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ANNEX IMODELS FOR THE UNION CERTICATES OF QUALIFICATION AS A BOATMASTER, A LIQUEFIED NATURAL GAS (‘LNG’) EXPERT AND A PASSAGER NAVIGATION EXPERT

1. Model for the electronic form of the union certificates of qualification as a boatmaster, as a liquefied natural gas (LNG) expert and as a passenger navigation expert

The model for Union certificates of qualification as a boatmaster and the model for Union certificates of qualification as a liquefied natural gas (‘LNG’) expert or as a passenger navigation expert shall be the PDF/A document that includes the data related to the concerned certificate, which may be extracted from the database referred to in Article 25(2) of Directive (EU) 2017/2397 of the European Parliament and of the Council(1), under the crew member personal file. The Union certificate of qualification in PDF/A shall include the security features allowing verification of origin and integrity of data in accordance with Regulation (EU) No 910/2014 of the European Parliament and of the Council(2).

Instructions for the issuing authorities

1.Current family name(s) of the holder
2.Current first name(s) of the holder

Names shall be those appearing on the ID card or passport of the person concerned and shall be entered in UNICODE.

If a name is spelled differently in UNICODE and in ASCII, it shall also be transcribed in ASCII in brackets.

3a.Date of birth (dd/mm/yyyy)
3b.Place of birth (city)
4.Crew member identification number of the holder (CID) as in the database referred to in Article 25(2) of Directive (EU) 2017/2397
5.Physical identification of the holder by importing the electronic image file
6.Serial number of the certificate.

The serial number of the certificate shall consist of:

7.Date of issue of certificate
8.Date of expiry
9.Name of issuing authority
10.Specific authorisation(s) coded: R (for sailing with the aid of radar); M (for sailing on inland waterways with a maritime character); Stretches for specific risk as coded in the European Reference Data Management System (ERDMS); C (for sailing large convoys), coded with the issuing authority and indication of serial number of the authorisation
11.Fitness related mitigation measures and restrictions (code 01 until 09 as in ES-QIN as included in Commission Delegated Directive (EU) 2020/12(3)).

For the Union certificates of qualification as an LNG expert and as a passenger navigation expert, points 10 and 11 shall not apply.

Visual characteristics of the Union certificates of qualification:

Background in light blue colour Pantone 290C, printable in A4.

2. Model for the hard copy of the Union certificates of qualification as a boatmaster

(front)

(back)

Instructions for the issuing authorities

1.Current family name(s) of the holder
2.Current first name(s) of the holder

Names shall be those appearing on the ID card or passport of the person concerned and shall be entered in UNICODE.

If a name is spelled differently in UNICODE and in ASCII, it shall also be transcribed in ASCII in brackets.

3a.Date of birth (dd/mm/yyyy)
3b.Place of birth (city)
4.Crew member identification number of the holder (CID) as in the database referred to in Article 25(2) of Directive (EU) 2017/2397
5.Physical identification of the holder by importing the electronic image file
6.Serial number of certificate.

The serial number of the certificate shall consist of:

7.Date of issue of certificate
8.Date of expiry
9.Name of issuing authority
10.Specific authorisation(s) coded: R (for sailing with the aid of radar); M (for sailing on inland waterways with a maritime character); Stretches for specific risk as coded in ERDMS); C (for sailing large convoys)
11.Fitness related mitigation measures and restrictions (code as in ES-QIN as included in Delegated Directive (EU) 2020/12).
Physical characteristics of the Union certificate of qualification as a boatmaster:

Background in light blue colour: Pantone 290C

Card format ID-1 according to ISO/IEC 7810

3. Model for the hard copy of the Union certificates of qualification as an LNG expert or as a passenger navigation expert

(front)

(back)

Instructions for the issuing authorities

1.Current family name(s) of the holder
2.Current first name(s) of the holder

Names shall be those appearing on the ID card or passport of the person concerned and shall be entered in UNICODE.

If a name is spelled differently in UNICODE and in ASCII, it shall also be transcribed in ASCII in brackets.

3a.Date of birth (dd/mm/yyyy)
3b.Place of birth (city)
4.Crew member identification number of the holder (CID) as in the database referred to in Article 25(2) of Directive (EU) 2017/2397
5.Physical identification of the holder through importation of electronic image file
6.Serial number of certificate

The serial number of the certificate shall consist of:

7.Date of issue of certificate
8.Date of expiry
9.Issuing authority
Physical characteristics of the Union certificate of qualification as a passenger navigation expert or as an LNG expert:

Background in light blue colour Pantone 290C

Card format ID-1 according to ISO/IEC 7810

ANNEX IIMODEL FOR THE SINGLE DOCUMENT COMBINING UNION CERTIFICATES OF QUALIFICATION AND THE SERVICE RECORD BOOK

Page 1 of the model

Name of country

Service record book combined with certificates of qualification

Identification of the holder 2D barcode
1.Name(s) of the holder:
2.First name(s):
3a.Date of birth:3b. Place of birth:
4.Crew member identification number:
5.Photo

Identification of the service record book

1.Serial number:
2.Date of issue:
3.Issuing authority:
4.Signature and stamp of issuing authority:
5.Serial number of former service record book:

SRBXXXXSSSS

Page 2 of the model European Union certificates of qualification and certificates of qualification issued according to the Regulations for Rhine Navigation Personnel as apprentice, deckhand, boatman, able boatman and helmsman

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

SRBXXXXSSSS

Page 3 of the model Other certificates concerning qualifications relevant for inland navigation

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

Title of certificate: ________________________________________

Fitness related mitigation measures and restrictions:

Serial number:

Date of issue: Date of expiry:

Issuing authority:

Signature and stamp of issuing authority:

SRBXXXXSSSS

Page 4 of the model

Service time

Service time on board, name of craft:

Unique European vessel identification number or other official craft number:

Type of craft(4):

State of registration:

Length of craft in m(5)/number of passengers(5):

Owner (name and address):

Holder assumed service as(6):

Holder assumed service on (date):

End of service (date):

Boatmaster (name and address):

Place, date and signature of boatmaster:

Service time on board, name of craft:

Unique European vessel identification number or other official craft number:

Type of craft

State of registration:

Length of craft in m(5)/number of passengers(5)

Owner (name and address):

Holder assumed service as:

Holder assumed service on (date):

End of service (date):

Boatmaster (name and address):

Place, date and signature of boatmaster:

SRBXXXXSSSS

Pages 5 to 22 as page 4

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 23 of the model

Navigation time and stretches of inland waterways sailed over last 15 months Year:

The number of days navigated must be consistent with the navigation time entered in the logbook!

Name of craft or unique European identification number or other official craft numberjourney from via to(km)Start of journey(date)Days of interruptionEnd of the journey (date)Total number of navigation daysSignature of boatmaster
ABCDEFG
1
2
3
4
5
6
7
8
9
10

Complete document ☐ yes ☐ no

☐ Doubts at line(s):________

Doubts have been eliminated by presenting ☐ (parts of) the logbook ☐ other official documents

Space reserved for the competent authority

To be completed by the authority: total number of navigation days taken into consideration from this page

Validation mark of the competent authority

Presented on (date) ___________

Signature and stamp of the authority

SRBXXXXSSSS

Pages 24 to 55 as page 23

Headings of columns A to G not printed on those pages

Page 56 of the model

Without content

Instructions for the issuing authorities

Identification of the holder

1.Current family name(s) of the holder
2.Current first name(s) of the holder

Names shall be those appearing on the ID card or passport of the person concerned and shall be entered in UNICODE.

If a name is spelled differently in UNICODE and in ASCII, there shall also be transcribed in ASCII in brackets.

3a.Date of birth (dd/mm/yyyy)
3b.Place of birth (city)
4.Crew member identification number of the holder (CID) as attributed in the database referred to in Art. 25(2) of Directive (EU) 2017/2397 of the European Parliament and of the Council.

Identification of the service record book

The serial number of the service record book shall consist of:

The serial number of the service record book without the part on CID shall be repeated in the lower section of each page.

Certificates of qualification

The title of the issued certificate shall be inserted (in caps font) by the relevant competent authority. It shall be complemented by the following numbers in brackets, as appropriate: ‘(2)’ for Helmsman, ‘(3)’ for Able boatman, ‘(4)’ for Boatman, ‘(5)’ for Deckhand and ‘(6)’ for Apprentice.

As regards the Union certificates of qualifications, the title ‘European Union certificate of qualification in inland navigation’ accompanied by the relevant qualification shall be indicated for example ‘European Union certificate of qualification in inland navigation – Able boatman (3)’.

As regards certificates of qualifications issued in accordance with the Regulations for Rhine Navigation Personnel, the title ‘CCNR certificate of qualification’ accompanied by the relevant qualification shall be indicated for example ‘CCNR certificate of qualification – Able boatman (3)’.

Physical characteristics of the document

Colour: cover: light blue Pantone 290C; white background of inner pages

Format A5 according to ISO 216

Example of a filled in entry for service time

Service time on board, name of craft: UNTERWALDEN

Unique European vessel identification number or other official craft number: 07000281

Type of craft1:

State of registration: CH

Length of craft in m*/number of passengers* 105 m

Owner (name and address):

TSAG, Hauptstrasse 55, CH-4127 Riehen, Basel-Stadt

Holder assumed service as2: 3

Holder assumed service on (date): 22.10.1995

End of service (date): 22.11.1996

Boatmaster (name and address):

K. Huber, Rheinstrasse 55, D-76497 Wintersdorf

Place, date and signature of boatmaster: Rotterdam, 20.11.1996

K.Huber

Example of a filled in page for navigation time and stretches sailed

Navigation time and stretches of inland waterways sailed over last 15 months Year: 2015/2016

The number of days navigated must be consistent with the navigation time entered in the logbook

ABCDEFG
1 07000281Rotterdam (999,90)Mainz (500,00) Wien (1930,00)22.11.151117.12.1515Signature Huber
2 07000281Wien (1930,00) Mainz (500,00) Basel (169,90)20.12.1544.1.1612Signature Huber
3 07000281Basel (169,90) Rotterdam (999,90)6.1.16010.1.165Signature Huber
4 07000281Rotterdam (999,90) Antwerpen (20,00) Basel (169,90)13.1.16123.1.1610Signature Huber
5 07000281Basel (169,90) Antwerpen (20,00)25.1.16029.1.165Signature Huber
6 07000281Antwerpen (20,00) Basel (169,90)1.2.1607.2.167Signature Huber
7 07000281Base (169,90) Mainz (500,00) Bratislava (1867,00)9.2.16522.2.169Signature Huber
8 07000281Bratislava (18657,00) Regensburg (2376,30)27.2.1602.3.165Signature Huber
9 07000281Regensburg (2376,30) Mainz (500,00) Rotterdam (999,90)3.3.1609.3.167Signature Huber
10 07000281Rotterdam (999,90) Basel (169,90)12.3.16017.3.166Signature Huber

Complete document ☑yes ☐ no

☐ Doubts at line(s)__________

Doubts have been eliminated by presenting ☐ (parts of) the logbook ☐ other official documents

Space reserved for the competent authority

To be completed by the authority: total number of navigation days taken into consideration from this page81

Validation mark of the competent authority

Presented on (date) 15.04.16

Signature and stamp of the authority

SRBXXXXSSSS

ANNEX IIIMODEL FOR PRACTICAL EXAMINATION CERTIFICATES

We, name of the examining body,

hereby certify with document number …that

1.

Current family name(s) of the holder

2.

Current first name(s) of the holder

3a.

Date of birth (dd/mm/yyyy)

3b.

Place of birth (city)

has passed the practical examination [for obtaining a certificate of qualification as a boatmaster] [and] [for a specific authorisation for sailing with the aid of radar]

on the simulator (name of the simulator), approved by (name of the competent authority).

Place and date of issue

Signature and stamp of the examining body

Instructions

Names shall be those appearing on the ID card or passport of the person concerned and shall be entered in UNICODE.

If a name is spelled differently in UNICODE and in ASCII, it shall also be transcribed in ASCII in brackets.

Choose the applicable examination and delete the other examination if not applicable.

Physical characteristics

Colour: white background. Format A4 according to ISO 216

ANNEX IVMODEL FOR SERVICE RECORD BOOKS

Page 1 of the model

Name of country

Service record book

Identification of the holder

1.

Name(s) of the holder:

2.

First name(s):

3a.

Date of birth:

3b.

Place of birth:

4.

Crew member identification number:

5.

Photo

Identification of the service record book

1.Serial number:

2.Date of issue:

3.Issuing authority:

4.Signature and stamp of issuing authority:

5.Serial number of former service record book:

SRBXXXXSSSS

Page 2 of the model

Without content

Page 3 of the model

Service time

Service time on board, name of craft:

Unique European vessel identification number or other official craft number:

Type of craft(7):

State of registration:

Length of craft in m(8)/number of passengers(8):

Owner (name and address):

Holder assumed service as(9):

Holder assumed service on (date):

End of service (date):

Boatmaster (name and address):

Place, date and signature of boatmaster:

Service time on board, name of craft:

Unique European vessel identification number or other official craft number:

Type of craft

State of registration:

Length of craft in m(8)/number of passengers(8):

Owner (name and address):

Holder assumed service as:

Holder assumed service on (date):

End of service (date):

Boatmaster (name and address):

Place, date and signature of boatmaster:

SRBXXXSSSS

Pages 4 to 22 as page 3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Page 23 of the model

Navigation time and stretches of inland waterways sailed over last 15 months Year:

The number of days navigated must be consistent with the navigation time entered in the logbook!

Name of craft or unique European identification number or other official craft numberJourney from via to(km) (km)Start of journey (date)Days of interruptionEnd of the journey (date)Total number of navigation daysSignature of Boatmaster
ABCDEFG
1
2
3

Complete document ☐ yes ☐ no

☐ Doubts at line(s) ___________

Doubts have been eliminated by presenting ☐ (parts of) the logbook ☐ other official documents

Space reserved for competent authority

To be completed by the authority: Total number of navigation days taken into consideration from this page

Validation mark of the competent authority

Presented on (date):___________

Signature and stamp of the authority

SRBXXXSSSS

Pages 24 to 55 as page 23

Headings of columns A to G are not printed on those pages

Page 56 of the model

Without content

Instructions for the issuing authorities

Identification of the holder

1.Current family name(s) of the holder
2.Current first name(s) of the holder

Names shall be those appearing on the ID card or passport of the person concerned and shall be entered in UNICODE.

If a name is spelled differently in UNICODE and in ASCII, it shall also be transcribed in ASCII in brackets.

3a.Date of birth (dd/mm/yyyy)
3b.Place of birth (city)
4.Crew member identification number of the holder (CID) as in the database referred to in Art. 25(2) of Directive (EU) 2017/2397 of the European Parliament and of the Council(10).

Identification of the service record book

The serial number of the service record book shall consist of:

The serial number of the service record book without the part on CID shall be repeated in the lower section of each page.

Physical characteristics of the document

Colour: light blue Pantone 290C for the cover; white background of inner pages

Format: A5 according to ISO 216

Example of a filled in entry for service time

Service time on board, name of craft: UNTERWALDEN

Unique European vessel identification number or other official craft number: 07000281

Type of craft1:

State of registration: CH

Length of craft in m1/number of passengers* 105 m

Owner (name and address):

TSAG, Hauptstrasse 55, CH-4127 Riehen, Basel-Stadt

Holder assumed service as2: 3

Holder assumed service on (date): 22.10.1995

End of service (date): 22.11.1996

Boatmaster (name and address):

K. Huber, Rheinstrasse 55, D-76497 Wintersdorf

Place, date and signature of boatmaster: Rotterdam, 20.11.1996

K.Huber

Example of a filled in page for navigation time and stretches sailed

Navigation time and stretches of inland waterways sailed over last 15 monthsYear: 2015/2016

The number of days navigated must be consistent with the navigation time entered in the logbook

ABCDEFG
1 07000281Rotterdam (999,90)Mainz (500,00) Wien (1930,00)22.11.151117.12.1515Signature Huber
2 07000281Wien (1930,00) Mainz (500,00) Basel (169,90)20.12.1544.1.1612Signature Huber
3 07000281Basel (169,90) Rotterdam (999,90)6.1.16010.1.165Signature Huber
4 07000281Rotterdam (999,90) Antwerpen (20,00) Basel (169,90)13.1.16123.1.1610Signature Huber
5 07000281Basel (169,90) Antwerpen (20,00)25.1.16029.1.165Signature Huber
6 07000281Antwerpen (20,00) Basel (169,90)1.2.1607.2.167Signature Huber
7 07000281Base (169,90) Mainz (500,00) Bratislava (1867,00)9.2.16522.2.169Signature Huber
8 07000281Bratislava (18657,00) Regensburg (2376,30)27.2.1602.3.165Signature Huber
9 07000281Regensburg (2376,30) Mainz (500,00) Rotterdam (999,90)3.3.1609.3.167Signature Huber
10 07000281Rotterdam (999,90) Basel (169,90)12.3.16017.3.166Signature Huber

Complete document ☑ yes ☐ no

☐ Doubts at line(s) __________

Doubts have been eliminated by presenting ☐ (parts of) the logbook ☐ other official documents

Space reserved for the competent authority

To be completed by the authority: total number of navigation days taken into consideration from this page81

Validation mark of the competent authority

Presented on (date) _15.04.16

Signature and stamp of the authority

SRBXXXXSSSS

ANNEX VMODEL FOR LOGBOOKS

Page 1 of the model

Name of country

Logbook

Serial number of the logbook:

Date of issue:

Name of craft:

Unique European vessel identification number:

Issuing authority:

Signature and stamp of issuing authority:

LBKXXXXSSSS

Page 2 of the model Instructions for keeping the logbook

This logbook contains 200 pages, numbered from 1 to 200. Entries shall be legible and made in ink (e.g. using print letters).

Entries in the logbook shall be made in accordance with applicable crewing regulations. In the case of inland waterways whose courses are not fully within the scope of a manning requirement, the navigation time and rest time acquired on sections located outside the scope of the regulation shall also be taken into account.

Where loading and unloading activities require active navigational operations, such as dredging or manoeuvres between loading or unloading points, the time used for such activities shall be entered as navigation time.

Activities of crew members shall be entered according to their functions by using their respective number:

1

Boatmaster

2

Helmsman

3

Able boatman

4

Boatman

5

Deckhand

6

Apprentice

7

Engineer

8

Engine minder

9

If national regulations provide for other functions than the ones listed here above, such functions shall be entered using numbers from 9 onwards with the indication of the respective national title.

On each page the following entries shall be made:

Page 3 of the model

LBKXXXXSSSS

Page 4 of the model

Without content

Page 5 of the model REST TIMES

Operating mode(11)_______

YearCRAFTCREW
Start of the voyageEnd of the voyageCrew membersService record bookRest times of the crew membersEmbarkedDisemb.
12345678910111213
DateTimeLocationkmTimeLocationKmFunctionName and first nameNofromuntilfromuntilfromuntilTimeTime

LBKXXXXSSSS

Instructions for the issuing authorities

Identification of the logbook

The serial number of the logbook shall consist of:

The serial number of the logbook shall be repeated in the lower section of each page.

Physical characteristics of the document

Colour: red Pantone 187C for the cover; white background of inner pages

Format A4 horizontal according to ISO 216

(1)

Directive (EU) 2017/2397 of the European Parliament and of the Council of 12 December 2017 on the recognition of professional qualifications in inland navigation and repealing Council Directives 91/672/EEC and 96/50/EC (OJ L 345, 27.12.2017, p. 53).

(2)

Regulation (EU) No 910/2014 of the European Parliament and of the Council of 23 July 2014 on electronic identification and trust services for electronic transactions in the internal market and repealing Directive 1999/93/EC (OJ L 257, 28.8.2014, p. 73).

(3)

Commission Delegated Directive (EU) 2020/12 of 2 August 2019 supplementing Directive (EU) 2017/2397 of the European Parliament and of the Council as regards the standards for competences and corresponding knowledge and skills, for the practical examinations, for the approval of simulators and for medical fitness (OJ L 6, 10.1.2020, p. 15).

(4)

For type of craft, always indicate if type C or G tanker, large convoy or if craft using LNG as fuel

(5)

Delete if not applicable

(6)

Holder assumed service as’: the function must be numbered according to instruction for keeping the logbook

(7)

For type of craft, always indicate if type C or G tanker, large convoy or if craft using LNG as fuel

(8)

Delete if not applicable

(9)

Holder assumed service as’: the function must be numbered according to instruction for keeping the logbook

(10)

Directive (EU) 2017/2397 of the European Parliament and of the Council of 12 December 2017 on the recognition of professional qualifications in inland navigation and repealing Council Directives 91/672/EEC and 96/50/EC (OJ L 345, 27.12.2017, p. 53).

(11)

if applicable