch Ratings.. Applicants for all other grades must be at least 21 years of age. Applicants may be of any nationality and need not be citizens or residents of Barbados.

6. Training Requirements

a) Fire fighting training – every applicant for Master, Chief Mate or officer in charge of a navigational watch & every applicant for Chief Engineer, First Engineer or officer in charge of an engineering watch, must submit proof of completion of an advanced marine fire-fighting course.

b) Radar simulator training- every applicant for a Master, Chief Mate or officer in charge of a navigational watch

endorsement document must submit proof of completion of a marine radar simulator course*

c) GMDSS Certification- from 1st August 1998 every applicant for officer in charge of a navigational watch, Chief Mate

or Master Endorsement. Document must hold GMDSS certification.

d) * First Aid Training – as of 1st August 1998 every applicant for an officer in charge of a navigational watch

endorsement document on vessels over 500 gross tons; every applicant for a Master / Chief Mate endorsement

document on vessels less than 500 gross tons and every applicant for an officer in charge of an engineering watch

endorsement document must complete first aid training.

e) * Survival craft/ rescue boat training – As of 1st August 1998 every applicant for a Master, Chief Mate, or officer in

charge of a navigational watch endorsement document and every candidate for an officer in charge an engineering

watch endorsement document must complete survival craft /rescue boat training.

f) Automatic Radar Plotting Aids (ARPA) training – as of 1st August 1998 every applicant for a Master, Chief Mate or

officer in charge of a navigational watch endorsement document must complete automatic radar plotting aids

ARPA) training.

Note : National certificates of competency containing the 1995 STCW Endorsement are evidence of completion of the requirements (a) to (f) above without having to submit training course certificates.

Similarly, national certificates of proficiency issued by STCW compliant administrations are accepted as evidence of completion of relevant training.

7. Global Maritime Distress and Safety System (GMDSS)

a) Restricted Operator – Previous service not required. The Applicant must present a foreign certificate in equivalent

grade.

b) General Operator – Previous service not required. The Applicant must present a foreign certificate in equivalent grade.

c) Second Class Radio Electronic Operator and Maintainer – Previous service not required .The Applicant must present

a foreign certificate of equivalent grade.

d) First Class Radio Electronic Operator and Maintainer - Previous service not required .The Applicant must present

a foreign certificate of equivalent grade.

8. Sea Service Requirements

a) Navigational Officers – Required to hold a Certificate of Competency appropriate for vessel on which the officer will serve,

and have served at least 1 year in the previous five years on a vessel of equal or greater GT to which the officer will

be appointed.

b) Engineer Officers – Required to hold a Certificate of Competency appropriate for vessel on which the officer will serve,

and have served at least one year in the previous five years on a vessel of equal or greater propulsive output to which

the officer will be appointed.

At least six (6) months of the total service required shall at some time have been served on the mode of propulsion

applied for.

9. Equivalent Certificates

National Governments who have Agreements with Barbados for the issuance of Endorsement Certificates as equivalent to their certificates in accordance with STCW 78 as amended are listed in the Barbados Ships’ Registry Information Bulletins and are updated periodically.