UNDERTAKING/ PROMISSORY NOTE

KNOW ALL MEN BY THESE PRESENT:

WE, ____________________ and ____________________, Filipino, of legal age,
(MAKER) (CO-MAKER)
and presently residing at _____________________________ by these presents, do hereby undertake and
declare, That:

WHEREAS, _____________________________________ (CREW), of legal age, single/married, and

presently residing at _______________________________ was hired as ______________________________
on board the vessel of Principal ____________________________________, by MAGSAYSAY MARITIME
CORPORATION, a corporation organized and existing in accordance with the laws of the Philippines, and with
principal offices and place of business at the Magsaysay Building, 520 T. M. Kalaw Street, Ermita, Manila,
hereinafter referred to as “COMPANY”;

WHEREAS, to guarantee the faithful compliance by said Crew of the terms and conditions of this
employment and to serve as a deterrent against desertion from the said Vessel and in order to indemnify the
COMPANY for the necessary expenses it will incur by reason of failure to comply with the terms and conditions
if his employment and/or his desertion;

NOW, THEREFORE, by virtue if the foregoing, we hereby undertake, promise, and bind ourselves jointly
and severally with each other to pay, indemnify, and/or reimburse the COMPANY the sum representing the
cost of repatriation and that of the replacement crew hired by the COMPANY, the penalty/fine that may be
imposed on the COMPANY of the government agency of the country where crew deserted and other related
expenses incurred, by reason of Crew’s desertion from the said vessel and/or failure to complete and comply
with the terms and conditions of the employment contract.

IN WITNESS WHEREOF, the parties hereto set our hand this ___ day of ____________ in Meycauayan,
Bulacan.

___________________________ _____________________________
MAKER (WIFE/FATHER/GUARDIAN) CO-MAKER (MOTHER/GUARDIAN)

__________________________________
CREW (SEAFARER)

Signed in the presence of:

_______________________ ________________________
 ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF BULACAN ) S.S.

BEFORE ME, a Notary Public for and in the above-jurisdiction, this ___ day of __________, personally
appeared the following:

NAME EVIDENCE OF IDENTITY ISSUED AT/ON

_____________________ ____________________________ _________________________
_____________________ ____________________________ _________________________
_____________________ ____________________________ _________________________

known to me and to me known to be the same persons who executed the foregoing instrument, an
Undertaking, and they acknowledgment is written and acknowledged to me that the same is their free and
voluntary act and deed.

WITNESS MY HAND AND NOTARIAL SEAL on the date and place first above written.

Doc. No. ____;

Page No. ____;
Book No. ____;
Series of 201__.