G910.03.2 POSITION:

NAME: (Last) (First) Sako ta

Norwegian Cruise Line

Safety & Environmental Management Sy stem

SEAFARER'S MEDICAL CERTIFICATE ( Pre-em ployment, Re-em ple>yment, Biennial)

ADDRESS: (street ) H d · · City: Ha dzeli 141 ·71 248 zici

Issue Date : A ril 30 2013

EXP. DATE:

NoO

I n accordance wit h t he provisions of I LO Maritime Labor Convent ion 2006 (MLC 2006), this m edical certificate indicates t hat t he above m entioned Seafarer has passed t he below minimum requirements, and a ll are satisfactory.

Proper Seafarer's identification was provided and verified at the t ime of examination by the Med ical Practitioner. Hearing, unaided hearing and visual acuity meet medical requirements.

Color vision meets medical standards (where applicable to Seafarers whose j obs/duties are affected). Seafarer has been deemed Fit for Duty and free of any medica l condition(s) li ke ly to be aggravated by sea service. Approved Physician's Name and Signature provided

HAVE YOU EVER HAD, DO YOU NOW HAVE, OR EVER BEEN TOLD THAT YOU HAVE/HAD ANY OF THE FOLLOWI NG:

CONDITION Yes No CONDITION

1. Epilepsy/Seizures/Fainting D .18I. 23. Rheumatic Fever/Typhoid Fever

2. Severe Headaches D ~ 24. Ma laria

3. Heart Problems or Disease D ~ 25. Genetic or Familial Disorders

4. High or Low Blood Pressure D N 26. Amputations/Prosthetics

5. Chest Pain/Shortness of Breath D _N 27 . Arthritis/Hand or Wrist Problems or Pain J..-~~~~~~~~~~~~~~~~~~-i-:==--+.,:=~~~

6. Tuberculosls

7. Asthma/Hay Fever/Allergies

8. Frequent Colds/Sore Th roat

9. Pneumonia/Influenza/Bronchitis

10. Lung Problems or Disease

11. Abdominal Pain/ Ulcer/Stomach Problems or Disease

12. Hepat itis/Gallbladder Stones/Liver Disease

13. Kidney Stones /Kidney Problems or Disease

14. Diabetes/Thyroid Disease/Other Endocrine Problems or Diseases

15. Prostate/Hernia/Other Urologlc Conditions or Diseases

16. HIV/Syphilis/Gonorrhea/Sexually Transmitted Diseases

17. Abnormal Blood Studles/Cancer/Tumor(s)/ Abnormal Pap Test

18. Rashes/Skin Problems or Diseases

19. Head Injury/Stroke/Concussion

20. Vision/Eye Problems or Diseases

21. Nose/Throat Problems or Diseases

D .N 28. Sprains/Dislocations/Fractures

D ,R 29. Neck Pain/Neck lnjury

0 N_ 30. Back Pain/Back Injury

0 ~ 31. Sciat ica/Scoliosis/Rheumatism

D~ 32. Bone or Joint I njury or Problems

33. Dege nerative Condition/Disease of t he Back/ Neck/Muscles/Joints

34. Knee Problems/Leg Injury/Varicose Veins or Leg Swelling

D R 35. Muscular Weakness

36. Psychiatric Illness/Counseling/Mental Dlsorder(s)

37. Drug usage/Excessive drinking/Failed drug test

D J8t 38. Hospi talization/Surgica l Operation

D ~ 39. Serious Inju ry/Serious Illness

D ~ 40. Elbow Pain/Elbow Injury

D -~ 41. Foot/Ankle pain/Injury

D ~ 42. Shoulder pain/Injury

D .18( 43. Hip pain/injury

22. Ear Problems or Diseases/Deafness D lJ8l 44. Any Other Medical Conditions Not Listed Above

HAVE YO U EVER RECEIVED ANY OF THE FOLLOWING: J HAVE YOU EVER BEEN:

45. Compensation/Disability for Job Injury D for 47. Refused Employment for Physical Reasons

Yes No

D R I D Z D H I

D J8'1

D )(J' I

D ~I D D p;rJ D

D IZ

DjZ" D M D J4'

D~ D ~.· ~S~jected for Military Service D ~I 46. Military Medica l Discharge

h"<.."''' "'" ~ ·~ ' ~~ '~\ Page 1 of 2 @

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Printed and electronic copies are uncontrolled document [ft 1P~MU~l6!'1 y of the user to verify that the issue date on any printed or <> i<>rtrnnir rnnv m ;1 trhPc: th<> lc:c:11 P rl;1t 'hf t~~OOP.1{~1hn1n'.i~ Nnrwpnl;m \.nilse Line SEMS document.

Norwegian Cruise Line Safety & Environmental Management System

G910 03 2 Issue Date:

I 1 A__Qri 30 20 3 NAME: (Last) Sakota (First) I_g_or Date of Birth: 18 • 11 . l 9Ji9_ I ARE YOU CURRENTLY:

CONDITION ] Yes No I CONDITION Yes No

49 . Under a doctor's care? } 0 ~SO. Taking medicines? 0 ~ 51. Have you taken any medications/injections over the past 12 months? 0 ~ 52. Do you Drink Alcohol? If yes, how much per day? 0 fa.r 53. Do you Smoke? If yes, how much per day?

IF ANY OF THE ABOVE ANSWERS (1-53) IS MARKED " YES" YOU MUST EXPLAIN BELOW: 0 :K

I AFFIRM THAT THE ABOVE ANSWERS ARE TRUE AND CORRECT TO THE BEST TO MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT I MUST DISCLOSE ALL MEDICAL CONDITIONS WHICH MIGHT AFFECT MY EMPLOYMENT, WHETHER LISTED ABOVE OR NOT. I ALSO AGREE ~O CONTINUOUSLY UPDATE NORWEGIAN CRUISE LINE WITH ANY AND ALL MEDICAL INFORMATION THAT MAY ARISE SUBSEQUENT TO lE DATE OF THIS DOCUMENT. IF I FALSIFY OR FAIL TO DISCLOSE ANY MEDICAL CONDillON/ INFORMATION, AND/OR FAIL TO PROV DE NORWEGIAN CRUISE LINE WITH UPDATED INFOMRATION AS NECESSARY SUBSEQUENT TO THE DATE OF THIS DOCUMENT, SUCH ACTION R INACTION WILL SERVE AS GROUNDS FOR TERMINATION WITHOUT EMPLOYMENT BENEFITS AND/OR MAINTENANCE AND CURE. I I AUTHORIZE RELEASE Of ANY MEDICAL INFORMATION CONCERING MY PAST, PRESENT OR FUTURE MEOICAL CONDITION, BY ly PRACTITIONER OR HOSPITAL, TO NORWEGIAN CRUISE LINE OR THEIR REPRESENTATIVES.

I AM ABLE TO READ, WRITE AND SPEAK ENG\!~ ~LL/"NDERSTANO THE ABOVE QUESTIONS.

Applicant's signature (Required}: ~ - . ' ~--J'--:s:

ai.tl~~ ~ wmmr~ gjl 'N.IJ lUlllJ !

EXAMINATION 71 000 BiH Name / Address of Examining Facility (Type or Print) P Z U 11 Po l j kl i n; k a d~ 0'1ebas:i:e11,0BB 8~1 Saraj evp Name of Medical Practitioner performing examination (Type or Print) ar. Ea es OdobasiG (MD/DO

a. TEMPERATURE: 36 HEIGHT: 175 WEIGHT: 64 7 PULSE: 76 BLOOD PRESSURE: 12 0 / 8 0 b. DISTANT VISION: WITHOUT GLASSES RIGHT 20/zo LEFT 20/'l-6 WITH GLASSES RIGHT 20/ LEFT 20/

NEAR VISION: WITHOUT GLASSES RIGHT 20/ LEFT 20/ WITH GLASSES RIGHT 20/ LEFT 20/ c. COLOR VIS ION : RIGHT: norm . LEFTnorm . (Date: 13. 09l 2013 .

Did the Doctor review the above medica l history with the applicant? 0Yes 0 No Did the a1>plicant have the abil!!Y_ to understand? [XJYes 0No

ABNORMAL NO] M,[L YES Jio 1. EYES (pteryglums?) ~ 11. EXTREMITY ABNORMALITY ~ 2. EAR DRUMS/HEARING ~ 12. REFLEX ABNORMALITY rS 3 . NOSE - ~ 13 . SKIN ABNORMALITY 0 K 4. THROAT/MOUTH ~ 14. HERNIA -1 i><t. 5. NECK ~;(] 15. RECTAL ABNORMALITY ~ 6. HEART MURMURS/RHYTHM )< 16. BACK ABNORMALITY ~ 7. LUNGS AND CHEST 18 17. VARICOSE VEINS/VASCULAR SYSTEM 0 ~ 8. ABDOMEN/ORGAN ENLARGEMENTS 0 ' >< 18. DEFORMmES/LIMITATION OF MOTION D ~ 9. GENITOURINARY (Pelvic only if Indicated) !( 19. FOOT ABNORMALITY/BUNIONS >< 10 . PSYCHIATRIC BEHAVIOR ~ 20. SCARS ON BACK/KNEES/ELSEWHERE 0 ?

REQUIRED LABORATORY TESTS

a. Chest X-Ray: Norma l _X_Abnormal __ e. Urinalysis: Normaf _X_ Abnormal --b. Drug Screen: THC~COC~AMPH~ OPIATES neg . f. HBSAG: Positive Negative _J.L_ c. Serology: Non-reactive _x_ Reactive __ g. Stool Ova/Parasites (food handlers): Posltive_Negative..]L d. Pa_p_Smear _{_female new hires}: N~ative I ntermediate Positive REMARKS (print):

;

~i;iJ,f ~CLASSIFICATION ~ '.J EMPLOYA Flt for Duty) REFER TO NCL FOR APPROVAL 4l11offfil'i~ neg. dru~ screen, no pre-existing conditl?r'is) Non-employable (Not Fit for Dub.U* S 1Z ~ - p

ate of Examination 3 • 0 9 • 2013 • Medical Practitioner's Signatur( ~ . ..c. ~~D9) ~_..:.;/

*Any Seafarer found permanently unfit, or fit only for restricted service, or wflose cerlificate is cancelled or suspended for more tflan three (3) month b (r6 . f@s B right . . . . ' of revieworappeal byanmdependentmed1cat refereeappomledby/heBMC. 6-;.~,...... Dr. n1ed ~tf~~ d' . . ) t.ll\\~ Hy~~- ~ . • 1·· 1·1 t:r~\·t1ln~ nw ic1ne ·,, ., spcc tJ •' " ' . . Page 2 o 2

Printed and electronic copies are uncontrol led documents. j' Uie responsi~~I of the user to verify that the li!lls 8<ltf!ldri'Jny printed orl electronic coov matches the issue date ofithifQ1./V6iftJtffllirfe 1 orweoian Cruise line SEMS document.

f-309.02

NORWEG IAN CRUISE LINE"'

ISSUP Dlll l' : 2tJ Jr1 nuary 2011

Rt>visc•d: M .iy 2013

CERTIFICATE OF SERVICE

Last Name of Seafarer First Name of Seafarer

Sakata Igor

Rank of Rating National ity

Cashier Bosnia and Herzegovina

Place of Engagement Date of Engagement Place of Discharge

Boston, MA 10/11/2013 Boston, MA

Total Time in Service Days in Service

10/11/2013 266 Days

Name of Vessel Port of Registry

Norwegian Dawn Nassau

Call Sign Official Number IMO Number

C6FT7 9000046 9195169

Gross Tonnage Horsepower kW

92,250 4x14,1700

Owners I Operators: NCL (Bahamas) Ltd . d/b/a Norwegian Cruise Line 7665 Corporate Center Drive Miami, Florida 33126 USA , c '- --Au1

Tel: (305)436-160 _ _ \

www.ncl.com \ , J i

Martin Holmqvist ~~1: -.,, 0~ Master's Signature (w7Stat;;\p)

Norwegian Dawn. 4th July 2014 Place and Date

Class

DNV

Date of Birth

11/18/1989 Passport Number

A0792725

Date of Discharge

7/4/2014

GMDSS

311 307 000