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About Us
About MCI
Why Choose the Cook Islands?
Meet the Team
Cook Islands Agents
Ministry of Transport
Cook Islands
Sanctions Monitoring Program
Cook Islands Maritime Legislation
Cook Islands Maritime Jurisdiction
International Maritime Organization
Cook Islands Lawyers
Approved Fuel Suppliers
Registration
Online Application
Vessel Registration Requirements
Yacht Registration
Commercial Yachts
Private Yachts
Dual Registration
Ownership Structure
Mortgage Registration
Civil Liability Certificates
P&I Insurers
Bunkers
CLC
Wrecks
Survey and Certification
Classification Societies
Recognised Security Organisations
Cook Islands Approved Surveyors
Port State Control Compliance Support
Electronic Certificate Verification
Ship to Ship Transfers
Safe Manning Guidelines
Seafarers
Seafarer Training & Certification
Certificate of Endorsement
Approved Training Centres
Seafarer Discharge Book
STCW Dispensations
Certificate of Medical Fitness
Seafarer Certificate Verification
Seafarers FAQ
Info Centre
Document Library
Calendar of Events
Search
MLC Complaint Form
MLC Complaint Form
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Vessel Details
Please enter the details of the vessel below
Vessel Name
*
Vessel Type
IMO Number
Port of Registry
*
Please select
Arutanga
Avatiu
Rarotonga
CIYS – Arutanga
CIYS – Avatiu
CIYS – Cook Islands
Gross Tonnage
Call Sign
*
Company's MLC Designated Person's* contact details
*Or other person appointed by the Company
Name
*
Position
*
Phone
Email
Details of Seafarer that this complaint relates to
of to Why
Name
*
Position
*
Nationality
*
Embarkation Date
*
Cook Islands Certificate of Endorsement (if any)
Phone
*
Email
*
Email
Confirm Email
Is this complaint being submitted by the Seafarer above?
*
Yes
No
If you are filling out this complaint form on behalf of the Seafarer above, please select ‘No’ and enter your details below.
Details of the person making this complaint on behalf of the Seafarer
Name
*
Position
*
Relationship to the Seafarer
*
Nationality
Embarkation Date
Cook Islands Certificate of Endorsement (if any)
Phone
*
Email
*
Competent authority in the Seafarer's country of residence (if applicable)
Name
Contact Person
Position
Phone
Email
Details of person(s) onboard authorised to assist complainants
Name
Position
Phone
Email
Add another authorised person?
Yes
No
Name
Position
Phone
Email
Summary of onboard complaint
Date of complaint
*
Please provide the date that the onboard complaint was made
Were onboard complaint procedures followed?
Yes
No
Why were onboard complaint procedures not followed?
*
Please provide a summary of the reason(s) why onboard complaint procedures were not followed.
Onboard complaint was filed at the following levels
*
Superior Officer
Head of Department
Master
Shipowners representative ashore
Other
Nature of complaint
*
Recruitment and placement services (Manning Agency)
Seafarers Employment Agreement
Payment of wages
Hours of work or hours of rest
Entitlement to leave
Repatriation
Accommodation facilities
Recreation facilities
Food, water and catering
Medical care onboard and ashore
Other
Please select the item(s) that are most applicable
Summary of the complaint
*
Please provide a summary of the complaint related to the area(s) selected above.
Summary of why the complaint was not resolved
Please provide a summary of the reasons the complaint was not resolved.
Seafarer employment agreement details
Employer
*
Employee
*
Type of contract
*
Definite period
Indefinite period
Voyage agreement
Salary
*
Start Date
*
Termination Date
*
Upload Employment Agreement
*
Click or drag a file to this area to upload.
Please upload a signed copy of the Seafarer’s Employment Agreement. Allowed file types are jpg, jpeg and pdf with a maximum size of 5MB
Protection and Indemnity Policy details (if available)
Insurers Name
Policy Number
Expiry Date
Email
Evidence supporting this MLC Complaint
Upload Evidence
Click or drag files to this area to upload.
You can upload up to 5 files.
Please upload evidence supporting this MLC Complaint. Allowed file types are jpg, jpeg and pdf with a maximum file size of 5MB
Submit Complaint
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