1st ANNUAL VERIFICATION,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,
2nd ANNUAL VERIFICATION,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,
3rd ANNUAL VERIFICATION,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,
4th ANNUAL VERIFICATION,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,
    If applicable. Reference is made to paragraph 3.4.1 of the Guidelines on Implementation of the International Safety Management (ISM) Code by Administrations (Resolution A.913(22)).    ,
INTERMEDIATE VERIFICATION (to be completed between the second and third anniversary date),Signed: …,
(Signature of authorised official),
Place: …,
Date: …,
ADDITIONAL VERIFICATION ,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,
ADDITIONAL VERIFICATION ,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,
ADDITIONAL VERIFICATION ,Signed: …,
,(Signature of authorised official),
,Place: …,
,Date: …,