4201, Akademia Morska, Atlantic United Marine


MGA RECAPITULATION MONTHLY STATEMENT

M/V:

Location:

Date From:

To:

No

Name

Allotment

Cash

Advance

Telecom

Exps

Sales

O/B

Other

Exps

Balance

Due

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

TOTALS

Cash ROB from last Month:

Owners Telecommunications:

Cash received current Month:

Charterers Telecommunications:

Expenses Paid cash by Master:

Private Telecommunications:

Cash ROB for current Month:

Total Telecommunications:

Master: Date:

Should be completed and forwarded to the Office by Fax at the end of each month. A complete MGA shall follow by courier.

ATLANTIC UNITED MARINE INC.

FORM / 4201

Safety Management System Manual - IMO Res. A. 741 (18)

Developed by

Date of Initial Issue

Chapter

: SMS Designated Person

: April 1998

: 14

Authorized by

Revision No / Effective date

Page

: Managing Director

: 2 / 07-99

: 1



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