CV.

THOMAS FAJAR SULAKSONO

APPLICATION FOR EMPLOYMENT

Rank 2E First Name Thomas Last Name Sulaksono Nationality indonesia

Date & Place of

Semarang 17 october 1965 Marital Status: Divorced
Birth:
Jl.karimata , vila nusa indah u 14/3 bojong kulur
Present Address: Next of Kin Details: Tirzah ayu
bogor
Skype : Thomas.sulaksono Name / Relationship: daughter
cell phone: +6281210396164 (WA) Address: Same above
Email: Thomasfajarofficial@gmail.com Next of kin Cell Phone : +6281298770852
University STIP Jakarta Mother’s name: Katharina siti yudani (Alm)
Present/Last
Nearest Airport: Halim pk Km from Airport: 5 PT.EQUINOX BAHARI UTAMA
Employer:
Languages: English , Indonesia, Malaysia
Medical Certificate Address: RS Assadah medical center, tebet jaksel
12 april 2017 Expired: 12 april 2019
issued:
Any visa issued: Expired: Tel:
Weight(kg) 76 Height(cm) 168 Coverall Size: xl Shoes Size: 42 Hair: black Eyes: black
Position Applied: 2ND / 3RD ENGINEER/ SUPERVISOR Date of availability: Any time

License
License Country Grade of Licence Number Place & Date Issued Date Expired
INDONESIA III / 2 MANAGEMENT .6200039241S30207 JAKARTA 10 FEB 2017 10 Feb 2022
LIBERIA SECOND ENGINEER .1069279 JAKARTA 14 JUNE 2017 10 Feb 2022

Passport indonesia
Number Place Issued Date Issued Date Expired
C7387509 JAKARTA 06 NOV 2020 06 NOV 2025

Seaman’s Book - If several seaman’s books write them all

Country Place Issued Date Issued Number Date Expired
INDONESIA JAKARTA 17 OCT 2017 F072313 17 OCT 2021
LIBERIA JAKARTA 4 MAY 2017 1331872 4 MAY 2022

Application Form Page 1 of 5

 CV. THOMAS FAJAR SULAKSONO

APPLICATION FOR EMPLOYMENT

Certificate
Certificates STCW Date Issued Place Issued Expiration date License Number

Basic Safety Training Certificate 11 JAN 2017 JAKARTA 11 JAN 2022 6200039241010717
PSCRB (Proficiency of Survival Craft other than Fast
Rescue Boat)
SSO 14 DEC 2016 JAKARTA 14 DEC 2021 6200039241240116
ARPA
Radar
GMDSS

Advanced Fire Fighting 18 JAN 2017 JAKARTA 18 JAN 2022 6200039241060117

Security Awarenes Training

SDSD

Medical First Aid 19 JAN 2017 JAKARTA 19 JAN 2022 6200039241070117

Bridge Resources Management

Engine Resources Management 7 DEC 2016 JAKARTA 7 DEC 2021 6200039241270216

ISM Code 19 SEP 1999 JAKARTA 611-ISM1/DP/KI-99

BOCT 9 JAN 2017 JAKARTA 9 JAN 2022 6200039241390717

AOT 6 DEC 2016 JAKARTA 6 DEC 2021 6200039241410116

Oil Tanker

Medical Care on Board Ship 23 JAN 2017 JAKARTA 23 JAN 2022 6200039241080117

Genral Operator Certificate

International Maritime Dangerous Goods Code

Electronic Chart Display System (ECDIS)

ADVANCE TRAINING CHEMICAL TANKER 14 DEC 2016 JAKARTA 14 DEC 2021 6200039241400116

SURVIVAL CRAFT & RESCUE BOATS 19 JAN 2017 JAKARTA 19 JAN 2022 6200039241040117

ADVANCE TRAINING GAS TANKER 7 DEC 2016 JAKARTA 7 DEC 2021 6200039241380116

BACHELOR/DIPLOMA TECHNICAL
21 JAN 1988 JAKARTA BA00205
ENGINEERING

Offshore Training Certificates Date Issued Place Issued Expiration Date License Number

HUET 19/4/2017 JAKARTA 19/4/2020 2K17-PDC-011/EQX.10

BOSIET 17/3/2014 SINGAPORE 17/3/2018 841757071903140008

PERMIT CONTROL WORK TRAINING LV 2 15/6/2015 JAKARTA 15/6/2022 HSES2015/VI-021

Application Form Page 2 of 5

 Sea Service Record

Engine Type + No of days

Vessel’s Name Flag GRT/BHP Vessel Type Company Name Rank Period: From Period: To
KW onboard
CRUDE OIL
FSO.INTAN LIBERIA 96000 STEAM SHIP PT.EQUINOX BAHARI UTAMA 2E 23/4/2017 14/4/2018
VLCC
JACK UP SENIOR
MOPU BOSS 1 INDONESIA - - THOME OFFSHORE /PT.TIMUR 01/3/2014 17/5/2016
BARGE MECHANICA
CRUDE OIL
FSO.HERCULES MALAYSIA 276445 B&W ANSON MARINE 3E 12/12/2012 12/6/2013
VLCC
CRUDE OIL
FSO HERCULES MALAYSIA 276445 B&W ANSON MARINE 3E 26/9/2011 18/8/2012
VLCC
CRUDE
FSO.HERCULES MALAYSIA 276445 B&W ANSON MARINE 3E 29/11/2010 26/7/2011
OILVLCC

MT.SEA PIONEER NIGERIA 7000 BUNKER SHIP BLACKSTONE PT.EQUINOX BAHARI UTAMA 2E 12/1/2010 05/8/2010

MT.AZALEA KOREA 3500 LPG AKASAKA DAELIM SHIPPING 1E 06/9/2008 18/3/2009

CORAL CARBONIC HOLLAND 2500 LPG MAK ANTHONY VEDER 1E 31/5/2008 05/8/2008

CORAL CAEBONIC HOLLAND 2500 LPG MAK ANTHONY VEDER 1E 19/9/2007 07/2/2008

SURVEY
GEO SURVEYOR SINGAPORE 1145 MAK FUGRO 3E 04/4/2007 28/8/2007
SEISMIC

CORAL FAVIA HOLLAND 4475 LPG AKASAKA ANTHONY VEDER 2E 25/3/2006 17/1/2007

MT.KIRANA PRATAMA SINGAPORE 36800 OIL B&W NISSHO ODYSSEY 2E 03/2/2005 10/12/2005

MT.SINGAPURA UTARA KOREA 2540 CHEMICAL AKASAKA NISSHO ODYSSEY 1E 16/4/2004 03/12/2004

MT.APOLLO PACIFIC SINGAPORE 4336 LPG HANSHIN NISSHO ODYSSEY 2E 16/6/2003 12/2/2004

MT.PRANEDYA TRITYA INDONESIA 17850 OIL B&W NISSHO ODYSEY 3E 03/5/2002 26/3/2003

MT.SEAGUL SPIRIT KOREA 1775 CHEMICAL HANSHIN NISSHO ODYSSEY 1E 15/4/2001 10/1/2002

SAMUDRA AYU INDONESIA 4235 OIL HANSHIN PT.EQUINOX BAHARI UTAMA 2E 02/9/1999 08/7/2000

SAMUDRA AYU INDONESIA 4235 OIL HANSHIN PT.EQUINOX BAHARI UTAMA 2E 03/6/1998 11/1/1999

PM ALPHA SINGAPORE 5335 CHEMICAL WARTSILA PT.EQUINOX BAHARI UTAMA 3E 02/5/1997 28/11/1997

Application Form Page 3 of 5

 SHELL ENTALINA HOLLAND 13885 OIL SULZER SHELL TANKER BV 3E 08/1/1996 29/7/1996

MT. TEMPLAR GRACE 12555 CHEMICAL B&W ISTANA HITAWACANA 3E 28/5/1995 08/11/1995

WAN HAI 223 TAIWAN 14445 CONTAINER M.SULZER WAN HAI LINE 3E 15/9/1994 23/3/1995

STOLT BIRCHWOOD LIBERIA 3245 CHEMICAL ALLEN PT.EQUINOX BAHARI UTAMA 2E 28/5/1993 16/1/1994

STOLT CEDARWOOD LIBERIA 3245 CHEMICAL ALLEN PT.EQUINOX BAHARI UTAMA 2E 22/5/1992 17/3/1993

STOLT BIRCHWOOD LIBERIA 3245 CHEMICAL ALLEN PT.EQUINOX BAHARI UTAMA 2E 21/1/1991 07/3/1992

MV.BAGUR INDONESIA 3875 CARGO HANSHIN GESURY LLOYD 2E 03/5/1990 15/8/1990

MV.BAGUR INDONESIA 3875 CARGO HANSHIN GESURY LLOYD 3E 08/3/1989 02/5/1990

Reference check  from last 2 companies :

No. Company Name Vessel Type Person In Charge Designation Company Address
   PT.Equinox bahari  FSO.Intan Angga Crewing manager ( Hp  Gd.Globe 5/fl , buncit jaksel
utama +628118694878 )

   Thome /pt.Timur  Boss 1 Jack Up  Anna M Crewing Manager (Hp Gd .Permata Kuningan bldg. 16 fl,jaksel
Barge +628118132561 )
Accommodation  

Application Form Page 4 of 5

ANY ADDITIONNAL INFORMATIONS OR JOB DESCRIPTIONS /EXPERIENCES YOU WANT TO DETAIL IN PARTICULAR. WRITE HERE:
Detail the work you have done onboard previous vessels and your previous experience

Application Form Page 5 of 5