2nd Marine Engineer for Offshore Vessel
Resume:
This application form serves to provide with all information of the Applicant and will be treated as personal record should the Applicant be employed.
Applicant is required to complete all parts in BLOCK CAPITALS. Copies of all certificates, Seaman's book, passport and appraisal from the previous companies (if any) are to be attached.
POSITION APPLIED FOR: 2nd Engineer
Date: 01-08-2016
PERSONAL DETAILS
Surname
Middle Name
Last Name
Nationality
Arif
Rahman
Sidik
Indonesia
Date of Birth
Place of Birth
Religion
Age
25-August-1983
Tasikmalaya
Islam
33
Education Qualification
COC Grade
Marital Status
Height/Weight
Marine Engineer Officer Class II
2nd Engineer Unlimited
Married
167cm/77kg
Passport Number
Issuing Authority
Date of Issue
Date of Expiry
Overall Size
A 9041694
Indonesia
15-Sep-2014
15-Sep-2019
Large
Seaman’s Book Number
Issuing Authority
Date of Issue
Date of Expiry
Safety Shoe Size
Y 053957
Indonesia
20-Jun-2014
20-Jun-2018
42
Mobile Phone Number
House phone Number
Email Address
Hometown Airport
***************@*****.***
Soekarno-Hatta International Airport
Permanent Address
Tagog, Mangunreja, Tasikmalaya, West Java, Indonesia. 46462.
NEXT-OF-KIN
Name
Relationship
Contact Number
Yayat Jumyati
Father
Address (if different from the above)
Same as above.
Officer Certification (STCW)
Certificate Number
Issuing Authority
Date of Issue
Date of Expiry
Certificate of Competency
6201021469T20214
Indonesia
16-Jun-14
16-Jun-19
COC Endorsement
6201021469TB0214
Indonesia
16-Jun-14
16-Jun-19
Flag State Endorsement - COC
385687
Republic of The Marshall Island
03-Sep-15
16-Jun-19
Flag State Endorsement - COC
KY-035299
Cayman Island
27-Feb-2015
16-Jun-19
Rating Certification (STCW)
Certificate Number
Issuing Authority
Date of Issue
Date of Expiry
Watchkeeping
Able Seafarer (STCW 2010)
STCW CERTIFICATE
Certificate Number
Issuing Authority
Date of Issue
Date of Expiry
Basic Safety Training
6201021469010315
Indonesia
4-Mar-2015
4-Mar-2020
Survival Craft & Rescue Boat
6201021469040315
Indonesia
4-Mar-2015
4-Mar-2020
Advanced Fire Fighting
6201021469060315
Indonesia
4-Mar-2015
4-Mar-2020
Medical Care
6201021469080315
Indonesia
4-Mar-2015
4-Mar-2020
Ship Security Officer
6201021469240315
Indonesia
4-Mar-2015
4-Mar-2020
ARPA
RADAR
BTM/BRM
ERM
6201021469270216
Indonesia
2-Jun-2016
2-Jun-2021
Security Awareness Training
6201021469310214
Indonesia
21-Nov-2014
21-Nov-2019
Seafarer with Designated Security Duties
6201021469320214
Indonesia
21-Nov-2014
21-Nov-2019
ISM Code
Indonesia
19-Feb-2010
N/A.
Medical First Aid
6201021469070315
Indonesia
4-Mar-2015
4-Mar-2020
Tanker Familiarization
6201021469090315
Indonesia
4-Mar-2015
4-Mar-2020
Flag State Tanker Endorsement
Security Training (STCW 2010)
OFFSHORE CERTIFICATE
Certificate Number
Issuing Institute
Date of Issue
Date of Expiry
T-BOSEIT (OPITO Approved)
0058550122041440640
ETSDC,Abu Dhabi
22-Apr-2014
21-Apr-2018
T-HUET (OPITO Approved)
62010121469010315
Enertech, Qatar
23-Oct-2013
22-Oct-2017
Rigging & Slinging
14046/2014
ETSDC,Abu Dhabi
14-May-2014
13-May-2017
H2S
0058901422041440760
ETSDC,Abu Dhabi
22-Apr-2014
21-Apr-2016
Basic Offshore Safety
11923/2014
ETSDC,Abu Dhabi
24-Apr-2014
23-Apr-2014
Banksman
Crane Operator
Oxygen Resuscitator
Dynamic Positioning (Unlimited)
Dynamic Positioning (Limited)
Dynamic Positioning (Advanced)
Dynamic Positioning (Basic)
Offshore Safety Passport
Certificate Number
Issuer
Date of Issue
Date of Expiry
Type of Offshore Medial
Certificate Number
Medical centre
Date of Issue
Date of Expiry
Physical Examination Report, Blood Test, Urinalysis.
030/MCUIS/TM/VI/16
Indosehat 2003 Medical Centre Maritime Clinic.
6-Jun-2016
6-Jun-2018
Medical Fitness Certificate (MFC1). ZADCO Requirement.
ZADCO Medical Centre
16-Apr-2014
01-Apr-2017
Record of Sea Service
Company
Name of Vessel
IMO No.
Type
GT
kW
Rank
Trading Area
Scope of Operation
From
To
Topaz Marine
MV. DMS Conqueror
9277163
PSV
1369
3516
2nd Eng.
Aramco Oil Field
Platform Maintenance
29-Jul-15
26-Nov-15
Topaz Marine
MV. DMS Conqueror
9277163
PSV
1369
3516
2nd Eng.
Aramco Oil Field
Platform Maintenance
8-Mar-15
24-May-15
Topaz Marine
MV. DMS Conqueror
9277163
PSV
1369
3516
2nd Eng.
Zacum Field
Platform Maintenance
22-Sep-14
10-Jan-15
Topaz Marine
MV. DMS Fortune
9302360
AHTS
1294
3522
2nd Eng.
Ras gass, Qatar
Anchor Handling, Towing, Rig Move
27-Mar-14
9-Jul-14
Topaz Marine
MV. DMS Fortune
9302360
AHTS
1294
3522
2nd Eng.
Ras gass, Qatar
Anchor Handling, Towing, Rig Move
23-Oct-13
24-Jan-14
Topaz Marine
MV. DMS Challenger III
9363895
PSV
1387
3516
2nd Eng.
Ras gass, Qatar
ROV Stndby Vessel
3-Jun-13
6-Aug-13
Topaz Marine
MV. DMS Champion
7726392
MPSV
776
1668
2nd Eng.
Aramco Oil Field
Platform Maintenance
3-Jan-13
26-Mar-13
Zamil Offshore Services
MV. Zamil 14
9371488
AHTS
1705
4080
2nd Eng.
Aramco Oil Field
Rig move, Running Cargo
17-Jul-12
24-Oct-12
Zamil Offshore Services
MV. Zamil 26
9299006
Supply Vessel
701
3100
2nd Eng.
Aramco Oil Field
Field Services,
31-Jan-12
20-May-12
Zamil Offshore Services
MV. Zamil 11
9362281
AHTS
1621
3856
2nd Eng.
Aramco Oil Field
Rig move, Running Cargo
16-Sep-11
24-Dec-11
Suntechno Marine
MT. Sunrise Sakura
9140475
Chemical Tanker
4744
2743
3rd Eng.
Foreign going.
Chemical Carrier
27-Apr-10
16-Apr-11
Nissho Odyssey Ship Management
MT. Janesia Asphalt IV
9370991
Oil Tanker
4318
3200
4th Eng.
Foreign going.
Asphalt Carrier
9-Jan-08
29-Jan-09
Nissho Odyssey Ship Management
MT. Janesia Asphalt II
9031894
Oil Tanker
3297
2743
4th Eng.
Foreign going.
Asphalt Carrier
25-Oct-06
12-Oct-07
Nissho Odyssey Ship Management
MT. Janesia Asphalt II
9031894
Oil Tanker
3297
2743
E. Cadet
Foreign going.
Asphalt Carrier
6-Feb-05
11-Feb-06
APPLICANT’S DECLARATION
Medical History / Background
Yes/No
If yes, please provide details
Do you have history of illness such as tuberculosis, high blood pressure, mental illness etc…?
No
Do you have physical disability?
No
Have you ever been hospitalised, operated or currently undergoing any medical treatment?
No
Have you had premature termination of employment agreement?
No
Have you been dismissed or logged for misconduct?
No
Have you been refused entry by any country?
No
Have you ever been charged in court for any offence?
No
Do you have alcohol drinking habit?
No
REFERENCE
Name
Betchner Arizo
Name
Company
Topaz Marine
Company
Position
Crewing Manager
Position
Contact
Contact
I confirm that the information given by me herein is true and correct. I also understand that any falsification or misrepresentation in my personnel records can result in my immediate dismissal and may be subject to legal action if I am employed by the Company. I do agree to submit myself to a thorough medical examination, which I must successfully pass as one of the conditions for being accepted for employment.
Date: Applicant’s Signature:
01-August-2016 Arif Rahman Sidik
Contact this candidate