KIRIBATI SHIP REGISTRY
Declaration of Designated Person(s)

To ensure the safe operation of each vessel and to provide a link between the “Company” and those on board, every “Company” shall designate person(s) ashore (DPA(s)) having direct access to the highest level of management. The responsibility and authority of the DPA(s) shall include monitoring the safety and pollution prevention aspect of the operation of each vessel and ensure that adequate resources and shore-based support are applied, as required.

The undersigned affirms that:

Name of DPA	24hr Mobile Contact	Email
(1)
(2)	(alternate)

has/have been assigned as the DPA(s) in accordance to IMO resolution A741(18) Section 4 of ISM code for the following Kiribati registered vessel(s)*:

Name of Vessel	Official Number	RO for SMC	IMO Number

and undertaken that the said DPA(s) will be available to the Administration at any time, as follows:

Contact details of the DPA(s) to which official correspondence and materials may be sent to:

Name Of Company	Company IMO No.
Telephone	Fax	Email
Full Address

The undersigned individuals further understand that any change in DPA(s) or RO(s) must be made in writing by fax/email. Any change will be acknowledged within 24 hours of being received.

Title of DPA	Signature	Date

Name & Title of Senior Management of “Company”	Signature	Date

* add additional sheets if required

RO - ABS / BV / DNV / GL / KR / LR / NK / RINA etc. Full list can be found at www.kiribaship.com

KSR/FORM/DPA/2012/REV.1

Kiribati Ship Registry

2012-08-31

david

maritimeChain