REPRESENTATION
VESSEL:			FROM		TO
ACCOUNT			CHARTERERS		OWNERS
DATE		PORT	ACCOUNT	ITEMS	QUANTITY	UNIT/COST	TOTAL COST
						TOTAL
MASTER:		……………………….				PORT:…………………….
SIGNATURE:		……………………….				DATE:…………………….
SHOULD BE COMPLETED AND FORWARDED TO THE OFFICE BY COURIER AT THE END OF EACH MONTH.

ATLANTIC UNITED MARINE INC.

FORM / 4204

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 : 3 / 07-99 : 1

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