APPLICATION FOR CREDIT FACILITIES Name of vessel: Call Sign: Port of Registry: Former names  (if any): Name & address of vessel's legal owner: Name & address of vessel's operator: Name of person responsible for purchasing: Telephone: Fax: Name of person responsible for payment: Telephone: Fax: Banker's name and address: ADDITIONAL INFORMATION Date of Commencement of Business (registered owner): Date of Commencement of Business (operator): 1st Trade Reference: Contact person: Telephone: Fax: 2nd Trade Reference: Contact person: Telephone: Fax: Credit Limit requested: Payment Terms: 30 days net / net monthly / other from date of delivery / invoice / other Conditions of Trade: I.S.S.A. Conditions (1991) .( http://www.shipsupply.org/admin/condition.htm) CERTIFICATE OF APPLICANT 1. We confirm that the information given above is accurate and is intended to induce The Saint Petersburg & Ust - Luga Shipchadlers Ltd. to provide credit facilities. 2. We hereby authorize the supplier or its assigns to seek Bank and Trade references now and at any time in the future without further reference to us. By signing this document we ask our bankers to assist in every possible way in giving true and correct picture of our financial state. 3. We hereby agree to I.S.S.A. Conditions (1995 without exception) Signed: Date: Print name: Job Title: For and on behalf of: I certify that I am officially authorized to sign on behalf of the owners this document.