IMO CREW LIST

(IMO FA L Form 5)

x

Arrival

Departure

Page Number

1.1 Name of ship

M almo

1.2 IMO number

8116738

1.2 Call sign

4LVR

1.4 Voyage number
112432

2. Port of arrival/departure
Trelleborg

3. Date of arrival/departure

14.05.2014

4. Flag State of ship
Tanzania

5. Last port of call

Świnoujście

6. No. 7. Family name, given names 8. Rank or rating

9. Nationality

10. Date and
place of birth

11. Nature and number of
identity document

1

Damian Rolewski

Master

Poland

18.02.1978

Jarosław

823455434554

2

Krzysztof Ignaczak

1

st

mate

Poland

12.03.1969
Warsaw

123454323452

3

John Brown

2

nd

mate

Ireland

23.12.1988
Dublin

456542345435

4

Jon Snow

3

rd

mate

England

30.01.1980
Huddersfield

354645336345

5

Robb Stark

Bosun

England

11.01.1970
London

543246786548

6

Tytus Bomba

Cook

Poland

31.12.1979
Szczebrzeszyn

125487954215

7

Michał Głuś

Chief Engineer

Poland

19.02.1983
Radom

658468765487

8

Kamil Zdun

O/S

Poland

12.07.1983
Szczecin

432123187954

9

Radosław Rumian

O/S

Poland

01.01.1990
Bydgoszcz

432187641896

10

Bogusław Łęcina

Cadet

Poland

29.10.1985

Wrocłąw

874348979434

12. Date and signature by master, authorized agent or officer

10.05.2014
Rolewski Damian