APPLICATION FORM
PERSONAL DATA
POSITION(s)/ RANK -
Third Mate
APPLIED
FAMILY NAME, GIVEN
SZABO ZSOLT IOAN
NAME
DATE OF BIRTH
(dd/mm/yyyy)
PRESENT ADDRESS TEL.NO.+407********
Str.Dacia,nr.73,bl.20,sc.A,ap.5,Brasov,Romania.
MARITAL STATUS NEXT OF KIN
Stoian Iuliana Fiancee / +40774 406
Engaged
HEIGHT 1.76 m WEIGHT 73 kg
ENGLISH LEVEL
PERSONAL DOCUMENTS
PASSPORT NUMBER DATE / PLACE OF
Romanian 51257308 23.04.2014/BRASOV,R
SEAMAN’ S BOOK NUMBER DATE / PLACE OF
NATIONAL 22440CT 13.07.2016/CONST
FLAG SEMAN’S BOOK 1100276 18.04.2013/LIBERIA
LICENCE NUMBER GRADE
NATIONAL 62840 DECK OFFICER
FLAG LICENCE (NAME Flag) 1036746 DECK OFFICER
Certificate Of Competency 62840 DECK OFFICER
OTHER CERTS. NUMBER DATE OF ISSUE
Basic Safety and instruction 00012973 6/22/2016
Radar Observer A-II/1
ARPA A-II/1 00000219 7/31/2015
GMDSS A-IV/2 00000627 7/3/2015
STCW Proficiency in Survival Craft and
00007724 3/25/2014
Rescue boat A VI/2-1
STCW Advanced Fire-Fighting
00006514 5/20/2016
A-VI/3
Maritime English 00484 12/4/2012
Prevention Of Pollution Of The Marine
00004270 3/20/2014
Environment-Marpol 73/78
TransasMarine Limited Certificate/Specific
2016-RO-CER-NS40-0227 6/30/2016
Training
Transport And Handling Of
Dangerous,Hazardous And Harmful 00004335 3/27/2014
Cargoes
Yellow Fever
G5233-3B 10/6/2011
USA VISA 201*********** 1/13/2015
Operational Use Of Electronic Chart
00004637 7/1/2016
Display And Informational System(ecdis)
Security Awareness Training&Security
Training For Seafarers Whit Designated 000*****-**/25/2013
Security Duties
Human Element,Leadership And
00001685 6/3/2016
Management-Operational Level
Medical First Aid 00003487 5/27/2016
Program De Actualizare Brevet Nivel
00000353 7/10/2015
Operational
SERVICE RECORDS LAST FIVE YEARS
RANK / POS NAME OF VESSEL TYPE DWT / HP ENG-TYPE
Deck OFF. Perseus k Gen. Cargo 8700/6100 Sulzer
Bremer Vulkan B&W 7L 60
Third mate Hansa Lubeck Reefer 12942/15220
MC
HYUNDAI HEAVY
Third mate NYK Theseus Container 80220/62810 kw INDUSTRIES ULSAN -
SOUTH KOREA
Third mate Aquarius Leader PCC 22815/19200 Mitsubishi
Third mate Beatrice Schulte Container 50701.6/36560 Doosan B&M
Third mate Hyundai Platinum Container 63010/27120 kw Hyundai-Wartsila
REMARKS – Contact number previous Companies service:
Name Company Phone Number
Metkar 024*-***-***
Stargate Constanta 0-241-******
AB crewing Constanta 0-241-***-***/0-341-***-***/0-241-***-***
NavMar Manpower Constanta 034*******
Capital 024*-***-***
ATION FORM Application Date: 17/07/2017
PHOTO
C
r
e
ITIZENSHIP ROMANIAN
w
S
EL.NO.+407********
e
a
EXT OF KIN
s
toian Iuliana Fiancee / +407**-***-***
S
rl
3 kg
.
DATE / PLACE OF ISSUE EXPIRY DATE
23.04.2014/BRASOV,ROMANIA 4/23/2017
DATE / PLACE OF ISSUE EXPIRY DATE
13.07.2016/CONSTANTA 28,12,2018
RIA 4/18/2018
E DATE / PLACE OF ISSUE ENDORSED TILL
CK OFFICER 29.03.2011/CONSTANTA 3/25/2019
CK OFFICER 29.08.2016/LIBERIA 3/25/2019
CK OFFICER 29.03.2011/CONSTANTA 3/25/2019
TE OF ISSUE PLACE OF ISSUE EXPIRY DATE
6/22/2016 CONSTANTA 6/22/2021
7/31/2015 CONSTANTA 7/30/2020
7/3/2015 CONSTANTA 7/2/2020
3/25/2014 CONSTANTA 3/25/2019
5/20/2016 CONSTANTA 5/20/2021
12/4/2012 CONSTANTA 12/4/2017
3/20/2014 CONSTANTA 3/20/2019
6/30/2016 CONSTANTA
3/27/2014 CONSTANTA 3/27/2019
10/6/2011 CONSTANTA 10/6/2021
1/13/2015 BUCURESTI 1/8/2020
7/1/2016 CONSTANTA
11/25/2013 CONSTANTA
6/3/2016 CONSTANTA
5/27/2016 CONSTANTA
7/10/2015 CONSTANTA
FROM TILL COMPANY
5/11/2012 11/25/2012 Metkar
Leonhardt&Blumberg(Stargate
4/30/2013 10/1/2013
Constanta)
6/20/2014 10/22/2014 NYK(AB Crewing Comstanta)
2/17/2015 6/12/2015 NYK(AB Crewing Comstanta)
Thomas Schulte(NavMar Manpower
11/22/2015 4/6/2016
Constanta)
8/23/2016 11/28/2016 Capital
ber Fax Number