Form MA-1085 EMBARC Statement of Compliance

OMB #: 2133-0553

Expiration: XX/XX/XXXX

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2133-0553. Public reporting for this collection of information is estimated to be approximately .25 hours per response, including the time for reviewing instructions, completing, and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Maritime Administration, MAR-390, 1200 New Jersey Avenue, SE, Washington, DC 20590.

STATEMENT OF COMPLIANCE WITH

EVERY MARINER BUILDS A RESPECTFUL CULTURE (EMBARC)

SEXUAL ASSAULT AND SEXUAL HARASSMENT (SASH) PREVENTION

MANDATORY ELIGIBILITY STANDARDS

Vessel operator ________________________________, and its subordinate entities to which cadets are assigned, herein referred to as “the Vessel Operator”, has met and fully implemented the Every Mariner Builds A Respectful Culture (EMBARC) Sexual Assault and Sexual Harassment (SASH) Prevention Mandatory Eligibility Standards (EMBARC Standards), promulgated by the Maritime Administration on [DATE].

The Vessel Operator has complied with all requirements enumerated in Section III of the EMBARC Standards document and is prepared to embark cadets from the United States Merchant Marine Academy (USMMA).

The Vessel Operator will comply with any change to EMBARC Standards within sixty days of receipt of written notice unless an exception or extension of time is granted by the Maritime Administration.

The Vessel Operator acknowledges that failure to adhere to the EMBARC Standards may, at the sole discretion of the Maritime Administration (in consultation, as necessary, with the appropriate Academy), disqualify the Vessel Operator from embarking Academy cadets.

By: ____________________________________ (signature)

____________________________________ (name of authorized official)

____________________________________ (name of Vessel Operator)

___________ (date)

Acknowledged by___________________________________ (signature)

for the Maritime Administration

______________________________________ (name)

____________ (date)

Form MA-1085 (Rev. 12/2021)