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THE PYA SEA SERVICE TESTIMONIAL 
FOR MASTER & DECK OFFICERS 
(MCA Approved for use in respect of service on 
commercially and privately operated yachts and sail training vessels) 
 
QP SRB F001 - Rev. : 7 16/05/2018 
 Page: 1 of 2 
 
 
 
 
Part 1 – Service 
 
This is to certify that: 
Name 
Email address 
Date of birth 
 
has served in CAPACITY of : Master / Chief Mate / OOW / Deckhand 
ON BOARD : 
Vessel name 
Flag 
Official No. 
Type (M/Y, S/Y, other) 
Length-metres 
GT 
From /date joined: 
(i.e. on board yacht 
service) 
 Until/ date signed off: 
(please fill in date 
even if still on board) 
 
The above service includes: 
Actual Days at Sea: 
(vessel leaves port/under way/at anchor associated with a 
24-hour passage) 
days 
Stand-by Service: 
(SHOULD NOT EXCEED DAYS AT SEA - waiting for owner, 
uniformed/ready to depart Max. 14 consecutive days without 
leaving port) 
days 
Shipyard Service: 
(max. 90 days allowed per application for OOW3000) 
days 
Watch keeping: (for HOLDERS OF MCA OOW3000 OR 
HIGHER ONLY- can be counted on cumulative basis: every 8 
hours = 1 day of watch keeping service until the 09/04/15 
and every 4 hours= 1 day after 09/04/15) 
days 
Leave of absence was granted as follows: 
 
Areas cruised 
 
 
 
 
 
THE PYA SEA SERVICE TESTIMONIAL 
FOR MASTER & DECK OFFICERS 
(MCA Approved for use in respect of service on 
commercially and privately operated yachts and sail training vessels) 
 
QP SRB F001 - Rev. : 7 16/05/2018 
 Page: 2 of 2 
 
 
 
 
Part 2 – Official endorsement 
 
ANY FALSE INFORMATION OR VERIFICATION SUBMITTED COULD LEAD TO THE 
WITHDRAWAL OF THE SIGNING OFFICER’S CoC 
 
IMPORTANT: By signing this testimonial, you agree for your personal details (name, email, 
CoC number and position) to be passed on to the PYA for the purpose of contacting you to 
verify that the information provided above is correct. 
Signature (should not 
be self-signed or left 
blank) 
 
Name (capitals) 
Date 
Capacity Owner / Master / Responsible Person in Management Company 
If signing as Master:- CoC No. 
CoC issuing authority 
If signing as 
Responsible Person 
Position 
Organisation and 
Address 
 
 
 
 
 Tel. 
EMAIL ADDRESS for 
verification purposes 
(leaving blank will 
result in delays) 
E-mail 
 
 
Yacht / Company Stamp 
 
 
 
 
 PYA verification 
 Verified by: 
 Date:

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