OFFICERS APPLICATION FORM

Personal Details:

First Name: DILAVER

Middle Name: KARAM

Surname: SINGH

Nationality: INDIAN

Date / Place of Birth: 14.11.73

Available From: 02.06.2020

Post Applied For: MASTER

Willing to Accept Lower Rank? NO

Last drawn wages:

MUI Membership No.: N025116

INDOS No.: 98NL0416

Expected Wages: Negotiable

Permanent Address:

Present Address:

A-401,Ashoka residency,sector-12,khargahar,navi Mumbai

Same as mentioned

PIN Code:410210

PIN Code:

STD Code:91 022 Phone Number:996-***-****

STD Code: Phone Number:

Email:addkrb@r.postjobfree.com

Mobile No:996-***-****

Travel Documents Details:

Passport No:

Date of Issue

Place of Issue

Date of Expiry

ECNR

Minimum 4

Blank Pages

Z3666845

04.04.16

MUMBAI

03.04.2026

ALL

Seaman’s Book (CDC)

Number

Date of Issue

Place of Issue

Expiry Date

HONDURAS

035159

14.03.17

NAVI MUMBAI

14.03.21

INDIAN

MUM 94658

28.03.12

MUMBAI

27.03.22

Certificate of Competency Details:

License

Grade

Number

Date of Issue

Place of Issue

Date of Expiry

HONDURAS

MASTER

DS-3855-P

14.03.17

NAVI MUMBAI

14.03.22

GMDSS

SMSSM-REC-1788

02.03.17

NAVI MUMBAI

02.03.22

GMDSS Endorsement

DS-3351-GO

14.03.17

NAVI MUMBAI

03.14.22

SSO

OPB REC-3170

02.03.17

NAVI MUMBAI

02.03.22

SSO ENDORSEMENT

DS-4354-SSO

14.03.17

NAVI MUMBAI

03.14.22

Details of courses & certificates:

STCW Courses:

Number

Date of Issue

Date of Expiry

Issued By / Place of Issue

Advanced Fire Fighting (AFF) / FIRE PREVENTION & FIRE FIGHTING (FPFF)

CAI REC-3913

02.03.17

02.03.22

NAVI MUMBAI

Medical First Aid (MFA) / Medical care

CPACM REC-3913

02.03.17

02.03.22

NAVI MUMBAI

Proficiency in Survival Craft & Rescue Boat (PSCRB)

CSMBR REC-3913

02.03.17

02.03.22

NAVI MUMBAI

Basic safety maritime training

CBSM REC-6674

02.03.17

02.03.22

NAVI MUMBAI

Radar Observer / ARPA ( Deck Officers )

RA/AP REC-1443

02.03.17

02.03.22

NAVI MUMBAI

STSD

FPGMATP REC 3278

02.03.17

02.03.22

NAVI MUMBAI

ECDIS ( Deck Officers )

UOCESI REC-1137

02.03.17

02.03.22

NAVI MUMBAI

DP BASIC

YAK/DP/B/046/07

22.03.12

21.03.22

NAVI MUMBAI

Previous Sea Service (Commencing from Last Vessel) (PLEASE FILL THE GRT/KW AS PER STCW REQUIREMENT)

Sr.

No.

Name of Company

Name of Vessel

Type

GRT / DWT

KW / BHP

Engine type

Rank

From

To

1

EXCEL INT.

JUPITER

PV

1574

194

WARTSILLA

MASTER

22.03.19

26.09.19

2

LAS OIL TRADING

DENNY Z

BC

14348

8298

SULZER

MASTER

26.08.18

16.09.18

3

TRICON

MASSIVE 3

TB

258

510

CATERPILLA

MASTER

23.07.18

05.08.18

4

OPEL SHIP MGT

SKY TRAIN

L.C

830

2010

CATERPILLA

MASTER

15.04.17

20.08.17

5

MARQABI SHIP MGT

PROSPERITY

BC

16582

9524

SULZER

MASTER

11.06.16

15.12.16

6

SAMSON

SWISSCO

S.V

884

1000

CATERPILLA

MASTER

24.02.16

04.06.16

7

YUDI SHIP MGT

ORUC RIES

BC

19707

10825

SULZER

C/O

21.05.15

16.02.16

8

YUDI SHIP MGT

ENIGMA

CARGO

4998

2467

SULZER

C/O

10.07.14

22.11.14

9

MERCATOR

GAURAV PREM

BC

40230

14250

SULZER

2/O

16.01.14

13.05.14

10

ALGHANIM

DALAL ALGHANIM

BC

23495

13700

BMW

2/O

11.01.12

28.02.12

11

IRISL

ATRIUM

BC

17500

7550

SULZER

2/O

01.02.10

18.04.10

12

DOCKENDALE

CLIPPER MERCURY

BC

17944

6555

SULZER

2/O

22.10.09

23.12.09

13

UDYA

SILVER CONSTELLATION

BC

77668

15290

SULZER

2/O

08.04.09

14.07.09

14

ASP

CHENNAI JAYAM

BC

24681

10550

SULZER

2/O

01.05.08

02.11.08

15

ANGLO EASTERN

GOOD PURPOSE

BC

41342

15400

SULZER

2/O

17.09.07

06.02.08

16

FLEET

TRITON STORK

BC

31242

12870

SULZER

2/O

28.07.06

12.02.07

17

DOCKENDALE

LEOPOLD OLDENDORFF

BC

22072

7650

SULZER

2/O

03.12.04

16.09.05

18

SCI

LOK PREM

BC

16818

10370

SULZER

3/O

30.04.04

20.07.04

19

SCI

LOK PRAKASH

BC

16835

10300

SULZER

3/O

15.05.03

24.12.03

20

SCI

S/O NAGALAND

BC

14166

9900

SULZER

3/O

08.04.02

22.08.02

DILAVER SINGH

Applicant’s Signature Date

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