crew7

UK P&I Club

THE ATTACHED WORKBOOK CONTAINS A SELECTION OF INTERNATIONAL (IMO RECOGNISED) AND UNITED STATES OF AMERICA PORT ENTRY FORMS WHICH SHOULD BE USEFUL TO ALL MASTERS.

The format of the workbook allows these forms to be easily filled in by computer on board and then to be printed as

USE OF THE FORMS

1

2

3 Follow through and insert information to each sheet as required.

4

5

PRINT CONTROLS

6

7

8

required for any port entry. Some countries may require other special forms which are not set out here.

REMEMBER: Make a copy of the spreadsheet to your hard disk and do not save information to the blank provided.

To print these instructions for reference, ensure your printer is connected and that the paper size is set correctly. For this go to Print Preview and check the size by clicking the settings command. Now close the preview and press the Print icon.

Go to the tab marked 'Data'. Follow the columns and enter the crew information as required. Information from this data is sent directly to the other worksheets, so be careful to complete this section acurately and to number each entry as required in the first column. This data base can later be used to include other items and allow new forms to be inserted into the workbook for both ISM and Outside inspection purposes (i.e. Port State Control, Class, Flag State, SIRE, CDI and UK Club Loss Prevention). Fill in by hand only the boxes shaded pale blue, do not change the contents of any other box (this applies to all sheets in the workbook). For the forms to function correctly you must number each crew member in the 'Data' sheet.

Now go to tab marked 'Info'. Fill in all the boxes as required by the sheet as these will then automatically enter the required information to both the International and USA forms. This sheet can also be printed to give information to port authorities if so desired.

Where United States forms are required to be in alphabetical order this can easily be achieved using the following means: 1. Go to 'Data', and select the cell B1, top of the column marked 'SURNAME'.2. Now click on the icon A/Z in the toolbar at the top. All information in the spreadsheet will go into the correct alphabetical order, thus importing to the US Crewlist and US Effects Declaration correctly.

To return the 'Data' sheet to normal order for International forms:1. Select cell A1, top of column marked 'No.'2. Now again click the icon A/Z in the toolbar at the top. All information is returned to the original entered order.

Each sheet is already set up to print as a single page on the correct size paper. All International forms are set to print as a single A4 size page and those for US forms as either Legal or Letter size as appropriate.

To make the double sided originals required, i.e. US Crew List, US Passenger List, or US Clearance documents, print the back page as appropriate onto the reverse of the previously printed front page.

Back 1300 refers to the clearance document only. The new I418 form has no back page, is printed as the number of pages required by the additional instructions in the spreadsheet before the forms.

No. SURNAME FIRST NAME & INITIAL FULL NAME RANK

1 VLASOV MYKHAYLO VLASOV MYKHAYLO MASTER

2 YERYOMENKO MYKOLA YERYOMENKO MYKOLA CH.OFF.

3 RYBCHUK ANDRIY RYBCHUK ANDRIY 2 OFF.

4 STARODUB MYKHAYLO STARODUB MYKHAYLO 3 OFF

5 KORCHYNSKY VIKTOR KORCHYNSKY VIKTOR CH.ENG.

6 SYZONENKO EDUARD SYZONENKO EDUARD 2 ENG.

7 SAVCHUK VOLODYMYR SAVCHUK VOLODYMYR 3 ENG.

8 LYSENKO VOLODYMYR LYSENKO VOLODYMYR 4 ENG.

9 BAKHIN VASYL BAKHIN VASYL ELECTR.

10 KONONOV SERGIY KONONOV SERGIY BOSUN

11 BRATUKHIN SERGIY BRATUKHIN SERGIY A/B

12 BAYGILDIN IGOR BAYGILDIN IGOR A/B

13 POPADYUK VITALIY POPADYUK VITALIY A/B

14 HUBRIY YEVHEN HUBRIY YEVHEN O/S

15 ZARVA IGOR ZARVA IGOR O/S

16 KOBLYK MYKHAYLO KOBLYK MYKHAYLO OILER

17 POZHYDAYEV SERHIY POZHYDAYEV SERHIY OILER

18 NITOCHKIN OLEG NITOCHKIN OLEG OILER

19 OMELCHENKO ANATOLIY OMELCHENKO ANATOLIY FITTER

20 SOBIESZCZANSKI ZBIGNIEV SOBIESZCZANSKI ZBIGNIEV FITTER

21 JANOWSKI TOMASZ JANOWSKI TOMASZ FITTER

22 PARTASOV ANATOLIY PARTASOV ANATOLIY COOK

23 KIRIN OLEKSIY KIRIN OLEKSIY M/M

24 CHEKOV OLEKSANDR CHEKOV OLEKSANDR M/M

PORT ARRIVED FROM/DESTIN Durban

PORT OF ARRIVAL/DEP Sankt Peterburg

DATE 9/9/2007

United States Coast Guard National Vessel Movement Center

NATIONALITY D.O.B PLACE OF BIRTH PASS NR. SEAMAN BOOK NO. JOINED DATE

UKRAINE 16/01/1964 UKRAINE AB310289 17/07/2007










RUSSIAN 17/01/1965 GERMANY AB278158 15/03/2007

UKRAINE 28/07/1967 GEORGIA AB336432 15/03/2007






UKRAINE 14/05/1975 KAZAKHSTAN AB139153 15/03/2007


POLISH 17/03/1950 227431 20/03/2007

POLISH 10/10/1968 210324 20/03/2007




Durban

Sankt Peterburg

9/9/2007

PLACE JOINED US VISA EXPIRY VISA TYPE YELLOW FEVER EXPIRY

Dahej 06-Feb-13

Antofagasta 28-Aug-16

Durban 29-Jul-13

Antofagasta 18-May-17

Durban 14-Apr-16

Valletta 05-May-16

Valletta 14-Nov-16

Valletta 28-Mar-15

Valletta 04-Jun-13

Durban 14-Apr-15

Valletta 15-Dec-16

Valletta 03-Aug-08

Valletta 27-Feb-16

Valletta 07-Dec-16

Durban 02-Jul-17

Valletta 15-Jun-16

Valletta 16-Apr-14

Valletta 13-Jun-11

Valletta 08-Jun-08

Sfax

Sfax

Valletta 21.Jul-09

Valletta 10-Apr-13

Valletta 08-Feb-16

I N F O R M A T I O NVessel's Name "ROGUE"

BUNKERSVessel's Nationality VALLETTA

Voyage Number 8 Heavy Fuel Oil (120cst) MT 340

Master's Name O.GRITSENKO Marine Diesel Oil MT 120

Register Number/IMO Number 6608/8021323 Lubrication Oils/Grease MT 15

Number of Crew (inc. Master) 22 Fresh Water Domestic MT 70

Call Sign 9HUF8 Tank Cleaning F.Water MT 230

Gross Tonnage 13432 USA ITINERARYNett Tonnage 8232Port of Arrival/Departure : Next Port ORDER

Date of Arrival November 23, 2005 Date of Arrival

Arrival Draft 9,3 m Agent

Vessel Built, Port/Country Shin Kurushima Dockyard Co, Japan

Year Built December 23, 1980 Loadline Cert Expires? March 1, 2005

Agent's Name & Address Silver Line Cert. Of Financial Responsibility No. 849018-03

Agent's phone number Cert. Of Financial Responsibility expires: January 14, 2006

Vessel Trade Group (back 1300) 02

Vessel Type (back 1300) DRY CARGO Period of Stay - Days 10

Owner's Name & Address AOSTA SHIPPING Co.Ltd. Cargo logs and sawn timbers

Operator's Name MARITEAM SERVICES INC. Cargo B/L figure - Metric Tonnes 14957.7

Operator's Address 6 RIZARIOU Str.HALANDRI,ATHENS,13233 GREECE

PORTS of CALL LIST

Port and Country Date of Arrival Date of Departure

Last Port NOVOROSSIYSK, RUSSIA 07-Nov-06 26-Nov-06

2nd last ALEKSANDRIA, EGYPT 01-Dec-06 17-Dec-06

3rd last TARANTO, ITALY 19-Dec-06 23-Dec-06

4th last PTA. DA MADEIRA, BRAZIL 06-Jan-07 07-Jan-07

5th last NEW ORLEANS, USA 18-Jan-07 21-Jan-07

6th last CORPUS CHRISTI, USA 24-Jan-07 27-Jan-07

7th last VARNA, BULGARIA 19-Feb-07 24-Feb-07

8th last ODESSA, UKRAINE 28-Feb-07 03-Mar-07

9th last TRIESTE, ITALY 09-Mar-07 12-Mar-07

10th last VALLETTA 14-Mar-07 17-Mar-07

11th last

12th last

13th last

14th last

M/V "ROGUE" DATE: 9/9/2007

Port of registry :VALLETTA, MALTA PORT: Sankt Peterburg

PORTS OF CALL LIST

No. Port and Country Date of arrival Date of departure

1

2 DURBAN 07-Aug-07 10-Aug-07

3 OFF COLOMBO 26-July-07 26-July-07

4 DAHEJ 17-July-07 22-July-o7

5 DURBAN 26-June-07 27-June-07

6 PTA.CHUNGO 02-June-07 02-June-07

7 CALETA COLOSO 30-May-07 31-May-07

8 ANTOFAGASTA 28-May-07 30-May-07

9 GUAYAQUIL 19-May-07 23-May-07

10 SAN LORENZO 30-Apr-07 01-May-07

Master of the m/v " ROGUE "___________________________ VLASOV MYKHAYLO

Sankt Peterburg

Purpose of call

bunkering

loading

bunkering

discharging

bunkering

loading

loading

loading

discharging

loading

VLASOV MYKHAYLO

IMO CREW'S EFFECTS DECLARATION

1.Name of ship 2.Effect wihc are dutiable or

"ROGUE" subject to prohibition ands

3.Nationality of ship and ristricts

VALLETTASigarets Tobaco Spirits Gold

4.No 5.Family name,given name 6.Rank or rating

1 VLASOV MYKHAYLO MASTER

2 YERYOMENKO MYKOLA CH.OFF.

3 RYBCHUK ANDRIY 2 OFF.

4 STARODUB MYKHAYLO 3 OFF

5 KORCHYNSKY VIKTOR CH.ENG.

6 SYZONENKO EDUARD 2 ENG.

7 SAVCHUK VOLODYMYR 3 ENG.

8 LYSENKO VOLODYMYR 4 ENG.

9 BAKHIN VASYL ELECTR.

10 KONONOV SERGIY BOSUN

11 BRATUKHIN SERGIY A/B

12 SOLOMAKHIN PAVLO A/B

13 POPADYUK VITALIY A/B

Date and signature by Master, authorized agent or officer

Port of Arrival/Departure : Master

Sankt Peterburg


1.Name of ship : 2.Effect wihc are dutiable or

"ROGUE" subject to prohibition ands

3.Nationality of ship : and ristricts

VALLETTASigarets Tobaco Spirits Gold


14 HUBRIY YEVHEN O/S

15 ZARVA IGOR O/S

16 KOBLYK MYKHAYLO OILER

17 POZHYDAYEV SERHIY OILER

18 NITOCHKIN OLEG OILER

19 OMELCHENKO ANATOLIY FITTER

20 SOBIESZCZANSKI ZBIGNIEV FITTER

21 JANOWSKI TOMASZ FITTER

22 PARTASOV ANATOLIY COOK

23 KIRIN OLEKSIY M/M


Port of Arrival


Page 1 of 2

7.Personal effects 8.Signature

VLASOV MYKHAYLO


Page 2 of 2

7.Personal effects 8.Signature

MASTER GRITSENKO OLEG

TELEPHONE CARDS LIST

1.Name of ship 2.Currency

"ROGUE"

3.Nationality of ship

PCS DATEVALLETTA













12 BAYGILDIN IGOR A/B



15 ZARVA IGOR O/S









24 CHEKOV OLEKSANDR M/M


Port of Arrival/Departure :

of 1

8.Signature

VLASOV MYKHAYLO

LIST OF CREWS ADVANCE

1.Name of ship and Nationality of ship 2.Currency

"ROGUE", VALLETTA

3.Port and date

USDSankt Peterburg 9/9/2007













12 BAYGILDIN IGOR A/B



15 ZARVA IGOR O/S









24 CHEKOV OLEKSANDR M/M

TOTAL SUM (USD):


of 1

8.Signature

VLASOV MYKHAYLO

CREW'S CURRENCY DECLARATION

1.Name of ship 2.Currency

"ROGUE"


E

UR

O

U

SD

VALLETTA OTHER CURRENCY



2 YERYOMENKO MYKOLA CH.OFF.50 263 Grv of Ukraine


4 STARODUB MYKHAYLO 3 OFFNIL NIL

5 KORCHYNSKY VIKTOR CH.ENG.26 NIL

6 SYZONENKO EDUARD 2 ENG.NIL NIL

7 SAVCHUK VOLODYMYR 3 ENG.NIL NIL

8 LYSENKO VOLODYMYR 4 ENG.NIL NIL

9 BAKHIN VASYL ELECTR.NIL NIL

10 KONONOV SERGIY BOSUNNIL NIL

11 BRATUKHIN SERGIY A/BNIL NIL

12 BAYGILDIN IGOR A/BNIL NIL

13 POPADYUK VITALIY A/BNIL NIL

14 HUBRIY YEVHEN O/SNIL NIL

15 ZARVA IGOR O/S

16 KOBLYK MYKHAYLO OILERNIL NIL NIL

17 POZHYDAYEV SERHIY OILERNIL NIL

18 NITOCHKIN OLEG OILERNIL NIL NIL

19 OMELCHENKO ANATOLIY FITTERNIL NIL NIL

20 SOBIESZCZANSKI ZBIGNIEV FITTERNIL NIL

21 JANOWSKI TOMASZ FITTERNIL NIL

22 PARTASOV ANATOLIY COOKNIL

23 KIRIN OLEKSIY M/MNIL NIL

24 CHEKOV OLEKSANDR M/MNIL NIL

Date and signature by Master, authorized agent or officer Master

Port of Arrival/Departure : Sankt Peterburg

14 Peso of Argentina; 4000 Peso of Chile; 100 Grv of Ukraine

9/9/2007

of 1

8.Signature

VLASOV MYKHAYLO


1.Name of ship 2.Effect which are dutiable or subject

"ROGUE" to prohibition and restricts


Sig

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Sp

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Go

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PC

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Mo

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TV

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CD

Mo

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Vid

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rec

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D p

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Ra

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VALLETTA

4.No 5.Family name,given name 6.Rank or rating 7.Personal effects

1 VLASOV MYKHAYLO MASTERClothing and Personal Effects

200 NIL 1 NIL 1 NIL NIL NIL NIL NIL 1

2 YERYOMENKO MYKOLA CH.OFF.Clothing and Personal Effects

200 1 1 1 1 NIL NIL 1 NIL NIL 1

3 RYBCHUK ANDRIY 2 OFF.Clothing and Personal Effects

4 STARODUB MYKHAYLO 3 OFFClothing and Personal Effects

200 NIL 4 1 1 NIL NIL NIL NIL NIL NIL

5 KORCHYNSKY VIKTOR CH.ENG.Clothing and Personal Effects

6 SYZONENKO EDUARD 2 ENG.Clothing and Personal Effects

200 NIL NIL 1 2 NIL NIL 1 NIL NIL NIL

7 SAVCHUK VOLODYMYR 3 ENG.Clothing and Personal Effects

200 NIL NIL NIL 1 NIL NIL 1 NIL 1 1

8 LYSENKO VOLODYMYR 4 ENG.Clothing and Personal Effects

NIL NIL NIL NIL 1 NIL NIL 1 NIL 1 NIL

9 BAKHIN VASYL ELECTR.Clothing and Personal Effects

200 NIL NIL NIL 1 NIL NIL NIL NIL NIL 1

10 KONONOV SERGIY BOSUNClothing and Personal Effects

11 BRATUKHIN SERGIY A/BClothing and Personal Effects

200 NIL 4 NIL 1 NIL NIL NIL NIL 1 1

12 BAYGILDIN IGOR A/BClothing and Personal Effects

200 NIL NIL NIL NIL NIL NIL NIL NIL NIL 1

13 POPADYUK VITALIY A/BClothing and Personal Effects

NIL NIL 1 NIL 1 NIL 1 NIL NIL NIL 1

14 HUBRIY YEVHEN O/SClothing and Personal Effects

200 NIL NIL NIL 1 NIL NIL NIL NIL NIL NIL

15 ZARVA IGOR O/SClothing and Personal Effects

16 KOBLYK MYKHAYLO OILERClothing and Personal Effects

NIL NIL 1 NIL 1 NIL NIL NIL NIL NIL NIL

17 POZHYDAYEV SERHIY OILERClothing and Personal Effects

NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL

18 NITOCHKIN OLEG OILERClothing and Personal Effects

200 NIL NIL NIL 1 1 1 NIL NIL NIL NIL

19 OMELCHENKO ANATOLIY FITTERClothing and Personal Effects

200 NIL 1 1 1 NIL NIL NIL NIL NIL 1

20 SOBIESZCZANSKI ZBIGNIEV FITTERClothing and Personal Effects

200 NIL 1 NIL 1 NIL 1 NIL NIL NIL 1

21 JANOWSKI TOMASZ FITTERClothing and Personal Effects

200 NIL NIL NIL 1 NIL 1 NIL NIL NIL 1

22 PARTASOV ANATOLIY COOKClothing and Personal Effects

NIL NIL NIL 1 2 NIL NIL NIL NIL 1 1

23 KIRIN OLEKSIY M/MClothing and Personal Effects

NIL NIL NIL NIL 1 1 1 NIL 1 NIL 1

24 CHEKOV OLEKSANDR M/MClothing and Personal Effects

200 NIL NIL NIL 1 NIL NIL 1 NIL NIL NIL

VLASOV MYKHAYLODate and signature by Master, authorized agent or officer Master

Port of Arrival/Departure : Sankt Peterburg

9/9/2007

of 1

8.Signature

FORM CODE: CR/5

C R E W L I S T

Arrival: Departure: Page No.11. Name of Vessel 3. Date of Arrival/Departure

"ROGUE" Sankt Peterburg 9/9/20074. Nationality of Ship

VALLETTA Durban7.No 8: Family Name, given Names 9. Rank/Rate 10. Nationality 11. Date of birth

12.Seaman Book No. 12.Date and Place of.

or passport No. singing on

1 VLASOV MYKHAYLO MASTER UKRAINE 16/01/1964 AB3102897/17/2007

Dahej

2 YERYOMENKO MYKOLA CH.OFF. UKRAINE 27/04/1950 AB2858635/29/2007

Antofagasta

3 RYBCHUK ANDRIY 2 OFF. UKRAINE 12/03/1972 AB0167767/08/2007Durban

4 STARODUB MYKHAYLO 3 OFF UKRAINE 6/08/1972 AB3154945/29/2007

Antofagasta

5 KORCHYNSKY VIKTOR CH.ENG. UKRAINE 6/10/1939 AB3318888/7/2007Durban

6 SYZONENKO EDUARD 2 ENG. UKRAINE 16/11/1974 AB2763863/15/2007Valletta

7 SAVCHUK VOLODYMYR 3 ENG. UKRAINE 28/07/1971 AB3246983/15/2007Valletta

8 LYSENKO VOLODYMYR 4 ENG. UKRAINE 6/03/1978 AB1810483/15/2007Valletta

9 BAKHIN VASYL ELECTR. UKRAINE 28/12/1959 AB3287213/16/2007Valletta

10 KONONOV SERGIY BOSUN UKRAINE 27/09/1962 AB2844288/7/2007Durban

11 BRATUKHIN SERGIY A/B RUSSIAN 17/01/1965 AB2781583/15/2007Valletta

12 BAYGILDIN IGOR A/B UKRAINE 28/07/1967 AB3364323/15/2007Valletta

13 POPADYUK VITALIY A/B UKRAINE 16/01/1983 AB0725893/15/2007Valletta

14 HUBRIY YEVHEN O/S UKRAINE 14/05/1979 AB3021333/15/2007Valletta

15 ZARVA IGOR O/S UKRAINE 28/11/1987 AB35656107.08.2007

Durban

16 KOBLYK MYKHAYLO OILER UKRAINE 23/11/1984 AB3529373/15/2007Valletta

17 POZHYDAYEV SERHIY OILER UKRAINE 3/02/1971 AB2922593/15/2007Valletta

18 NITOCHKIN OLEG OILER UKRAINE 14/05/1975 AB1391533/15/2007Valletta

19 OMELCHENKO ANATOLIY FITTER UKRAINE 8/11/1963 AB3112873/16/2007Valletta

20 SOBIESZCZANSKI ZBIGNIEV FITTER POLISH 17/03/1950 2274313/20/2007

Sfax

21 JANOWSKI TOMASZ FITTER POLISH 10/10/1968 2103243/20/2007

Sfax

22 PARTASOV ANATOLIY COOK UKRAINE 17/07/1969 AB3446193/15/2007Valletta

23 KIRIN OLEKSIY M/M UKRAINE 17/04/1979 AB0720513/15/2007Valletta

24 CHEKOV OLEKSANDR M/M UKRAINE 18/12/1980 AB3321773/15/2007Valletta

12. Date and signature by Master, authorised Agent or Officer.

Master of m/v "Rogue" M. VLASOVPage:1/1 Effective:01 May 2006

Form Code:CR-5 File no.:VS-D-19 / HO-CR-02 Revision 10

MARITEAM SERVICES INC.

2. Port of Arrival/Departure:

5. Port Arrived From / Port of destination:

SHIP'S STORES DECLARATION

Arrival Departure Page No.

1 of 11. Name of ship:

"ROGUE" Sankt Peterburg3. Date of arrival/dep.

9/9/2007

4..Nationality of ship:VALLETTA Durban

6. Number of persons onboard 24 7.Period of stay 8. Place of storage RESPECTIVE STORE ROOMS

9. Name of article 10. Quantity 11. For official use

DECK

Ammunition, 38 cal. NIL

Revolver, 38 cal NIL

Rope, Fibre - other than moorings 2350

Spare wire ropes (m) 686

Rope, Wire- other than moorings 3700

Mooring ropes 4100

ENGINE

Fuel Oil - Tons Metric

Diesel Oil - Tons Metric

Lubrication Oil - Ltrs

Fresh Potable Water - Tons Metric

STEWARD

Cereal & Pasta - inc rice + flour, etc. 386 kg

Coffee 20,600 kg

Dairy 176 ltr + 38 kg

Eggs 940 pcs

Fish - Frozen, fresh & canned 147 kg

Fruit - Fresh, dried &canned 176 kg

Meat - Fresh, canned & salt 875 kg

Poultry 204 kg

Vegetables - Fresh, frozen, can & Dry 334 kg

Sugar 235 kg

Cooking Oil 145 kg

Tea 10,800 kg

Soft drinks (cases) 27

Mineral water (cases) 15

Salt 64 kg

GENERAL

Engine Room Chemicals 888 ltr

Detergents & Soap 90,51 kg

Grease 80 kg

Kerosene & Solvents 140 ltrs

Paint and additives 1045 ltrs

Deck Chemicals nil

Rags 100 kg

BONDED

Cigarettes-all types (cartons) 15

Spirits - all types (bottles) nil

Wines (bottles) nil

Beer (cases) 1

CABIN

DVD/VHF/AUDIO 3/5/1 pcs

Sattelite system 1 set

Computers 10 (2 not in use) pcs

TV 8(1 not in use) pcs

Video/CD 137 / 93 pcs

Copy machine 4 (one not in use) pcs

PYROTECHNICS

Bridge

Rocket parachute flares 12 pcs

Red hand flares 12 pcs

Buoyant smoke signal 2 pcs

Line throwing apparatus 4 pcs

Life Boats (port / stbd)

Rocket parachute flares 8 pcs

Red hand flares 12 pcs

Buoyant smoke signal 4 pcs

Also such broken and sundry stores as linen, crockery, silver, spare parts, tools, instrument hospital supplies and slop chest stores

as required by law and/or necessary for the safe and efficient navigation of the vessel.

Also all spares required under IMO and Bahamian Regulations for the safe operation of the vessel per spares inventories on board

12. Date and Signature by master, authorized agent or officer. VLASOV MYKHAYLO

CUSTOMS FORM

2. Port of arrival/dep.

5. Port arrived from/Port of destination

VACCINATION LIST(Name of Shipping Line or Agent)

Arrival: Departure: 1. Name of Vessel

"ROGUE" Sankt Peterburg

VALLETTA Durban 7.No 8: Family Name, given Names 9. Rank/Rate

10. Nationality

1 VLASOV MYKHAYLO MASTER UKRAINE

2 YERYOMENKO MYKOLA CH.OFF. UKRAINE

3 RYBCHUK ANDRIY 2 OFF. UKRAINE

4 STARODUB MYKHAYLO 3 OFF UKRAINE

5 KORCHYNSKY VIKTOR CH.ENG. UKRAINE

6 SYZONENKO EDUARD 2 ENG. UKRAINE

7 SAVCHUK VOLODYMYR 3 ENG. UKRAINE

8 LYSENKO VOLODYMYR 4 ENG. UKRAINE

9 BAKHIN VASYL ELECTR. UKRAINE

10 KONONOV SERGIY BOSUN UKRAINE

11 BRATUKHIN SERGIY A/B RUSSIAN

12 BAYGILDIN IGOR A/B UKRAINE

13 POPADYUK VITALIY A/B UKRAINE

14 HUBRIY YEVHEN O/S UKRAINE

15 ZARVA IGOR O/S UKRAINE

16 KOBLYK MYKHAYLO OILER UKRAINE

17 POZHYDAYEV SERHIY OILER UKRAINE

18 NITOCHKIN OLEG OILER UKRAINE

19 OMELCHENKO ANATOLIY FITTER UKRAINE

20 SOBIESZCZANSKI ZBIGNIEV FITTER POLISH

21 JANOWSKI TOMASZ FITTER POLISH

22 PARTASOV ANATOLIY COOK UKRAINE

23 KIRIN OLEKSIY M/M UKRAINE

24 CHEKOV OLEKSANDR M/M UKRAINE

12. Date and signature by Master, authorised Agent or Officer.

9/9/2007

Master of the m/v "ROGUE " ____________

2. Port of Arrival/Departure:

4. Nationality of Ship 5. Port Arrived From / Destination:

9/9/2007

11.Yellow Fever

Expire Date.

06-Feb-13

28-Aug-16

29-Jul-13

18-May-17

14-Apr-16

05-May-16

14-Nov-16

28-Mar-15

04-Jun-13

14-Apr-15

15-Dec-16

03-Aug-08

27-Feb-16

07-Dec-16

02-Jul-17

15-Jun-16

16-Apr-14

13-Jun-11

08-Jun-08

03.Mar-09

08-Jun-09

21.Jul-09

10-Apr-13

08-Feb-16

VLASOV MYKHAYLO

3. Date of Arrival/Departure

Maritime Declaration of Health

Port of : Sankt Peterburg Date: 9/9/2007

Name of Ship: "ROGUE" From : Durban To: Sankt Peterburg

Nationality : VALLETTA

Net Registered Tonnage : 13807 Gross Tonnage: 23275

Deratting or Deratting Exemption Cert.: Exemption Dated: 22-Mar-07

Issued at : SFAX.TUNIS

List of ports of call from commencement of voyage with dates of departure :

DURBAN 27.06.07,DAHEJ 22.07.07, OFF COLOMBO 26.07.07, DURBAN 10.08.07

Health Questions Yes or No

1. Has there been on board during the voyage* any case of plague, cholera, yellow fever, small pox,

typhus or relapsing fever? Give particulars in the schedule. No

2. Has plague occured or been suspected among the rats or mice on board during the voyage* or

has there been an abnormal motality among them? No

3. Has any person died on board during voyage* otherwise than as a result of accident?

Give particulars in schedule. No

4. Is there on board or has there been during the voyage* any case of disease which you

suspect to be of infectious nature? Give particulars in schedule. No

5. Is there any sick person on board now? Give particulars in schedule. No

NOTE: In absence of a surgeon, the Master should regard the following symptoms as ground

for suspecting the existence of disease of an infectious nature ; fever accompanied by

prostration or persisting for several days, or eruption with or without fever; s

with symptoms of collapse; jaundice accompanied by fever.

6. Are you aware of any other conditon on board which may lead to infections or the

spread of disease ? No

I here by declare that the particulars and answers to the questions given in this Declaration of

Health (including the schedule) are true and correct to the best of my knowledge and belief.

Date 9/9/2007 M A S T E R: VLASOV MYKHAYLO

* If more than four weeks have elapsed since the voyage began, it will suffice to give particulars for the last 4 Weeks.

Carrier Instructions: Completing & Processing the Revised Form I-418 (United States Passenger/Crewlist)

1. Passengers, Supernumeraries and Stowawaysa) Provide all requested information on the upper half of the form, including the vessel’s proposed itinerary in the United States.b) Alphabetically list each passenger, supernumerary or stowaway’s: Given Name, First Name and Initial, Date of Birth, and Nationality & Document Number, as requested.c) If not all passenger names can be listed on page 1 of the form, continue to page 2d) Deliver complete passenger list to U.S. Public Health Service, U.S. Immigration & Naturalization Service, and two copies to the U.S. Customs Service.

2. Arriving Crewmena) Provide all requested information on the upper half of the form, including the vessel’s proposed itinerary in the United States, with related agent names and addresses (this will aid the Service in determining the responsible departure agent in the event that an updated copy of the I-418 is not received or not properly completed after departure).b) Check the “Crew List” box.c) Alphabetically list each crewman’s Given Name, First Name and Initial, Date of Birth, Nationality and Document Number, and Position or Title, as requested.d) If not all crew names can be listed on page 1 of the form, continue to page 2 and 3 as appropriate.e) Deliver complete crew list to U.S. Public Health Service, U.S. Immigration & Naturalization Service, and two copies to the U.S. Customs Service.f) An immigration officer will designate the inspection status of each crewman, assign a unique I-418 Receipt Number to the form, and return a copy of the form to the master and/or agent. This is the “traveling copy,” to be updated while the vessel is in the United States.

3. Crew Who Join or Separate in the United Statesa) If a crewman separates from the vessel while in the United States, record on the “traveling copy” the separation date in the “Date Separated” column for that crewman (note that INS must give prior authorization for discharge).b) If a crewman joins the vessel while it is in the United States, add to the “traveling copy” that crewman’s information at the next available blank line of the crew list and place the appropriate date in the “Date Joined” column for that crewman.

4. Departure Crew Lista) If the form has been appropriately annotated throughout the vessel’s time in the United States, all crew changes should already be reflected on the “traveling copy”. Confirm that all changes have been recorded.b) When the vessel departs, complete the “Summary of Departure” section.c) Provide one complete list (whether or not there have been crew changes to the Immigration and Naturalization Service at the port of departure.

U.S. Department of JusticeImmigration and Naturalization Service Passenger List - Crew ListPrior to arrival in the United States, complete a separate form a) working crew; and b) passengers and supernumeraries. In addition to its initial completion,the crew list shall be updated to reflect crew changes and other relevant activity (or lack thereof) until the vessel departs the United States.

Vessel Name: "ROGUE" Nationality: VALLETTA Official Number: 6608/8021323

Last foreign port (Place & Country): SANTA MARTA , COLOMBIA Date sailed from foreign: 07.09.2003

Date of Arrival in U.S.: 12.09.2003 Arrival Port: NEW ORLEANS # of Crew (including Master): 22 # of Passengers NIL

Agent at Arrival (Name & Address): BLUE WATER SHIPPING COMPANY FAX:504-4558650

PROPOSED ITINERARY

Next U.S. Port(s) Arrival Date Vessel Agent (Name & Address)

PASSENGER LIST X CREW LIST - Page 1 of 2List individuals alphabetically. Crew who join the vessel subsequent to its arrival while in the United States must be added to the original list and the appropriatedate recorded in the 'Date Joined' column. The 'Date Separated' column must be used when a listed crewman is separated from the vessel while it is in the .Unated States.Any crewman designated as "REFUSED" in the 'Government Use Only' column is to be detained on the vessel at all times.

VLASOV MYKHAYLO 01/16/64UKRAINE

MASTER 07/17/070

YERYOMENKO MYKOLA 04/27/50UKRAINE

CH.OFF. 05.08.030

RYBCHUK ANDRIY 03/12/72UKRAINE

2 OFF. 27.06.030

STARODUB MYKHAYLO 08/06/72UKRAINE

3 OFF 27.06.030

KORCHYNSKY VIKTOR 10/06/39UKRAINE

CH.ENG. 08/07/070

SYZONENKO EDUARD 11/16/74UKRAINE

2 ENG. 27.06.030

SAVCHUK VOLODYMYR 07/28/71UKRAINE

3 ENG. 05.08.030

LYSENKO VOLODYMYR 03/06/78UKRAINE

4 ENG. 27.06.030

BAKHIN VASYL 12/28/59UKRAINE

ELECTR. 05.08.030

X

Immigration and Naturalization Services has received the CREW LIST containing the names of allmembers of crew, including Master, on board said vessel at time of its arrival.

INS Port of Arrival (address):

SUMMARY OF DEPARTUREVessel Agent (at Departure): Following this vessel's departure from the United States, ensure that crew list reflects all crew additions and separations and is promptlysubmitted to the Immigration and Naturalization Service office at the port of departure. Summarize the departure circumstances by providing the following information:

Agent at Departure (Name & Address):

Date of Departure: Port of Departure: Total Added Crew: Total Separated Crew:

Form I-418 (Rev. 03/07/2002)N

Will crew perform longshore work while vessel is in the United States? [ X ] NO [ ] YES (Provide applicable INA Section 258 Exemption):

FamilyName

First Name& Initial

Date ofBirth

Nationality/Document #

Positionor Title

(Crew Only)

DateJoined

(Crew Only)

DateSeparated(Crew Only)

Inspection Status(INS Use Only)

Checked box indicates subsequent parole

I-418 Receipt Number (POE - YYMMDD - Stamp # - Military Time)

RECEIPT FOR CREW (INS Use Only). I-418 Receipt Number at right indicates that the

PROPOSED ITINERARY

Vessel Agent (Name & Address)

CONTINUED

SUMMARY OF DEPARTURE

Form I-418 (Rev. 03/07/2002)N



MASTER'S CERTIFICATION

Immigration Officer as to all departing crew on United States Flag Vessels, and before an Immigration Officer authorized to administer oaths as to alldeparting passengers on vessels.

I certify that Customs baggage declaration requirements have been made known to incoming passengers, that any required Customs baggagedeclarations have been or will simultaneously herewith be filed as required by law and regulation with the proper Customs officer; and that theresponsibilities devolving upon this vessel in connection therewith, if any, have been or will be discharged as required by law or regulation before theproper Customs officer. I further certify that there are no steerage passengers on board this vessel (46 U.S. C. 151-163).

Signature of Master:

CERTIFICATION OF COPY OF CREW LIST OF UNITED STATES FLAG VESSEL

I certify that this is a true copy of the original crew list of the named American vessel, which original crew list is on file in this office. Given under myhand and seal of office at the customhouse at on .

Signature of Customs Officer:

PASSENGER LIST X CREW LIST - Page 2 of 2 (CONTINUATION)

Vessel Name: "ROGUE" Arrival Port in U.S.: NEW ORLEANS Arrival Date: 12.09.03

KONONOV SERGIY 09/27/62UKRAINE

BOSUN 08/07/070

BRATUKHIN SERGIY 01/17/65RUSSIAN

A/B 03/15/070

BAYGILDIN IGOR 07/28/67UKRAINE

A/B 05.08.030

POPADYUK VITALIY 01/16/83UKRAINE

A/B 03/15/070

HUBRIY YEVHEN 05/14/79UKRAINE

O/S 03/15/070

ZARVA IGOR 11/28/87UKRAINE

O/S 27.06.03AT745080

KOBLYK MYKHAYLO 11/23/84UKRAINE

OILER 03/15/07AC792837

POZHYDAYEV YEVHEN 02/03/71UKRAINE

OILER 03/15/07AC987876

NITOCHKIN OLEG 05/14/75UKRAINE

OILER 27.06.030

OMELCHENKO ANATOLIY 11/08/63UKRAINE

FITTER 03/16/07AM100029

SOBIESZCZANSKI ZBIGNIEV 03/17/50POLISH

FITTER 03/20/070

JANOWSKI TOMASZ 10/10/68POLISH

FITTER 03/20/070

CHEKOV ANATOLIY 07/17/69UKRAINE

COOK 27.06.0330-Dec-99

I-418 Receipt Number (INS Use Only)

MASTER: Execute the following oath before a Customs Officer as to all arriving passengers on all vessels, and to a Customs Officer and an

FamilyName

First Name& Initial

Date ofBirth


Positionor Title

(Crew Only)

DateJoined

(Crew Only)






12.09.03

CONTINUED



Form I-418 (Rev. 03/07/2002)N






I certify that this is a true copy of the original crew list of the named American vessel, which original crew list is on file in this office. Given under myhand and seal of office at the customhouse at on .


PASSENGER LIST X CREW LIST - Page of (CONTINUATION)

Vessel Name: "ROGUE" Arrival Port in U.S.: Arrival Date:

TROYAN SERGIY 26.12.51UKRAINE

MASTER 01.04.03AB186625

FESHCHUK VOLODYMYR 23.03.51UKRAINE

CH/OFF 05.08.03AB137883

KURMANOV OLEKSANDR 02.06.67UKRAINE

2ND/OFF 27.06.03AB148916

BOGDANOV ANDREY 26.08.78RUSSIA

3RD/OFF 27.06.03MF0067625

RUSEISHVILI TENGIZ 20.09.46GEORGIA

CH/ENG 01.04.036765

KASYAN IVAN 20.01.50UKRAINE

2ND/ENG 27.06.03AB273366

SARBEYEV OLEKSANDR 08.07.62UKRAINE

3RD/ENG 05.08.03AB253181

ERMAKOV ANDRIY 04.07.62UKRAINE

4TH/ENG 27.06.03AB002675

YURCHENKO SERGIY 01.01.72UKRAINE

ELECTR. 05.08.03AB036220

ZANIN YEVGEN 22.08.68UKRAINE

BOS'UN 01.04.03AB143488

NAGORNYKH SERGIY 26.10.63UKRAINE

A/B 21.11.02AB104292

BILOUSOV OLEKSANDR 16.03.66UKRAINE

A/B 05.08.03AB162811

GONCHARUK RUSLAN 06.08.71UKRAINE

A/B 21.11.02AB112729

SURZHUK DMYTRO 04.10.71UKRAINE

O/S 01.04.03AB123949

PINKOVSKY VIKTOR 26.01.77UKRAINE

O/S 27.06.03AB113997

BAGRIY VASYL 23.06.70UKRAINE

OILER 21.11.02AB102725

MISCHENKO YEVHEN 29.11.61UKRAINE

OILER 21.11.02AB182632

ALUTIN YURIY 03.12.58UKRAINE

OILER 27.06.03AB144457

BEREZAN ANATOLIY 05.05.56UKRAINE

FITTER 21.11.02AB159760

IVANICHEK MYKHAYLO 03.08.56UKRAINE

CH/COOK 01.04.03AB070621

CONTINUEDI-418 Receipt Number (INS Use Only)

Form I-418 (Rev. 03/07/2002)N


FamilyName

First Name& Initial

Date ofBirth


Positionor Title

(Crew Only)

DateJoined

(Crew Only)




U.S. Department of Justice

Immigration and Naturalization Service

Prior to arrival in the United States, complete a separate form a) working crew; and b) passengers and supernumeraries. In addition to its initial completion,the crew list shall be updated to reflect crew changes and other relevant activity (or lack thereof) until the vessel departs the United States.

Vessel Name: "ROGUE" Nationality: VALLETTA Official Number: 6608/8021323

Last foreign port (Place & Country): SANTA MARTA / COLOMBIA Date sailed from foreign: 07.09.03

Date of Arrival in U.S.: 12.09.2003 Arrival Port: NEW ORLEANS # of Crew (including Master): 22 # of Passengers:

Agent at Arrival (Name & Address): BLUE WATER SHIPPING COMPANY

PROPOSED ITINERARY

Next U.S. Port(s) Arrival Date Vessel Agent (Name & Address)

PASSENGER LIST X CREW LIST - Page 1 of 2

List individuals alphabetically. Crew who join the vessel subsequent to its arrival while in the United States must be added to the original list and the appropriatedate recorded in the 'Date Joined' column. The 'Date Separated' column must be used when a listed crewman is separated from the vessel while it is in the .Unated States.Any crewman designated as "REFUSED" in the 'Government Use Only' column is to be detained on the vessel at all times.

VLASOV MYKHAYLO 01/16/64UKRAINE

MASTER 07/17/07AB310289

YERYOMENKO MYKOLA 04/27/50UKRAINE

CH.OFF. 05.06.03AB285863

RYBCHUK ANDRIY 03/12/72UKRAINE

2 OFF. 27.06.03AB016776

STARODUB MYKHAYLO 08/06/72UKRAINE

3 OFF 27.06.03AB315494

KORCHYNSKY VIKTOR 10/06/39UKRAINE

CH.ENG. 08/07/07AB331888

SYZONENKO EDUARD 11/16/74UKRAINE

2 ENG. 27.06.03AB276386

SAVCHUK VOLODYMYR 07/28/71UKRAINE

3 ENG. 03/15/07AB324698

LYSENKO VOLODYMYR 03/06/78UKRAINE

4 ENG. 27.06.03AB181048

BAKHIN VASYL 12/28/59UKRAINE

ELECTR. 03/16/07AB328721

X CONTINUED

Immigration and Naturalization Services has received the CREW LIST containing the names of all

members of crew, including Master, on board said vessel at time of its arrival.

INS Port of Arrival (address):


Vessel Agent (at Departure): Following this vessel's departure from the United States, ensure that crew list reflects all crew additions and separations and is promptlysubmitted to the Immigration and Naturalization Service office at the port of departure. Summarize the departure circumstances by providing the following information:Agent at Departure (Name & Address):

Date of Departure: Port of Departure: Total Added Crew: Total Separated Crew

Form I-418 (Rev. 03/07/2002)N

Will crew perform longshore work while vessel is in the United States? [ X ] NO [ ] YES (Provide applicable INA Section 258 Exemption):

FamilyName

First Name& Initial

Date ofBirth


Positionor Title

(Crew Only)

DateJoined

(Crew Only)




RECEIPT FOR CREW (INS Use Only). I-418 Receipt Number at right indicates that the

NIL

PROPOSED ITINERARY

Vessel Agent (Name & Address)

CONTINUED


Form I-418 (Rev. 03/07/2002)N








I certify that this is a true copy of the original crew list of the named American vessel, which original crew list is on file in this office. Given under my

hand and seal of office at the customhouse at on .


PASSENGER LIST X CREW LIST - Page 2 of 2 (CONTINUATION)

Vessel Name: "ROGUE" Arrival Port in U.S.: NEW ORLEANS Arrival Date: 12.09.2003

KONONOV SERGIY 09/27/62UKRAINE

BOSUN 08/07/07AB284428

BRATUKHIN SERGIY 01/17/65RUSSIAN

A/B 03/15/07AB278158

BAYGILDIN IGOR 07/28/67UKRAINE

A/B 03/15/07AB336432

POPADYUK VITALIY 01/16/83UKRAINE

A/B 03/15/07AB072589

HUBRIY YEVHEN 05/14/79UKRAINE

O/S 03/15/07AB302133

ZARVA IGOR 11/28/87UKRAINE

O/S 27.06.03AB356561

KOBLYK MYKHAYLO 11/23/84UKRAINE

OILER 03/15/07AB352937

POZHYDAYEV YEVHEN 02/03/71UKRAINE

OILER 03/15/07AB292259

NITOCHKIN OLEG 05/14/75UKRAINE

OILER 27.06.03AB139153

OMELCHENKO ANATOLIY 11/08/63UKRAINE

FITTER 03/16/07AB159760

SOBIESZCZANSKI ZBIGNIEV 03/17/50POLISH

FITTER 03/20/07227431

JANOWSKI TOMASZ 10/10/68POLISH

FITTER 03/20/07210324

CHEKOV ANATOLIY 07/17/69UKRAINE

COOK 27.06.03AB344619

CONTINUED

I-418 Receipt Number (INS Use Only)

Form I-418 (Rev. 03/07/2002)N


FamilyName

First Name& Initial

Date ofBirth


Positionor Title

(Crew Only)

DateJoined

(Crew Only)






12.09.2003

CONTINUED

Form I-418 (Rev. 03/07/2002)N



Health Service, United States Immigration Service, and two such lists to United States Customs Bureau on arrival at first port in the United States.

not in possession of a valid individual visa or lawful resident alien card.

Health Service, United States Immigration Service, and two such lists to United States Customs Bureau on arrival at

where promoted for a document number.

returning), discharge authorization must first be obtained from the United States Immigration Service via Form I-408 (Application to Pay Off or Discharge Alien Crewman) and the appropriate date of separation must be recorded in the

the appropriate date in the 'Date Joined' column.

and deliver one complete list (whether or not there have been crew changes) to the United States Immigration and Naturalization Service at the port of departure.

PAPERWORK REDUCTION ACT NOTICE. We try to create forms and instructions that are accurate, can be easily understood and which impose the least possible

complex. The average time to complete and process this form is one hour. If you have comments regarding the

Service, HQPDI, 425 I Street, N.W. Room 4034, Washington, D.C. 20536; OMB No. 1115-0083. DO NOT MAIL YOUR COMPLETED FORM TO THIS ADDRESS.

Form I-418 (Rev. 03/07/2002)N

INSTRUCTIONSALL NAMES AND OTHER DATA INSCRIBED ON THIS FORM MUST BE IN THE ENGLISH LANGUAGE.

PASSENGERS: Deliver one complete alphabetical passenger list, regardless of nationality, to United States Public

CREW LIST VISA APPLICATION: Submit form in duplicate to U.S. consular officer, specifying each alien crewman

ARRIVING CREW: Deliver one complete alphabetical crew list, regardless of nationality, to United States Public

first port in the United States. Where a crewman is a returning resident, show his/her alien registration receipt number

CHANGES IN CREW: If an alien crewman is separating from the vessel while in the United States (and will not be

'Date Separated' column of this form for that crew member. If a crew member joins the vessel while in the United States, add the crewman's name and other requested information at the next available blank line of the list and record

DEPARTING CREW: When the vessel departs the United States, complete the SUMMARY OF DEPARTURE section

burden on you to provide us with the information. Often this is difficult because some immigration laws are very

accuracy of this estimate or suggestions for making the form simpler, please write to the Immigration and Naturalization

DEPARTMENT OF THE TREASURY

UNITED STATES CUSTOMS SERVICE SHIP'S STORES DECLARATION

Arrival Departure

1. Name of ship: "ROGUE" 2. Port of arrival/dep. NEW ORLEANS

4..Nationality of ship: VALLETTA 5. Port arrived from/Port of destination : SANTA MARTA

6. Number of persons onboard NIL 7.Period of stay 8. Place of storage Respective Store Rooms

9. Name of article 10. Quantity 11. For official use

DECK

Ammunition, 38 cal. NIL

Revolver, 38 cal NIL

Rope, Fibre - other than moorings 16 PCS

Rope, Wire- other than moorings 1100 M

ENGINE

Fuel Oil - Tons Metric 276

Diesel Oil - Tons Metric 66

Lubrication Oil - Tons Metric 18350

Fresh Potable Water - Tons Metric 150

STEWARD

Cereal & Pasta - inc rice + flour, etc. 15/100/200 KGS

Coffee 7 KGS

Dairy 30 KGS

Eggs 360 PCS

Fish - Frozen, fresh & Salt 80 KGS

Fruit - Fresh, dried &canned NIL

Meat - Fresh, canned & salt 200 KGS

Poultry 100 KGS

Vegetables - Fresh, frozen, can & Dry 250 KGS

Sugar 200 KGS

Cooking Oil 60 LTRS

GENERAL

Engine Room Chemicals 510 KGS

Detergents & Soap 50 KGS/150 PCS

Grease 180 KGS

Kerosene & Solvents NIL

Paint and additives 925 KGS

Deck Chemicals 20 KGS

Rags 20 KGS

BONDED

Beer (cases) NIL

Cigarettes (cartons) 87

Spirits - all types (bottles) 2

Wines (bottles) NIL

Tobacco NIL

NARCOTICS

Gardenal(phenobarbital),tablets 20

Diazepam Tablets, 5mg 30

Diazepam ,ampuls 10mg 6


as required by law and/or necessary for the safe and efficient navigation of the vessel.


12. Date and Signature by master, authorized agent or officer. M a s t e r

CUSTOMS FORM 1303 (3-20-75)

Form Approved

O.M.B. No.48-RO486

Page No.

1 of 13. Date of arrival/dep. 12.09.03

Respective Store Rooms



O.GRITSENKO

CUSTOMS FORM 1303 (3-20-75)

DEPARTMENT OF THE TREASURY Form Approved

UNITED STATES CUSTOMS SERVICE O.M.B. No. 1515-0061

CREW'S EFFECTS DECLARATION19 CFR 4.7(a). 4.7a(b) Page No.

11. Name of Ship

"ROGUE" members of the crew (except those exclu-

3. Nationality of Ship sively for use on voyage or cleared through

VALLETTA Customs authorities

4. No.5. Family name, given names 6. Rank or rating Cigs. Spirits Beer Other

1 VLASOV MYKHAYLO MASTER 200 NIL NIL PERSONAL none2 YERYOMENKO MYKOLA CH.OFF. 200 NIL NIL PERSONAL none3 RYBCHUK ANDRIY 2 OFF. NIL NIL NIL PERSONAL none4 STARODUB MYKHAYLO 3 OFF 200 NIL NIL PERSONAL none5 KORCHYNSKY VIKTOR CH.ENG. 200 NIL NIL PERSONAL none6 SYZONENKO EDUARD 2 ENG. NIL NIL NIL PERSONAL none7 SAVCHUK VOLODYMYR 3 ENG. 200 NIL NIL PERSONAL none8 LYSENKO VOLODYMYR 4 ENG. NIL NIL NIL PERSONAL none9 BAKHIN VASYL ELECTR. NIL NIL NIL PERSONAL none

10 KONONOV SERGIY BOSUN 140 NIL NIL PERSONAL none11 BRATUKHIN SERGIY A/B 200 NIL NIL PERSONAL none12 BAYGILDIN IGOR A/B 200 NIL NIL PERSONAL none13 POPADYUK VITALIY A/B 200 NIL NIL PERSONAL none14 HUBRIY YEVHEN O/S 200 NIL NIL PERSONAL none15 ZARVA IGOR O/S 200 NIL NIL PERSONAL none16 KOBLYK MYKHAYLO OILER 200 NIL NIL PERSONAL none17 MISCHENKO YEVHEN OILER NIL NIL NIL PERSONAL none18 NITOCHKIN OLEG OILER NIL NIL NIL PERSONAL none19 OMELCHENKO ANATOLIY FITTER 200 NIL NIL PERSONAL none20 SOBIESZCZANSKI ZBIGNIEV FITTER NIL 1 NIL PERSONAL none21 JANOWSKI TOMASZ FITTER 200 NIL NIL PERSONAL none22 PARTASOV ANATOLIY COOK NIL NIL NIL PERSONAL none23 KIRIN OLEKSIY M/M NIL NIL NIL PERSONAL none24 CHEKOV OLEKSANDR M/M 200 NIL NIL PERSONAL none

8. Date and sinature by master, authorised agent or officer.

O.GRITSENKOThis form may be printed by private parties (see 19 CFR 4.99) CUSTOMS FORM 1304 (111888)For Sale by District Directors of Customs.

2. Articles aquired abroad by officers and

7. No. of crewmember's declaration of articles intended to be landed (if none:show "None" opposite name)

DEPARTMENT OF THE TREASURY UNITED STATES CUSTOMS SERVICE OMB No. 1515-0060

VESSEL ENTRANCE OR ENTRANCE CLEARANCECLEARANCE STATEMENT

Trade Code (see back) 02Customs Directive No.3120-017

1. Manifest Number 2. Port of Arrival 4. Vessel Operating Draft (in feet and inches)

NEW ORLEANS 12.09.2003 (see back for instructions) 9,3 m5. Nationality, Name and Type of Vessel (see 6. Vessel Built at/Year 7. Name Address & Phone No. of Ship's Agentback for instructions) Shin Kurushima Dockyard Co, Japan BLUE WATER SHIPPING COMPANY FAX 504-4558650

VALLETTA "ROGUE" 29578 504-8897409 504-5836077 504-3470424 504-5826192

DRY CARGO

8. Name & Country of Owner 9. Name & Country of Operator (see back for instructions)

MARITEAM SERVICES INC.

AOSTA SHIPPING Co.Ltd. 6 RIZARIOU Str.HALANDRI,ATHENS,13233 GREECE

10. Gross Tonnage 11. Net Tonnage 13.IMO#/Official No./Call Sign (see back for instructions)

13432 8232 SANTA MARTA 6608/8021323 9HUF8

14. List All Dock Locations (scontinue on back if necessary)

15. Particulars of Voyage. (Previous and Subsequent Ports off Call; underline where remaining cargo will be discharged) (scontinue on back if necessary)

TUBARAO-PARANAGUA-ROSARIO-DJEN.DJEN-NUEVA PALMIRA-SANTA MARTA-NEW ORLEANS16. Brief Description of Cargo 17. Check if incomplete Manifest for Export Check if Complete

IN BALLAST Manifest filed for

Check if Licensed Cargo Loaded export.

18. Number of Crew 19. Number of Passengers 20. List All Carriers on Board by SCAC Code

22 NIL21. Tonnage Mark 22.Bunkers; Type, Barrels, Value

None Submerged Not Submerged

23. Load Line Expires 24. Solas Certificate Expires 25. Passengers Allowed Per Coast Guard 26. Number of Passengers

1-Mar-05 Certificate NIL Embarking/Disembarking NIL27. Cert. Of Fin. Resp. No. (Oil Pollution) and 28. Cert. Of Fin. Resp. (Passenger Death/Injury) 29. Cert. Of Fin. Resp. (Passenger Transportation

Exp. Date. 849018-03 Identification)

14-Jan-06 NIL NIL30. PURPOSE OF ENTRY OR CLEARANCE

D (Discharge Foreign Cargo) X (Export Cargo on Board on Arrival) L (Lade Cargo For Export)

F (Foreign Cargo to Remain On Board (FROB)) N (No Cargo Transportation) Y (Military Cargo For Discharge)

31. Print and Sign Name of Master, Authorised Agent or Officer, Date.

O.GRITSENKO

FOR CUSTOMS USE ONLY

32. Customs Fee Paid Up* 33. APHIS User Fee Paid Up* 34. Tonnage Tax Paid UP*

35. Cash Receipt, CF 368 or Transaction No. 36. Total Fees Collected 37. Port Entered/Cleared, Time and Date

38. Customs Officer Remarks

39. Signature and Title of Officer Receiving Entry/Granting Clearance

CHECK BOXES ONLY IF FEES NOT COLLECTED Customs Form 1300 (0100)

3. Date & Time of Arrival/Departure

12. Port Arrived From/Departed For

INSTRUCTIONS

Trade Codes: Please enter the code that best describes the arriving or departing vessel.

(1) Foreign in Ballast(2) Foreign Bulk(3) Foreign General Cargo(4) Domestic or Coastwise Ballast(5) Domestic or Coastwise Bulk(6) Domestic or Coastwise General Cargo

Block 4 - Vessel Operating Draft: (not the design draft)

Deepest draft of the vessel on entrance (in feet and inches)Deepest draft of the vessel on clearance (in feet and inches)

Block 5 - Vessel Types: List one of the codes and descriptions from below

111 Crude Oil Tanker 350 Passenger112 Crude/Products Tanker 410 Fish Processing & Catching140 Tank Barge 421 Drilling Ship150 Other Tanker 422 Tug/Supply Offshore Support210 Bulk/Oil Carier 431 Tug/Tow boat229 Bulk Carrier 432 Pushboat310 Container 492 Research/Survey325 Vehicle Carrier 493 Dredger330 General Cargo 494 Yacht333 RO-RO Cargo 499 Other NEI340 Dry Cargo Barge 600 Lakers Vessels341 Deck Barge

Block 9 - Operator as listed on the Certificate of Financial Responsibility (Oil Pollution); unless other verifiable charter or lease arrangement indicatesotherwise.

Block 13 - If IMO # is available list that and cross out other two titles. If IMO # not available list either or both the Official number and/or Call Sign andcross out the IMO #.

Block 14 -- Additional information

Block 15 -- Additional Information

PAPERWORK REDUCTION ACT NOTICE: This request is in accordance with the Paperwork Reduction Act of 1995. The information to be provided issubmitted by the Master of the vessel and is used by Customs to attest to the truthfulness of the forms, certificates, and manifest on board and whichmust be present to Customs. Completion of this form is mandatory. It is also used by Customs to verify the various registration certificates and numbers.The estimated average burden associated with this collection of information is 5 minutes per respondent depending on individual circumstances.Comments concerning the accuracy of this burden estimates and suggestions for reducing this burden should be directed to U.S. Customs Service,Reports Clearance Officer, Information Services Branch, Washington D.C. 20229, and to the Office of Management and Budget, Paperwork ReductionProject (1505-0060), Washington D.C. 20503.

U.S. GPO: 2000-511-342 Customs Form 1300 (01/00)

crew7

Documents

shin kurushima

article deck

rice flour

instrument

respective

salt poultry

slop chest

list individuals