Oceanic International Shipping (Pvt) Ltd

Recruitment & Placement Services Manual

Application Form of Seafarers (CV)

Revision: 0 Page: 1 of 4 Date: 03.01.2017

Prepared By: Ops/Crew Manager Approved By: MD

FORM no: 02

APPLICATION FORM OF SEAFARERS

PHOTO

Position applied OILER/MECHNICE

Surname GHAZI

Name NOMAN

Date of birth 5/23/1988

Birth Place KARACHI

Nationality PAKISTANI

Salary expectation 1000 USD TO 850 USD

Preffered contract period 3 TO 5

For Office use only

Date and method of receipt of CV

Acknowledgement of receipt of CV

Is the CV clear enough? Interview date if fixed Remarks Are the certificate details given in

CV meets the basic requirement

Signature Date

Travel / Identity documents

Document Document No.

Date of issue

Date of

expiry Country

Passport - 1 DH4116801 KARACHI PAKISTAN

Passport - 2 (if applicable DH4116802 15-Feb-2013 13-Feb-2023 KARACHI PAKISTAN Seaman book - 1 013106-S 11/11/2010 11/10/2020 KARACHI PAKISTAN Seaman book - 2

Seaman book - 3

Seaman book - 4

Have you been rejected for any visa applied for? IF YES, indicate country and reasons

CERTIFICATE OF COMPETENCY

CERTIFICATE Number Place Issued Expiry

National COC

Endorsement

Rating forming a part of Nav. Watch

Rating forming a part of Eng. Watch 2287-E MMD KARACHI 6-3-2015 Electrical / Electronic Eng. Certificate

GMDSS certificate

GMDSS endorsement

Liberia endorsement

Panama endorsement

INDOS

Other

Oceanic International Shipping (Pvt) Ltd

Recruitment & Placement Services Manual

Application Form of Seafarers (CV)

Revision: 0 Page: 2 of 4 Date: 03.01.2017

Prepared By: Ops/Crew Manager Approved By: MD

FORM no: 02

STCW - (78 as amended in 2010) TRAINING CERTIFICATES CERTIFICATE Number Place Issued Expiry

Basic safety training (A-VI/1 )

Elementary first aid (A-VI/1) EFA-2185/2017 ANDROS MARINE INSTITUTE 7/1/2017 6/1/2022

Fire prevention & fire fighting (A-VI/1) FPFF-2181/2017 ANDROS MARINE INSTITUTE 4/1/2017 3/1/2022

Proficiency in survival techniques (A-VI/1) PST-2182/2017 ANDROS MARINE INSTITUTE 14-01-2018 13-01-2022

Personal safety & social responsibilities (A-VI/1) PSSR-2201/2017 ANDROS MARINE INSTITUTE 11/1/2017 10/1/2022

Medical care onboard (A-VI/4 )

Advanced fire fighting (A-VI/3) 64 ANDROS MARINE INSTITUTE 20-02-2015

Proficiency in survival craft & rescue boats other than fast rescue boats (A-VI/2)

PSCRB-869/2018 M.T.I

28-04-2018 27-04-2023

Proficiency in fast rescue boats (A-VI/2)

Ships security officer - SSO (VI/5)

STSDS (VI/6)

Radar observer

Bridge or engine resource management

ISM code

DP course (Induction)

International Ships & Port Facilities Security Code ISPS-0437 NAUTICAL STUDIES 24-02-2014 Certificate: Ship's Welder

Maritime English Language Course – Support Level

Pre-Sea Training & Deck Rating Programme

MEDICAL HISTORY

Medical pre-employment examination Issued Expiry

Drug & alcohol test Issued Expiry

Yellow fever vaccination Issued 2011 Expiry 2021

YES NO

1. Have you ever signed off from a ship due to medical reasons? NO 2. Have you undergone any operation / surgery in the past? NO 3. Have you consulted a doctor during last 12 months for any illness / accident? NO 4. Do you have any history of physical or mental problems or any behavioral problems? NO

(if the answer is YES to any of the above, please give full details and attach a separate signed and dated page if necessary) Oceanic International Shipping (Pvt) Ltd

Recruitment & Placement Services Manual

Application Form of Seafarers (CV)

Revision: 0 Page: 3 of 4 Date: 03.01.2017

Prepared By: Ops/Crew Manager Approved By: MD

FORM no: 02

GENERAL

YES NO

1. Have you, in any country, been the subject of a court of injury or involved in a maritime accident? NO 2. Are you, in any country, presently facing charges for any offence (including transport safety regulatory offences)? NO 3. Have you, in any country, during past 5 years been issued any warning letter in relation to violating safety / transport / disciplinary regulatory issues?

NO

4. Have you, in any country, had any document, license of competency suspended, cancelled or revoked? NO 5. Have you, in any country, been convicted for any criminal offence or been given police diversion for any offence? NO 6. Have you ever been convicted in any court of law for any offence involving violence or causing danger to any person, or criminal damage?

NO

7. Have you, in any country, previously had an application for a document or certificate of competency rejected? NO 8. Have you ever been convicted in any court of law for any offence relating to controlled drugs, prescribed medicine or alcohol misuse?

NO

9. Have you ever been convicted in any court of law for any offence involving violence or causing danger to any person, or criminal damage?

NO

10. Have you had any ITF / authority exposures? NO 11. Is there any other information that is relevant to your application that has not been addressed in the questions above? NO

(if the answer is YES to any of the above, please give full details and attach a separate signed and dated page if necessary) REFERENCES

Name of the Company

Name of the person to contact

Address

Contact nos

Name of the Company

Name of the person to contact

Address

Contact nos

Name of the Company

Name of the person to contact

Address

Contact nos

Oceanic International Shipping (Pvt) Ltd

Recruitment & Placement Services Manual

Application Form of Seafarers (CV)

Revision: 0 Page: 4 of 4 Date: 03.01.2017

Prepared By: Ops/Crew Manager Approved By: MD

FORM no: 02

PERSONAL

Blood group A+ POSITIVE

Height 01 M 58CM 5 FEET 3 INCH

Weight 76KG

Eye color BROWN

Hair color BLACK/WHITE

Coverall size (S/M/L/XL/XXL/XXXL) MEDIUM/LARGE

Safety Shoes (38/40/42/44/46) 40/41

Shirt size (S/M/L/XL/XXL/XXXL) LARGE

Waist 34

Mother's name AREENA PARVEEN

Father's name TIPU SULTAN

Religion MUSLIM

Marital status MARRIED

Contact nos 923*********/+923*********

Email address

Home address HNO#BII,C/2 MASSAN ROAD BHUTTA VILLAGE KEAMARI KARACHI Next of kin (Name & relationship) NEELAM

WIFE

Contact nos of next of kin 923*********/+923********* Details of children (if applicable) NO

Name Date of Birth Male / Female

I hereby declare that above, including medical history, is true. I accept any investigation with regards to my previous work experience with any party concerned. Further I confirm that I give the rights to SIS to share my personal data with third party for service purposes or as required applicable legislation. I understand that my working contract will be cancelled without notifying and I am liable to pay all costs if any submitted information and document are found as false. RECORDS OF SEA SERVICE

(Please give full details starting from last vessel on which you served) Name of vessel Flag Vessel type GRT Engine type KW Rank Signed on Signed off

Company name

dd/mm/yy dd/mm/yy

AHTS FANOOS ST.VINCENT SUPPLY 712 NIGATA (I) 3000 OILER 7/8/200*-**-**-** WHITESEA SHIPPING AHTSSHAHZAMAN UAE SUPPLY 876 DEUTZ (V) 4000 OILER 4/8/200*-**-**-** WHITESEA SHIPPING MV SHAHAB 14 IRAN CONTINER 3120 CATERPILER 1900 OILER **-**-**-**-**-** DARYA DILAN KAROON MT FIONA PANAMA CHEMICAL TENKER 5038 WARTSILA 5496 OILER 8/5/201*-**-**-** MERAMAR SHIPPING TSHDHARB TOGO HOPPER DRADER 3683 MAK*3 1950 OILER **-**-**-**-**-** MAQBOOL ASSOCIAT AHTS SAMED PANAMA DP 1 1579 WARTSILA 5500 OILER **-**-**-**-**-** WHITESEA SHIPPING AHTS SAREM ST.VINCENT DP1 1579 WARTSILA 5500 OILER **-**-**-**-**-** WHITESEA SHIPPING AHTS SAREM ST.VINCENT DP1 1579 WARTSILA 5500 OILER **-**-**-**-**-** WHITESEA SHIPPING AHTS SAEB PANAMA DP1 1579 WARTSILA 5500 OILER **-**-**-**-**-** WHITESEA SHIPPING AHTS SAHEB ST.VINCENT DP1 1579 WARTSILA 5500 OILER **-**-**-**-**-** WHITESEA SHIPPING JU.RISING PHOENIXSINGAPORE CUNSTRATION JACK UP BARGE 5097 CATERPILER*4 MECHENIC 19-10-17 08=04-18 WHITESEA SHIPPING NOMAN GHAZI KARACHI PAKISTAN 16/05/2018

Applicant signature Place Date

Contact this candidate