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Position applied for: Second Officer Safety

Are you willing to accept any other positions? If YES, which positions would you consider? YES Second Officer

Are you responding to a media advertisement? If YES, please state which publication NO From what date will you be available? Dec 18

2 Personal details

Name: (Surname) THAKUR

(First Names) BHASKAR

(Middle Name) RAMESHCHAND

Date/Place of Birth: 25 NOVEMBER 1984/ MUMBAI Nationality: INDIAN Permanent address: 38/1121, RAJANI CHS. PANTNAGAR, GHTAKOPAR EAST Pin Code: 400075

E-Mail:

bhaskarthakur25@gmsil

.com

Tel No. : Mobile 887-***-****

Local address: SAME AS ABOVE

Pin Code:

E-Mail: Tel No. Mobile

3a Educational Background

Qualification School / College From To Percentage/ Grade HSC RAMNIRANJAN JHUNJHUNWALA COLLEGE 2001 2002 FIRSTCLASS 3b Technical Background

Degree/ Diploma Institute/ College From To Percentage / Grade CHIEF MATES LIVERPOOL JOHN MOORES

UNIVERSITY

2016 2016

4 Identity documents

DOCUMENT COUNTRY NUMBER DATE OF ISSUE PLACE OF ISSUE DATE OF EXPIRY Passport: INDIAN L4339041 12/08/2013 MUMBAI 11/08/2023 Seaman Book: National MUM127089 09/06/2004 MUMBAI 09/06/2024 Panamanian

Liberian

MARSHALL

ISLANDS

MH 579621 05/02/2018 MUMBAI 04/02/2023

Do you hold a US Visa ‘C1/D’?

YES/NO YES Issue Date: 20/09/2013 Expiry Date: 17/09/2018 Do you hold a US Visa ‘B1/B2’?

YES/NO Issue Date: Expiry Date:

Have you been rejected for any visa applied for? NO NO If YES, please state the country and reasons

INDOS No: (only for Indians) 03GL2603 YELLOW FEWER V/T YES MUI NO : N 037165 V/T

5 Family Details: (If Unmarried kindly give details of Father / Mother) NAME

Relation DOB POB

PASSPORT

NO.

PLACE OF

ISSUE

DATE OF

ISSUE

DATE OF

EXPIRY

ECNR

KAVITA RAJARAMANI WIFE 06/02/1982 ULH

ASN

AGA

R

MUMBAI

6 Certificates (Highest certificate of competency held) PAGE 2 OF 4

Grade/Class

Of COC

Country

Issuing Country

Date of Passing

Exam

Certificate

No.

Date Issued Place Issued Valid Until

CHIEF MATES

UNLIMITED

UNITED KINGDOM JULY 2017

COC0077481

3-Oct-2017 UK 6-Sep-2022

7 Certificates Of Competency issued by other countries (Issued by countries other than in Section 6) Issuing Country Certificate No. Date Issued Place Issued Valid Until MARSHALL ISLANDS 556684 05/02/2018 MUM 06/09/2022

Others

8 Details of Courses

Courses Certificate No. Issued By Date

Issued

Date Of

FPFF / AFF Expiry

BPMA/AFF/1147/2017

BPMA 05/09/2017 04/09/2022

EFA / MFA / MEDICARE

BPMA/SMM/536/2015

BPMA 05/01/2016 04/01/2021

PSCRB

BPMA/PSCRB/2783/2017

BPMA 06/09/2017 05/09/2022

PST

BPMA/PSCRB/2783/2017

BPMA 06/09/2017 05/09/2022

PSSR – Personal Safety & Social Responsibilities

SSO – Ship Security Officers Course

SSOC/0722/038/13

NAMAC 21/09/2013

ISPS Course

ROSC – Radar OBS Simulator

ARPA – Automatic Radar Plotting Aid

NAESTM/16/041

LIVERPOOL

RANSCO – Radar, Arpa & Navigation Simulator

BTM 3396 AEMTC 09/12/2017

SMS / SHS / ERS

ECDIS

ECDIS/13/2013-14/03

HERMES 05/07/2013

Bridge / Engine Resources Management (BRM / ERM)

Ship Master Command and Control Course

GMDSS + endorsement

GG047647 UNITED

KINGDOM

08/06/2013 06/09/2022

RUTC – Refresher & Up gradation Course

Container Operations Familiarization

Electrical Familiarization for Marine Engineers

Electronics for Marine Engineers

Instrumentation & Shipboard Control Systems

Automation and Controls

Container Refrigeration

Hydraulics for Engineers (Basic / Advance)

Hazmat (In compliance with STCW-95 Section-B -V/b & V/c & CFR – 49) CFR-49

Hydraulics and Pneumatics Workshop

Watch Keeping Certificate Ratings (Deck/Engine)

Applied Electronics (AELC)

Practical Marine Electrical Workshop

Engine Equipment Maintenance Workshop

Basic Electrical and Fluid Technology

Reefer Container and Maintenance Course

MEPC

Operational competence enhancement course for deck officers

Safety, Environment Compliance & Pollution Prevention Training for Crew

Vessel Resource Management (VRM)

Electro Technical Officer/ Rating Certificate

PAGE 3 OF 4

9

9

Record of previous service

(Please give a full record starting with the last vessel on which you served) COMPANY VESSEL NAME

VESSEL

TYPE

D.W.T/

GRT

CONTS

TEU’S

VSL

AGE

TYPE OF ENGINES

(Please give full dtls)

B.H.P RANK

SIGN ON

dd/mm/yy

SIGN OFF

dd/mm/yy

DURATION

yy/mm/dd

REASONS FOR

S/OFF

AESM

SEAMAX

ROWAYTON

CONT 93702 9443 3

YRS

WARTSILA 9X82 36870 3/O 02/02/2018 21/07/2018 5MONTH 18 DAY

CONTRACT

COMPLETE

AESM

FREEMANTLE

EXPRESS

CONT 23540` 2078 19

YRS

WARTSILA NSD 17940 3/O 05/10/2014 31/03/2015 5MONTH 25 DAY

CONTRACT

COMPLETE

AESM

NEW ORLEANS

EXPRESS

CONT 359**-****-**

YRS

SULZER 22140 3/O 11/10/2013 05/02/2014 6MONTH

22 DAY

DAY

CONTRACT

COMPLETE

AESM

VERACRUZ

EXPRESS

CONT 404**-****-**

YRS

SULZER 17425 CDT 15/03/2011 23/01/2012 10

MONTH

8 DAY

CONTRACT

COMPLETE

AESM

FEDERAL

SCHELDE

BULK 20837 13

YRS

MAN B&W 8559 CDT 08/03/2010 17/09/2010 06

MONTH

9 DAY

CONTRACT

COMPLETE

AESM

GENCO

LONDON

BULK 91373 2

YRS

LYF2.5-1.7-0.7 16860 CDT 07/04/2009 30/10/2009 06

MONTH

23 DAY

CONTRACT

COMPLETE

AESM

PHEONIX BETA TANK

ER

59831 6

YRS

MAC-25B 14254 CDT 25/02/2008 07/09/2008 06

MONTH

11 DAY

CONTRACT

COMPLETE

AESM

DARYA SHREE BULK 40524 3

YRS

MAN B&W 10200 CDT 09/04/2007 11/11/2007 07

MONTH

03 DAY

CONTRACT

COMPLETE

PAGE 4 OF 4

PAGE 5 OF 4

10 For Engineers (Please provide details)

Generators

Purifiers and Boilers

Type of Cranes / No of

Reefer Containers

11 Sailing Experience: (Please advise PRESENT RANK EXPERIENCE on each type of vessel) Container PCC Reefer Multi Purpose Others

29 MONTHS 27 MONTHS

LAST SALARY DRAWN (PLEASE MENTION CURRENCY) 3000

12 Medical history

Have you ever signed off a ship due to medical reasons? YES/NO NO

Have you undergone any operation in the past?

YES/NO NO

Have you consulted a doctor during the last 12 months for an illness/accident? YES/NO NO

Do you have any health or disability problems now? YES/NO NO

(If the answer is YES to any of the above, please give full details and attach a separate page if necessary) 13 General

Have you ever been the subject of a court of enquiry or involved in a maritime accident? YES/NO NO Have you ever had a professional license suspended or revoked? YES/NO NO

(If YES, please give full details and attach a separate page if necessary) 14 References (Please give the name and address of your current or immediate past employer) Name of company 1. AESM 2.

Name of person to contact KAVITA SHETTY

Address AESM PVT LTD

No. 022********

15 Review

If immediate employment is not available do you wish to be considered for future vacancies? YES/ NO YES If YES, please give any alternative contact details not shown in Section 2 16 Declaration

I hereby declare that the above particulars are true and authorise you to contact the referees listed above. BHASKAR THAKUR

Date: 03/10/2018

Signature

17 BOILER SUIT SIZE: XL SAFETY SHOE SIZE: 11

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