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До прибытия в порт освидетельствования или на льготный срок
в случае применения Правила 1/14(е), или 1/14(f) Настоящее Свидетельство в соответствии с Правилом 1/14(е)/14(f)* Конвенция признается действительным до ……………, при условии что Свидетельство ………………., к которому приложено настоящее Свидетельство, действительно …………………………. Подписано …………………………………… (Подпись уполномоченного лица) Место …………………………………………. Дата ………………………………………….... (Печать или штамп организации) ___________ * Ненужное зачеркнуть.
Form of Exemption Certificate EXEMPTION CERTIFICATE This Certificate shall be supplemented by a Record of Equipment (Form С) (Official seal) (State) Issued under the provisions of the International Convention for the Safety of Life at Sea, 1974, as modified by the Protocol of 1988 relating thereto under the authority of the Government of ………………………………………………………………………..… (Name of the State) by ……………………………………………………………………….. (Person or organized authorized) Particulars of ship* Name of ship ……………………………………..…………. Distinctive number or letters ………………………..………. Port of registry ………………………………………………. Gross tonnage ………………………………………..……… IMO Number ……………………………………………..…. THIS IS TO CERTIFY: That the ship is, the authority conferred by regulation ……………………. of the Convention, exempted from the requirements of ………………...the Convention. Conditions, if any, on which the Exemption Certificate is granted: ……………………………………………………………………………… Voyages, if any, for which the Exemption Certificate is granted: ……………………………………………………………………………… This Certificate is valid until …………………subject to the …………….. Certificate, to which this Certificate is attached, remaining valid. Issued at ……………………………………………………………... (Place of issue of Certificate) ………………… …………………………….. (Date of issue) (Signature of authorized official issuing the Certificate) (Seal or stamp of the issuing authority, as appropriate) ___________ · Alternatively, the particulars of the ship may be placed horizontally in boxes. Endorsement to extent the Certificate if valid for less than 5 years where regulation 1/14(c) applies This Certificate shall, in accordance with regulation 1/14 (c) of the Convention, be accepted as valid until ……………… subject to the ……………….Certificate, to which this Certificate is attached, remaining valid. Signed: …………………………………..… (Signature of authorized official) Place: ………………………………………. Date: …………………………………..…… (Seal or stamp of authority, as appropriate) Endorsement where the renewal survey has been completed and regulation 1/14(d) applies This Certificate shall, in accordance with 1/14(d)of the Convention, be accepted as valid until …………………………..subject to the ……………….….Certificate, to which this Certificate is attached, remaining valid. Signed: ………………………..……………… (Signature of authorized official) Place: …………………………………………. Date: ………………………………………….. (Seal or stamp of authority, as appropriate) Endorsement to extend the validity of the Certificate until reaching the port of survey or for a period of grace where regulation 1/14(e)
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