SEAFER APPLICATION FORM

TO : DEPERTMENT

Dear sir,

I would like to apply for joining your good company for as oiler On your vassel to complete any application l also provide following date as listed below PERSONALITY

Name : DEDI ISKANDAR SINIAGA

Date of birth : KISARAN

Place : 23-05-1980

Maritel status : MERRIED

Nationaly : INDONESIA

Blood : O

Religion: Muslim

WA : 081*********

Mobile:081*********

EMAIL :

ac8dhu@r.postjobfree.com

Heigth : 165

Weight : 65

Shoes: : 40

Coverall : L

PRESENT ADDRESS PERMANENT ANDDRESS

-

Jln : COIRUL ANWAR GANG MANGGA

08 KISARAN BARAT,SUMATRA UTARA

CERTIFICATE OF COMPETENSI

DETAILS NUMBER ISSUED Expire date

place Date

●Certificate of compentency

Rating as able seafarer engine

6200392169420717

jakarta

07-02-2017

Unlimited

CERTIFICATE OF PROFICIENCY

Details

Number

ISSUED Expire date

place Date

●Basic safety training 6200392169010115 Jakarta 09 November 2015 09 November 2020

●Prefiency in survival craft and

rescue boats

6200392169040115 Jakarta 09 November 2015 09 November 2020

●Medical firts Aid 6200392169070117 Jakarta 09 January 2017 09 January 2022

●Advanced fire fighting 6200392169060116 Jakarta 11 November2016 11january 2021

●Security awereness training - Jakata - PROGGREAS

●Seafarers with desingnated

training security duties

6200392169320116 Jakarta 07 November 2016 07 November 2021

● Besic training liquefied gas

tanker( BLGT)

6200392169370116 Jakarta 15 November 2016 15 November 2021 TRAVEL DOCUMENT

Detail Number Issued Expire date

place Date

●Passport PROGGRES

●Seamen book E 077512 PONTIANAK 03 JULI 2016 02 JULI 2019

● YELOW FEVER B 401133 JAKARTA 07 NOV 2011 07 NOV 2021

● PANAMA BOOK 673268 MANILA - -

SEA SERVICES

Name of veessel Kind of

vessel

Engine type Rank DWT/BH.P Periode company

KM. BUNDA SEJATI CARGO HANSIN OILER 1200 GT

2000 HP

05-06-2008

15-09-2009

PT: KARANA LINE

MV SANDI PEARL HARBOUR

TUG

NIGATA OILER 1819 GT

4000X 2 HP

01-06-2010

15-01-2013

PT : MUGS

MV SHIN LINE -4 GENERAL

CARGO

Makita-

mitsui-MAN

B&w

OILER

5618 GT

3000 HP

21-06-2013

10-10-2015

PT: BARUNA ADITA

PRASTIYA

MT GAS ASAHAN GAS

TANKER

HANSIN 6 EL

40 D

OILER 2810 GT

3000 HP

13-11-2015

03-07-2016

PT: PELAYARAAN

USAHA GAS ELPINDO

MT GAS MELAWI GAS

TANKER

Makita-

mitsui-MAN

B&w

MANDOR

MESIN

3428 GT

3275 HP

22-11- 2016

05-11-2017

PT: PELAYARAAN

USAHA GAS ELPINDO

MT GAS ASAHAN GAS

TANKER

HANSIN 6 EL

40 D

OILER 2810 GT

3000 HP

26-01-2018

PT: PELAYARAAN

USAHA GAS ELPINDO

I will very grefefully if you could give me a change to get personal interviewin the near future,there l could explain more detail about my self,thank you very much for you attention and i am looking forward to hearing from you

Best regardS

dedi iskandar sinaga

Contact this candidate