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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