Crew/HR-04

Date: 01.11.2014
SEAFARER APPLICATION OF EMPLOYMENT
Revision: 02
Approved: G.M.

A. Personal data & Documents

Seaman
Date of birth. 29-08-1984 Name. Usman Ali Rana
Name of Muhammad Yaqoob Seaman
father. Rana Middle Name. Ali
Name of Seaman
mother. Zahida Yaqoob Rana Surname. Rana
Name of wife. Saira Usman Rank. 2E
Number of
children. One Nationality. Pakistani
Address. 65-4-AII Township Religion. Islam
Seaman’s
Lahore Book no. 010580-EO
Passport
number. AH 9797852 Place of issue. Karachi, Pakistan
Place / date of
issue. Lahore/ 07-05-2013 Date of issue. 03-02-2010
Passport exp. Last sign off
date. 06-05-2023 date. 02-02-2020

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

Name of Certificate: Number: Issued on: Expires on: Authenticated on:
National certificate
of competence
National endorsement of
competence certificate*
GMDSS G.O.C. (IV/2)*
Personal Survival Techniques
12097 18-01-2019 17-01-2023
(VI/1.1)
Basic Fire-fighting (IV/1.2) 1337 22-01-2019 21-01-2023

Elementary First Aid (IV/1.3) 1301 22-01-2019 21-01-2023

Personal Safety & Social
12360 04-01-2019 03-01-2023
Responsibility (IV/1.4)
Medical First Aid (VI/4) 3461 16-01-2019 15-01-2023

FP & FF
Survival Craft & Rescue Boats
1825 16-02-2015 15-02-2019
(VI/2.1)
RADAR & ARPA

Advanced Fire-fighting (VI/3) 6935 11-01-2019 10-01-2023

Bridge Team Management

Watch keeping
Security Awareness With
175 18-01-2019 17-01-2023
Designated Security Duties
Advance Training For Oil Tanker 2011 22-01-2019 21-01-2023
Chemical Tanker Specialized
Training (V/1)
Efficient Deck Hand

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 Crew/HR-04
Date: 01.11.2014
SEAFARER APPLICATION OF EMPLOYMENT
Revision: 02
Approved: G.M.

C. Flag State Endorsements of Recognition for certificates with (*)

Name of Certificate: Number: Issued on: Expires on: Authenticated on:

C. Flag State Endorsements of Recognition for certificates with (*) continues….

Name of Certificate: Number: Issued on: Expires on: Authenticated on:

D. Seaman’s book:
Nationality: Number: Issued on: Expires on: Authenticated on:

E. Additional Company Requirements.

Documents: Number: Issued on: Expires on: Authenticated on:
1. ENGINE PLANT
SIMULATOR
2. ECDIS
3. Ecdis ship specific
4.Risk assessment

5. RADAR ARPA
6. Accident investigation
7. SSO
8. Ship Board Safety
Officer
9.ILO/MLC 2006
10. Cargo handling
F. Experience / Service Record.
Ship Type Previous
Oil/Chemical Tanker experience Serviced from /
Ship’s Name Company DWT Eng. Type Rank
IMO Number with Framo to
( IMPERATIVE) Pumps
M.T ATHINA SOECHI 78000 CRUDE TANKER MAN B&W SMCC 2E 05-04-18
II 25-10-18
M.T SOECHI 107000 CRUDE TANKER Sulzer RTA 2E 04-08-17
FORTUNEVIL 09-11-17
LAXL III
M.T SOECHI 105000 CRUDE TANKER Sulzer RTA 2E 10-11-16
SCWARRIOR 27-03-17
L
M.T TRUE FSMHK 158000 CRUDE TANKER MAN B&W SMC 2E 23-12-15
OCEAN 30-05-16
M.T EVA FSMHK 11200 CHEMICAL TANKER Framo YANMAR 2E 27-05-15
14-10-15
M.T ANMOL FSMHK 36900 CRUDE TANKER Sulzer RTA 3E 04-02-14
03-07-14
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 Crew/HR-04
Date: 01.11.2014
SEAFARER APPLICATION OF EMPLOYMENT
Revision: 02
Approved: G.M.

45000 CHEMICAL TANKER Framo 3E 09-10-11

15-04-12

F. Experience / Service Record (continuous…)

Serviced from /
Ship’s Name Company DWT Ship Type Eng. Type Rank
to
M.T RAGGA IRISL 45000 CHEMICAL B&W GFC 3E 09-10-11
TANKER 15-04-12
M.T AGEAN VIII ÀGEAN OIL 22500 OIL TANKER Sulzer RTA 3E 11-02-10
15-07-10
M.T BAHADUR KPT 4900 BARGE MAN 4E 11-11-09
10-11-10
S.H.B KPT 4900 BARGE MAN 5E 11-08-09
BHITSHAH 10-11-09

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

Ability Understands Speaks Reads Writes Comments on language ability (mandatory)
Excellent
Good    
Fair

Poor
Score on English Language Test Exam: …………………

H. Medical.
Document: Number: Issued on: Expires on: Authenticated on:

Medical Card (I/9)

Vaccinations (YELLOW
FEVER)

Authenticity of Diplomas &

Licenses checked & verified.
CONFIDENTIAL
Manning Agent Signature.
F. Inquiry and/or Interview Results.

Manning Agency Name:Mars Marine Services

Company Crew/ H/R Dept. Comments: Responsible Person:Majid Maqsood

Manning Agent Comments:

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 Crew/HR-04
Date: 01.11.2014
SEAFARER APPLICATION OF EMPLOYMENT
Revision: 02
Approved: G.M.

Crew Manager Applicant Name /Signature:

Signature Date:

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