<p> THE PYA SEA SERVICE TESTIMONIAL FOR MASTER & DECK OFFICERS (MCA Approved for use in respect of service on commercially and privately operated yachts and sail training vessels)</p><p>Part 1 – Service</p><p>This is to certify that:</p><p>Name Email address Date of birth</p><p> has served in CAPACITY of : Master / Chief Mate / OOW / Deckhand </p><p>ON BOARD : </p><p>Vessel name Flag Official No. Type (M/Y, S/Y, other) Length-metres GT From /date joined: Until/ date signed off: (i.e. on board yacht (please fill in date service) even if still on board)</p><p>The above service includes:</p><p>Actual Days at Sea: days (vessel leaves port/under way/at anchor associated with a 24-hour passage) Stand-by Service: days (SHOULD NOT EXCEED DAYS AT SEA - waiting for owner, uniformed/ready to depart Max. 14 consecutive days without leaving port) Shipyard Service: days (max. 90 days allowed per application for OOW3000) Watch keeping: (for HOLDERS OF MCA OOW3000 OR days HIGHER ONLY- can be counted on cumulative basis: every 8 hours = 1 day of watch keeping service until the 09/04/15 and every 4 hours= 1 day after 09/04/15) </p><p>Leave of absence was granted as follows:</p><p>Areas cruised</p><p>QP SRB F001 - Rev. : 6 20/09/2017 Page: 1 of 2 THE PYA SEA SERVICE TESTIMONIAL FOR MASTER & DECK OFFICERS (MCA Approved for use in respect of service on commercially and privately operated yachts and sail training vessels) Part 2 – Official endorsement ANY FALSE INFORMATION OR VERIFICATION SUBMITTED COULD LEAD TO THE WITHDRAWAL OF THE SIGNING OFFICER’S CoC</p><p>Signature (should not be self-signed or left blank) Name (capitals) Date Capacity Owner / Master / Responsible Person in Management Company If signing as Master:- CoC No. CoC issuing authority If signing as Position Responsible Person Organisation and Address</p><p>Tel. EMAIL ADDRESS for E-mail verification purposes (leaving blank will result in delays)</p><p>Yacht / Company Stamp</p><p>PYA verification Verified by: Date:</p><p>QP SRB F001 - Rev. : 6 20/09/2017 Page: 2 of 2</p>