A-NOR Form CL - ( MV Rev 3 - Fnal ) | Commercial Item Transport And Distribution | Logistics

14 DAYS NOTICE OF READINESS TO RESUME SHIPBOARD SERVICE

( 14 Hari Notis Sedia Berkhidmat Diatas Kapal )

Date: 07/01/2011

(To be tendered by e-mail: nor2sail@miscbhd.com, or Courier/Pos Laju or by hand. Pls retain proof of submission or postage ). (Hantar notis melalui e-mail: nor2sail@miscbhd.com atau Pos Laju atau hantar sendiri. Sila simpan bukti penghantaran atau kiriman pos laju). ADDRESS / Alamat (if sending via Courier/Pos Laju )
FLEET PERSONNEL DEPARTMENT (ATTN : NOR/LOGISTICS), LEVEL 18 MENARA DAYABUMI,JLN SULTAN HISHAMUDDIN, 50050 KUALA LUMPUR,MALAYSIA

NAME /CREW NO: HASNOL HAIRANI BIN HASSAN (Nama/No Pekerja) DATE SIGN OFF : 15/11/2010 (Tarikh Sign Off) LATEST ADDRESS: NO.25 DAT.PENGKALAN BARAT 6, 3549686 (Alamat Terkini TAMAN TEMARA 31650 IPOH , PERAK.

RANK/LAST VESSEL : CATERING OFFICER (Jawatan/Kapal Terakhir) DATE LEAVE EXPIRE: 25/02/2011 (Cuti Tamat) CONTACT NO/EMAIL: H:05 216582 H/P:019 (No Tel/Alamat email) hasnolhairanih@yahoo.com

I declare that I am ready IN ALL RESPECTS to join ship within 2 weeks of my leave expiry date. (Saya mengaku dan bersedia untuk menaiki kapal dalam masa 2 minggu sebelum cuti saya tamat) I declare that all my travel documents/seaman card/discharge book and all relevant and required certificates for shipboard service are valid and in order. (Saya mengaku bahawa dokumen perjalanan/ Kad Pelaut/ Buku Pelaut and dokumen berkaitan serta yang diperlukan di atas kapal adalah sah dan mengikut peraturan)
TICK NO

A

DOCUMENTS AND CERTIFICATES – APPLICABLE TO ALL International Passport (required validity > one year) *(Expiry date: ) Medical Fitness Certificate /Category A (> 50 yrs every year) & (18-50 yrs every 2 yrs) (validity > one year) *(Expiry date: ) Seaman Identification Card ( New microchip format for Msians ) *(Expiry date: )
Discharge Book Vaccination Book (For Yellow Fever – Validity 5 years)

YES √ √ √ √

N/A

1 2 3
4 5 6

)

*(Expiry date:

√ √

Basic Safety Training (For all ranks) Comprises 4 Training Certs ( Personal Survival Techniques / Personal Safety & Social Responsibilities / Basis First Aid / Basic Fire Fighting )

B1/C1

CERTIFICATE OF COMPETENCY (COC) FOR OFFICERS

YE S

NO

N/A √

1

Certificate of Competency (Min validity of COC > 6 months) )

*(Expiry date:

Certificate of Recognition (for Expatriate & M’sian holding foreign COC) *(Expiry date:

√ √

2 3

) Dangerous Cargo Endorsement (Min. validity >6months) :*Oil ) *Chemical ) *Gas ) *(Expiry date: √

*(Expiry date: *(Expiry date:

Remarks ( if any ) :

FPD/FMO/NOR/OCT/2009

A/O & E/O ) Advanced Liquefied Gas Tanker Training ( For all ranks except CTOF. C/Off. C/Off.C2 MODULAR/SPECIALIZED COURSES (WHERE APPLICABLE) FOR DECK OFFRS /ENGRS YES NO N/A √ 1 Advance Fire Fighting ( For all ranks except CTOF . C/E & 2/E) Electronic Chart Display (ECDIS) – ( For all Deck Officers ) √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ FPD/FMO/NOR/OCT/2009 . C/E & 2/E) Risk Assessment (Master. A/O & E/O ) Advanced Chemical Tanker Training ( For all ranks except CTOF.(Master. A/O and E/O ) √ 2 Shipboard Management ( Master. C/E & 2/E) Ship Handling Simulator (Master & C/Off) Tripod Incident Investigation Course (Master. C/Off. C/E and 2/E ) GMDSS ( for all officers except CTOF. C/O. A/O & E/O ) *(Expiry date: ) General Operator Certificate (GOC) for all Deck Officers except CTOF/AO&EO *( Expiry date: ) ARPA Bridging ( for all deck officers except CTOF. C/O. A/O & E/O ) GMDSS Refresher ( For all ranks except CTOF. A/O & E/O ) Bridge Resources Management ( For all ranks except CTOF. A/O & E/O ) Shipboard Safety Officer (C/O MUST have – Others Optional ) Ship Security Officer (SSO-ISPS) . C/E and 2/E ) √ 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Medical Care (Master. A/O & E/O ) Tanker Familiarization: Combined Oil /Chem/Gas ( For all Deck Offrs and Engrs )Tankers Only Advanced Oil Tanker Training ( For all ranks except CTOF.

D1 1 2 CERTIFICATES FOR RATINGS Rating Watch Keeping Certificate (For Deck Rating and Eng Rating) Dangerous Cargo Endorsement (Min. this NOR shall be deemed as NOT VALID . if I refuse or fail to take up shipboard assignment when called upon after giving this NOR within the 2 week period from my leave expiry date or thereafter . I shall be deemed to be placed on “Forced Unpaid Leave Status” upon expiry of my leave . (Not required if submission by e-mail/ Tandatangan tidak perlu jika hantar melalui e-mail) FPD/FMO/NOR/OCT/2009 . Signature: …………………………………………. validity >6months) *Oil *(Expiry date: ) *Chemical *(Expiry date: ) *Gas *(Expiry date: ) MODULAR/SPECIALIZED COURSES (WHERE APPLICABLE) FOR RATING YES NO N/A √ √ √ √ √ D2 YES √ NO N/A 1 Tanker Familiarization – Combined (For Deck and Eng Rating) (Saya memaha sebelum cuti ta sebelum cuti ta dalam tempoh I understand that if I wrongfully declare any of the above information OR if any of my required documents / certicates are found to be invalid/expired OR if I tender this notice less than 2 weeks before my leave expiry date or after my leave expiry date . In such case . Further. I am required to re-tender a new NOR within 30 days thereafter failing which my service with the Company may be ceased after that 30 day grace period.

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