Seafarer : 6201194654 Place, Date of birth : Ps. Matanggor 01 Januari 1990 Marital Status : Married Nationality : Indonesian Religion : Moslem Phone : 081314545953 Home Address : Jl. Kelurahan RT. 006/010 Keranji
II. EDUCATION FO COMPETENCY
No Type of Document Number Issued Date Place 01 ATT IV 6201194654T42414 February 28, 2014 Jakarta 02 Endorsement ATT-IV 6201194654TD2414 March 20, 2014 Jakarta
III. DOCUMENT HELD
No Type of Document Number Date of Issued Date of Expired Place 01 Seaman Book Y008286 April 15, 2015 Dec 15,2017 Tanjung Priok
IV. CERTIFICATE OF PROFICIENCY
No Type of Document Number Issued Date Place
01 Basic Safety Trainning 6201194654010110 June 06, 2010 Jakarta 02 Survival Craft and Rescue Boats 6201194654040113 May 20, 2013 Jakarta 03 Advanced Fire fighting 6201194654060116 February 01, 2016 Jakarta 04 Security Awareness Training 6201194654314116 January 22, 2016 Jakarta 05 Seafarers with Designated Security Duties 6201194654324116 January 22, 2016 Jakarta 06 Ship Security Officer 6201194654244116 January 22, 2016 Jakarta
V. EXPERIENCE WORKING IN SHIP
No Name of Ship Company Rank Date Sign On Date Sign Off
01 KM. Barelang 1 Cargo- 1313 T PT. PMM Kadet Mesin January 13, 2011 January 13, 2012 02 KM. Sentosa 209 Cargo-1510T PT. BJL Masinis III April 22, 2014 January 05, 2015 03 LCT. Niaga Samudra 18 Landing 1662T PT. NJS Masinis II March 04, 2015 May 30, 2016 04 LCT. Niaga Samudra 18 Landing 1662T PT. NJS KKM May 30, 2016