25th May 2000

Greatship (India) LimitedOS/O/50/R-0

PPE ISSUANCE FORM

Location / Rig: ___________________________ Date: _____________________

Name: ___________________________ Job Title: _____________________

Date IssuedType of PPESignatureDate ReturnedSignature

DECLARATION BY EMPLOYEE

I hereby confirm that the PPE items as listed above have been issued to me. I understand that the items listed above are for my own safety and shall always use them wherever required. I also understand that it is my responsibility to use these PPE items with care and as per recommended best practices.

Signature Date