APPLICATION FORM

Position to Apply for : MASTER (Class I)

Name : Capt. Janner Wilmon Marihot M. Mar

Place/ Date of Birth : Medan, July 13th 1966

Religion : Christian

Meritial Status : Married

Nationality : Indonesia

Height/Weight : 166 cm / 70 kg

Address : Taman Nirwana Blok E No. 19 Bekasi Timur Indonesia

Sex : Male

Phone Number/Email : +62-821-****-****/acvejx@r.postjobfree.com

DOCUMENT

Name Document

Certificate Number

Place, Date of Issued

Date of Expire

Passport

B 2166320

Jakarta, September 30th 2015

September 30th 2020

Seaman Book

Y 016134

Jakarta, January 17th 2011

January 17th 2018

CERTIFICATE OF COMPETENCY

Name Certificate

Certificate Number

Place, Date of Issued

MPB –III

M.32.263/N/III/SMG/SCTW/89

Jakarta, October 16th 1989

MPB –II

DL.251/I/B/0676.IV/DII-95

Jakarta, April 20th 1995

ANT –II

6200018860N20102

Jakarta, March 01st 2002

ANT –I

6200018860N10207

Jakarta, September 21st 2007

Endorsement ANT -I

6200018860NA0207

Jakarta, February 21st 2013

ANT –I

6200018860N10214

Jakarta, July 16 th 2014

Endorsement ANT -I

6200018860N10214

Jakarta, July18th 2014

CERTIFICATE OF PROFICIENCY

Name Certificate

Certificate Number

Place, Date of Issued

Basic Safety Training

6200018860010114

STIP Jakarta, April 07th 2014

Advance Fire Fighting

6200018860060114

STIP Jakarta, April 07th 2014

Proficiency In Survival Craft and Rescue Boats

6200018860040114

STIP Jakarta, April 07th 2014

Operational Use Of ECDIS Training Programme

6200018860280111

STIP Jakarta, December 19th 2011

Radar Simulator

6200018860030215

BP3IP Jakarta, June 25th 2015

Arpa Simulator

6200018860020215

BP3IP Jakarta, June 26th 2015

Medical First Aid

6200018860070215

BP3IP Jakarta, July 08th 2015

Medical Care on Boat

6200018860080215

BP3IP Jakarta, June 26th 2015

Ship Security Officer

6200018860240215

BP3IP Jakarta, September 03rd 2015

GOC

42508/SOU/T/XI/2015

Jakarta, November 25th 2014

GMDSS

6200018860111105

Bina Sena Jakarta, November 5th 2015

BRM

6200018860230213

BP3IP Jakarta, May 23rd 2013

ISM Code

143/ISCM/IX/BP3IP04

BP3IP Jakarta, September 14th 2004

Tanker Familiarization

6200018860090109

STIP Jakarta, March 16th 2009

Oil Tanker

6200018860100109

STIP Jakarta, March 16th 2009

Chemical Tanker

6200018860110111

STIP Jakarta,January 24th2011

qSEA SERVICE RECORD

Vessel Name

Type of Vessel

Company/Flag

Rank

GT

Sign On

Sign Off

KM. Majapahit

Container

Djakrta Lloyd

Cadet

15000

11.07.1987

27.10.1988

MV. Ronjai

Cargo

KYC Line Singapore

2nd /Off

10000

27.04.1990

03.02.1992

MV. Equator

Passenger

Neptank Singapore

C/O

722

04.03.1992

01.03.1993

MT. Ruby

Tanker

Samta Ship Managemen Singapore

C/O

2836

03.03.1993

04.02.1994

MT. Ruby

Tanker

Samta Ship Managemen Singapore

Master

2836

09.10.1995

07.05.1997

MT. Hayini

Tanker

Hayini Diesel Singapore

Master

2844

03.06.1997

15.02.1998

MT. Ruby

Tanker

Samta Ship Managemen Singapore

Master

2836

15.02.1998

20.03.1999

MT. Ruby

Tanker

Samta Ship Managemen Singapore

Master

2836

25.05.1999

24.04.2000

MT. Fortune

Tanker

Samta Ship Managemen Singapore

Master

1833

12.10.2000

22.12.2001

MT. Maple

Tanker

Jurong Oceanic Singapore

Master

1957

25.02.2003

28.11.2003

MV. Amal

Tanker

Coral Shipping Greece Athena

Master

1433

10.02.2005

01.02.2006

MT. Orion

Tanker

IS Ship Management Singapore

Master

3167

25.03.2006

19.04.2007

MV. Halul 30

AHTS

Halul Ofshore Service Company WLL

Master

1218

09.11.2007

16.03.2008

MT. Amira

Tanker

Coral Shipping Greece Athena

Master

2973

26.04.2008

20.10.2008

MV. Oriental Courage

Tugboat

BALTIC Singapore

Master

655

04.04.2009

06.10.2009

MT. Maju Jaya

Tanker

Cahaya Shipping Singapore

Master

6379

27.11.2009

02.04.2010

MV. Standford Prince

AHTS

Standfort Marine Dubai

Master

680

22.04.2010

08.10.2010

MT. Asumi XXVI

Tanker

Aquarius Maritime Singapore /Jakarta

Master

3611

13.02.2011

30.10.2011

MT. Asumi XXVI

Tanker

Aquarius Maritime Singapore /Jakarta

Master

3611

30.05.2012

25.01.2013

MT.Amira

Tanker

Coral Shipping Greece Athena

Master

2973

30.06.2013

20.03.2014

MT. Almuntazah

Tanker

Coral Shipping Greece Athena

Master

3676

22.08.2014

23.05.2015

Best Regards, Capt. Janner Wilmon Marihot M. Mar

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