293 



Periodical inspeotiona 



This is to certiify that at o periodical inspection required "by- 

 Regulation 4 (!)(•) of iinnex I of the said Convention, this ship was 

 found to coDply with the relevant provisions of the said Convention. 



Place Bate 



Signature and/or Seal of issviing authority- 



Place Da-te 



Signature and/or Seal of issuing au-thori"ty 



The pro-Tlsions of -the Con-vention being fully complied wi-th hy this ship, 

 the -validi-ty of tk±B certificate is, in accordance wi-th Regulation 8(2) 

 of Annex I of -the ConvmitioQ, extended Tsitil ...o 



Place ...*.. Date 



Slgna-ture and/or Seal of issuing authori-ty 



