A. Personal data & Documents

Date of birth.

**-**-****

Seaman Name.

GUSTASIB

Name of father.

KHAN MUHAMMAD

Seaman Middle Name.

Name of mother.

KHIFZA BIBI

Seaman Surname.

KHAN

Name of wife.

N/A

Rank.

2nd OFFICER

Number of children.

N/A

Nationality.

PAKISTANI

Address.

CENTRAL JAI L ROAD,

Religion.

ISLAM

MOHALLAH PATHAN COLONY HARIPUR

Seaman’s Book no.

015774-S

Passport number.

CK4129053

Place of issue.

KARACHI, PAKISTAN

Place / date of issue.

HARIPUR / 07-09-2020

Date of issue.

25-11-2011

Passport exp. date.

06-09-2025

Last sign off date.

17-07-2019

B. Qualifications & Diplomas according to STCW’95 conventional requirements.

Name of Certificate:

Number:

Issued on:

Expires on:

Authenticated on:

National certificate

of competence

CT – 039329/17

20-04-2017

11-04-2022

PANAMA

National endorsement of competence certificate*

GMDSS G.O.C. (IV/2)*

CT-047656/17

08-05-2017

26-04-2022

PANAMA

Personal Survival Techniques (VI/1.1)

5267

23-07-2016

01-07-2021

PAKISTAN

Fire Prevention & Fire-fighting (IV/1.2)

4473

27-07-2016

26-07-2021

PAKISTAN

Elementary First Aid (IV/1.3)

5103

16-07-2016

24-06-2021

PAKISTAN

Personal Safety & Social Responsibility (IV/1.4)

5443

20-07-2016

28-06-2021

PAKISTAN

Medical First Aid (VI/4)

1915

16-07-2016

15-07-2021

PAKISTAN

Medical Care (VI/4)

Survival Craft & Rescue Boats (VI/2.1)

008

06-03-2017

11-04-2022

PANAMA

Fast Rescue Boats (VI/2.2)

Advanced Fire-fighting (VI/3)

2903

23-07-2016

22-07-2021

PAKISTAN

Ship Security Officer (A-VI/5)

275/2018

26-07-2018

25-07-2023

PAKISTAN

Designated Security Duties (A-VI/6-2)

842

23-07-2016

N/A

PAKISTAN

Tanker Familiarization Course (V/1)

467

30-07-2016

29-07-2021

PAKISTAN

Shore-based fire-fighting course (V/1)

Oil Tanker Specialized Training (V/1)

080/2018

09-08-2018

08-08-2023

PAKISTAN

Chemical Tanker Specialized Training (V/1)

539/2018

19-07-2018

18-07-2023

PAKISTAN

C.Flag State Endorsements of Recognition for certificates with Name of Certificate:

Number:

Issued on:

Expires on:

Authenticated on:

SSO

000259788

20-04-2017

25-02-2022

PANAMA

ADVANCE OIL TANKER

000012554

06-06-2017

19-02-2022

PANAMA

ADVANCE CHEMICAL

000012553

06-06-2017

01-03-2022

PANAMA

D.Flag State Endorsements of Recognition for certificates with continues….

Name of Certificate:

Number:

Issued on:

Expires on:

Authenticated on:

E.Seaman’s book:

Nationality:

Number:

Issued on:

Expires on:

Authenticated on:

LIBERIA

PANAMA

E. Additional Company Requirements.

Documents:

Number:

Issued on:

Expires on:

Authenticated on:

1. BTM/BRM

BTM/095/2016

20-05-2016

N/A

PAKISTAN

2. ECDIS Generic

480

14-05-2016

N/A

PAKISTAN

3. BRM

248

27-04-2016

N/A

PAKISTAN

4.Leadership and team

work

002

17-02-2017

11-04-2022

PANAMA

5. Marine Environmental

002

14-02-2017

11-04-2022

PANAMA

6.Safety office course

7. SSO

SSO-089/2016

18-04-2016

N/A

PAKISTAN

8. Ship handling/BMS

9.ILO/MLC 2006

10. Cargo handling

F. Experience / Service Record.

Ship’s Name

Company

DWT

Ship Type

Oil/Chemical Tanker

IMO Number

( IMPERATIVE)

Previous experience with Framo Pumps

Eng. Type

Rank

Serviced from / to

MT NAMISA

VAL OIL TRADING

9103

OIL / CHEMICAL

9031492

FRAMO PUMPS

DECK CADET

04-07-2012

05-09-2013

MT NAMISA

VAL OIL TRADING

9103

OIL / CHEMICAL

9031492

FRAMO PUMPS

3RD OFF

06-10-2013

06-05-2014

MT NAMISA

VAL OIL TRADING

9103

OIL / CHEMICAL

9031492

FRAMO PUMPS

3RD OFF

07-05-2014

12-10-2014

MT MATRIX I

VAL OIL TRADING

5800

OIL TANKER

9041136

FRAMO PUMPS

2ND OFF

04-01-2015

19-12-2015

MT DELIA I

EURO TANK

13898

CHEMICAL /OIL

9557630

FRAMO PUMPS

3RD OFF

14-10-2016

03-05-2017

MT LIANA

EURO TANK

11479

OIL TANKER

9397030

SCREW PUMPS

2ND OFF

25-05-2017

09-05-2018

MT SELENE

EUROTANK

18041

OIL / CHEMICAL

9576818

FRAMO PUMPS

2ND OFF

22-08-2018

06-11-2018

MT LIANA

EURO TANK

11479

OIL TANKER

9397030

SCREW PUMPS

2ND OFF

06-04-2019

17-07-2019

G.English language competency level (interview & exam test required).

Ability

Understands

Speaks

Reads

Writes

Comments on language ability (mandatory)

Score on English Language Test Exam:

Excellent

Good

Fair

Poor

H.Medical.

Document:

Number:

Issued on:

Expires on:

Authenticated on:

Medical Card (I/9)

Vaccinations

G-5234-I

12-06-2012

11-06-2022

PORT HEALTH KARACHI

Authenticity of Diplomas &

Licenses checked & verified.

CONFIDENTIAL

Manning Agent Signature.

F. Inquiry and/or Interview Results.

Company Crew/ H/R Dept. Comments:

Manning Agency Name: SEA & SEAS SHIPPING PVT LTD.

Responsible Person: SAQIB KHAN

Manning Agent Comments:

Crew Manager

Signature

Applicant Name /Signature:

GUSTASIB KHAN

Date:

Contact this candidate