Applicant Details
Date of Application: **/**/****
Rank: CHIEF OFFICER
Type of Contract:
Available From: 20/04/2017
Surname: MANDAL
First Name: NILANJAN
Marriage Status: married
Date of Birth: 19/11/1970
Place of Birth: KOLKATA
Nationality: INDIAN
Height (cm): 168
Weight: 75KG
Eye Colour: BLACK
Next of Kin
Surname: MANDAL
First Name: SIMA
Relation: Wife
Address: KUKREJA EMERALD,FLAT NO 901,9TH FLOOR,SECTOR 2,PLOT NO 100,KOPARKHAIRNE
Town/ City: NAVI MUMBAI
Country: INDIA
Post Code: 400709
Telephone Number:
Mobile Number: +918*********
Identification
Passport Number: Z2310333
Date of Issue: 22/07/2013
Date of Expiry: 21/07/2023
Country Issued: INDIA
Seaman’s Book Number: BY70505
Date of Issue: 22/06/2012
Date of Expiry: 24/06/2022
Country Issued: INDIA
Visa Number: 201***********
Date of Issue: 25/10/2013
Date of Expiry: 22/10/2018
Country Issued: USA
Type: C1D
Certificate of Competency
Certification Rank: CHIEF MATE(FG)
CoC Number: CT 029299/17
Issuing Authority: PANAMA
Date of Issue/ Revalidation: 29/03/2017
Date of Expiry: 17/03/2022
Endorsements: Oil Yes
Chemical No
Gas No
Level Operational Management
Level Operational Management
Level Operational Management
Contact Details
Address: 41 GARFA MAIN ROAD KOLKATA 700078
Town/ City: KOLKATA
Country: INDIA
Postcode: 700078
Telephone Number: 808*******
Mobile Number: 808*******
E-Mail Address: ******************@*****.***
Nearest Airport: MUMBAI
Applicant Details
Date of Application: 25/04/2017
Rank: CHIEF OFFICER
Type of Contract:
Available From: 01/03/2017
Surname: MANDAL
First Name: NILANJAN
Marriage Status: married
Date of Birth: 19/11/1970
Place of Birth: KOLKATA
Nationality: INDIAN
Height (cm): 168
Weight: 75KG
Eye Colour: BLACK
Identification
Passport Number: Z2310333
Date of Issue: 22/07/2013
Date of Expiry: 21/07/2023
Country Issued: INDIA
Seaman’s Book Number: BY70505
Date of Issue: 22/06/2012
Date of Expiry: 24/06/2022
Country Issued: INDIA
Visa Number: 201***********
Date of Issue: 25/10/2013
Date of Expiry: 22/10/2018
Country Issued: USA
Type: C1D
Certificate of Competency
Certification Rank: CHIEF OFFICER
CoC Number: CT 029299/17
Issuing Authority: PANAMA
Date of Issue/ Revalidation: 29/03/17
Date of Expiry: 17/03/2022
Endorsements: Oil
Chemical
Gas
Level Operational Management
Level Operational Management
Level Operational Management
Contact Details
Address: 41 GARFA MAIN ROAD KOLKATA 700078
Town/ City: KOLKATA
Country: INDIA
Postcode: 700078
Telephone Number: 808*******
Mobile Number: 808*******
E-Mail Address: ******************@*****.***
Nearest Airport: MUMBAI
Medical Certificates
Country:
Type:
Date of Issue:
Date of Expiry:
Result:
Date of last Drug and Alcohol Test:
Expiry Date of Yellow Fever Vaccination:
Training
Please check all the qualifications you hold below and detail their issue and expiry dates.
Personal Safety Techniques:
Issue: Expiry:
Basic Safety:
Issue: Expiry:
GMDSS General Operator:
Issue:27/10/2016 Expiry:31/10/2016
Personal Safety & Social Responsibilities:
Issue:12/02/1998 Expiry:27/10/2016
Advanced Fire Fighting:
Issue:22/03/1997 Expiry:27/10/2016
Fire Fighting and Prevention:
Issue: Expiry:
Proficiency in Survival Craft & Rescue Boats:
Issue:10/03/2003 Expiry:27/10/2016
Safety Officer:
Issue: Expiry:
Security Officer:
Issue:09/03/2004 Expiry:27/10/2016
Medical Care:
Issue: Expiry:
Elementary First Aid:
Issue: Expiry:
Medical First Aid:
Issue:25/09/2004 Expiry:27/10/2016
ECDIS:
Issue: Expiry:
Bridge Team Management:
Issue:09/07/2010 Expiry:27/10/2016
Hull Integrity:
Issue: Expiry:
Crowd Management:
Issue: Expiry:
Crisis Management:
Issue: Expiry:
FRAMO:
Issue: Expiry:
Ice Navigation:
Issue: Expiry:
ISM/ISO Auditor:
Issue: Expiry:
Tanker Familiarisation Training: Oil Chemical Gas
Specialised Tanker Training: Oil Chemical Gas
DP Induction:
Issue: Expiry:
DP Simulator :
Issue: Expiry:
DP Operator:
Issue: Expiry:
Other specialised training certificates held:
Marlins English Test : Issue: Expiry: Result: Issued at
Other languages you are proficient in: French: German: Italian: Spanish:
Next of Kin
Surname: MANDAL
First Name: SIMA
Relation:
Address: KUKREJA EMERALD,FLAT NO 901,9TH FLOOR,SECTOR 2,PLOT NO 100,KOPARKHAIRNE
Town/ City: NAVI MUMBAI
Country: INDIA
Post Code: 400709
Telephone Number:
Mobile Number:
Identification
Passport Number: Z2310333
Date of Issue: 22/07/2013
Date of Expiry: 21/07/2023
Country Issued: INDIA
Seaman’s Book Number: BY70505
Date of Issue: 22/06/2012
Date of Expiry: 24/06/2022
Country Issued: INDIA
Visa Number: 201***********
Date of Issue: 25/10/2013
Date of Expiry: 22/10/2018
Country Issued: USA
Type: C1D
Certificate of Competency
Certification Rank: Chief Mate unlimited
CoC Number: CTB 934010
Issuing Authority: PANAMA
Date of Issue/ Revalidation: 30/06/2014
Date of Expiry: 31/12/2016
Endorsements: Oil Yes
Chemical No
Gas No
Level Management
Level Operational Management
Level Operational Management
Contact Details
Address: 41 GARFA MAIN ROAD KOLKATA 700078
Town/ City: KOLKATA
Country: INDIA
Postcode: 700078
Telephone Number:
Mobile Number:
E-Mail Address:
Nearest Airport: MUMBAI
Applicant Details
Date of Application: 25/04/2017
Rank: CHIEF OFFICER
Type of Contract:
Available From: 01/03/2017
Surname: MANDAL
First Name: NILANJAN
Marriage Status: Married
Date of Birth: 19/11/1970
Place of Birth: KOLKATA
Nationality: INDIAN
Height (cm): 168
Weight: 75KG
Eye Colour: BLACK
Medical Certificates
Country:
Type:
Date of Issue:
Date of Expiry:
Result:
Date of last Drug and Alcohol Test:
Expiry Date of Yellow Fever Vaccination:
Training
Please check all the qualifications you hold below and detail their issue and expiry dates.
Personal Safety Techniques:
Issue: Expiry:
Basic Safety:
Issue: Expiry:
GMDSS General Operator:
Issue:27/10/2016 Expiry:31/10/2016
Personal Safety & Social Responsibilities:
Issue:12/02/1998 Expiry:27/10/2016
Advanced Fire Fighting:
Issue:22/03/1997 Expiry:27/10/2016
Fire Fighting and Prevention:
Issue: Expiry:
Proficiency in Survival Craft & Rescue Boats:
Issue:10/03/2003 Expiry:27/10/2016
Safety Officer:
Issue: Expiry:
Security Officer:
Issue:09/03/2004 Expiry:27/10/2016
Medical Care:
Issue: Expiry:
Elementary First Aid:
Issue: Expiry:
Medical First Aid:
Issue:25/09/2004 Expiry:27/10/2016
ECDIS:
Issue: Expiry:
Bridge Team Management:
Issue:09/07/2010 Expiry:27/10/2016
Hull Integrity:
Issue: Expiry:
Crowd Management:
Issue: Expiry:
Crisis Management:
Issue: Expiry:
FRAMO:
Issue: Expiry:
Ice Navigation:
Issue: Expiry:
ISM/ISO Auditor:
Issue: Expiry:
Tanker Familiarisation Training: Oil Chemical Gas
Specialised Tanker Training: Oil Chemical Gas
DP Induction:
Issue: Expiry:
DP Simulator :
Issue: Expiry:
DP Operator:
Issue: Expiry:
Other specialised training certificates held:
Marlins English Test : Issue: Expiry: Result: Issued at
Other languages you are proficient in: French: German: Italian: Spanish:
References
Please provide your most recent employer as your first referee. Contact to current employer will only be made upon acceptance of a job offer.
Name: MR BRIAN
Job Title:
Reference:
Telephone Number: 098********
Email Address:
Company Name: SEA SPAN
Address:
Please fill in full sea time history from beginning of cadetship to current date. Please use additional sheets if necessary.
Sea Time History
Rank
Vessel Type
Vessel Name
Employer
Flag
From
To
DWT
Gross Tonnage
Main Engine Model
BHP
CADET
AFRAMAX
MT NORD JAHRE PROGRESS
WALLEMS
NORWAGEIAN
17/12/1994
26/12/1995
52164
THIRD OFFICER
VEG OIL
MT STRENGTH
LAKAR MARINE
PANAMA
03/08/1996
07/08/1996
17257
THIRD OFFICER
PRODUCT
MT OCEAN TRADER
OCEAN TANKERS
SINGAPORE
31/07/1996
30/01/1997
15162
THIRD OFFICER
AFRAMAX
MT JAHRE SPRAY
WALLEMS
NORWEGIAN
05/10/1997
16/12/1997
62381
THIRD OFFICER
VLCC
MT DORADO STAR
MMS MUMBAI
LIBERIA
09/01/1998
23/11/1998
157196
SECOND OFFICER
PRODUCT
MT HIGH SEAS
NAZ MARINE
LIBERIA
28/03/1999
22/08/1999
27450
SECOND OFFICER
LPG
LPG/C STEVEN N
BIBBY
PANAMA
27/11/1999
02/02/2000
32853
SECOND OFFICER
LPG
LPG/C LINCOLNSHIE
BIBBY
NASSAU
25/10/2002
29/11/2002
19289
SECOND OFFICER
LPG
LPG/C CHESHIRE
BIBBY
DOUGLAS
13/02/2003
13/03/2003
19719
SECOND OFFICER
LPG
LPG/C ENERGY ORPHEUS
WALLEMS
PANAMA
15/12/2003
28/06/2004
44576
SECOND OFFICER
AFRAMAX
MT HS TOSCA
WALLEMS
LIBERIA
27/10/2004
25/04/2005
62796
SECOND OFFICER
VLCC
MT UNIVERAL HOPE
WALLEMS
PANAMA
21/11/2005
10/04/2006
158475
SECOND OFFICER
OIL/CHEM
MT MERLIN CHAMPION
GENOA
LIBERIA
06/05/2006
20/08/2006
21963
Officers with experience on Product/Chemical tankers please state Cargoes carried:
Please fill in full sea time history from beginning of cadetship to current date. Please use additional sheets if necessary.
Sea Time History
Rank
Vessel Type
Vessel Name
Employer
Flag
From
To
DWT
Gross Tonnage
Main Engine Model
BHP
SECOND OFFICER
PRODUCT
MT ANALIPSY LADY
AD STEAM
LIBERIA
12/04/2006
25/03/2007
42058
SECOND OFFICER
PRODUCT
MT GULF STREAM
SELANDIA
NASSAU
13/07/2007
01/09/2008
42443
SECOND OFFICER
PRODUCT
MT GULF COAST
SELANDIA
NASSAU
27/05/2008
31/10/2008
42440
SECOND OFFICER
BULK
MV PAGUERA
SELANDIA
ANTIGUA
26/02/2009
17/08/2009
29985
SECOND OFFICER
OIL/CHEM
MT MARITIME NORTH
MSI
MALAYSIAN
15/12/2009
22/03/2010
29174
SECOND OFFICER
VLOC
MV ORE MUTUCA
MSI
LIBERIA
28/09/2010
28/03/2011
77096
SECOND OFFICER
CONVERSIAON/FPSO
MT TARII
NEPTUNE SINGAPORE
LIBERIA
23/07/2011
09/10/2011
157196
SECOND OFFICER
VLCC
MT SAMCO RAVEN
GOODWOOD
FRENCH
23/12/2011
27/03/2012
160348
SECOND OFFICER
FPSO
SS ENDEAVOR
NORTRANS
LIBERIA
31/08/2012
10/05/2012
36845
SECOND OFFICER
PRODUCT
MT CARINA
BIBBY
SINGAPORE
10/12/2012
13/06/2013
28813
SECOND OFFICER
PRODUCT
MT ASIA ASPHALTII
SEA PRIME
PANAMA
19/12/2013
17/04/2014
2999
MASTER
PRODUCT
MT ORIENTAL GULF
SM SHIP MANAGENT
PANAMA
08/08/2014
09/09/2014
1993
CHIEF OFFICER
BITUMEN
MT ASPHALT TEN
SM SHIP MANAGENT
PANAMA
27/12/2014
11/03/2015
2873
CHIEF OFFICER
BITUMEN
MT BHAGAVATHY
SM SHIP MANAGENT
PANAMA
12/04/2015
25/06/2015
1351
CHIEF OFFICER
BTUMEN
MT SEA PRINCESS
SM SHIP MANAGENT
PANAMA
12/01/2016
15/03/2016
4492
CHIEF OFFICER
OIL/CHEM
MT ARK PROGRESS
SM SHIP MANAGENT
PANAMA
15/06/2016
25/10/2016
4238