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DoS Copy

Application for Dos Number


Application ID: 2521122011540683
Bangladeshi CDC/ID for Others : C/O/9293

Name: MD SHAREEAT ULLAH MIR Documents Attached


Date of Birth: 11-05-1995 1x Photocopy CDC or NID or Passport
Father's Name: MD SHAFI ULLAH MIR 1x Main copy of Attendance Certificate
Birth Place: MUNSHIGANJ 1x Appropriate Evidence of your Old DoS No
CDC: C/O/9293

Previous
Sl Course Name Previous Institute
Registration
1 ELEMENTARY FIRST AID IMA/EFA-A328 International Maritime Academy
2 PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES IMA/PSSR-A261 International Maritime Academy
3 SEAFARER WITH DESIGNATED SECURITY DUTIES IMA/DSD-A222 International Maritime Academy
4 SECURITY AWARENESS IMA/SAT-A319 International Maritime Academy

DoS Comment:

20-12-2021
Application Date Candidate Signature CME Signature

For Bank Use

Application ID:2521122011540683

Application Fee for 4 DoS Number 800.00


Processing Charge (Service Provider) 16.00
Total Payable: 816.00 Bank Signature & Seal

Please submit DoS, Bank & Candidate copies to Bank during payment and get these copies signed and sealed by
Bank. Then submit the DoS copy to Counter.
Candidate Copy
Application for Dos Number
Application ID: 2521122011540683
Bangladeshi CDC/ID for Others : C/O/9293

Name: MD SHAREEAT ULLAH MIR Documents Attached


Date of Birth: 11-05-1995 1x Photocopy CDC or NID or Passport
Father's Name: MD SHAFI ULLAH MIR 1x Main copy of Attendance Certificate
Birth Place: MUNSHIGANJ 1x Appropriate Evidence of your Old DoS No
CDC: C/O/9293

Previous
Sl Course Name Previous Institute
Registration
1 ELEMENTARY FIRST AID IMA/EFA-A328 International Maritime Academy
2 PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES IMA/PSSR-A261 International Maritime Academy
3 SEAFARER WITH DESIGNATED SECURITY DUTIES IMA/DSD-A222 International Maritime Academy
4 SECURITY AWARENESS IMA/SAT-A319 International Maritime Academy

DoS Comment:

20-12-2021
Application Date Candidate Signature CME Signature

For Bank Use

Application ID:2521122011540683

Application Fee for 4 DoS Number 800.00


Processing Charge (Service Provider) 16.00
Total Payable: 816.00 Bank Signature & Seal

Please submit DoS, Bank & Candidate copies to Bank during payment and get these copies signed and sealed by
Bank. Then submit the DoS copy to Counter.
Bank Copy
Application for Dos Number
Application ID: 2521122011540683
Bangladeshi CDC/ID for Others : C/O/9293

Name: MD SHAREEAT ULLAH MIR Documents Attached


Date of Birth: 11-05-1995 1x Photocopy CDC or NID or Passport
Father's Name: MD SHAFI ULLAH MIR 1x Main copy of Attendance Certificate
Birth Place: MUNSHIGANJ 1x Appropriate Evidence of your Old DoS No
CDC: C/O/9293

Previous
Sl Course Name Previous Institute
Registration
1 ELEMENTARY FIRST AID IMA/EFA-A328 International Maritime Academy
2 PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES IMA/PSSR-A261 International Maritime Academy
3 SEAFARER WITH DESIGNATED SECURITY DUTIES IMA/DSD-A222 International Maritime Academy
4 SECURITY AWARENESS IMA/SAT-A319 International Maritime Academy

DoS Comment:

20-12-2021
Application Date Candidate Signature CME Signature

For Bank Use

Application ID:2521122011540683

Application Fee for 4 DoS Number 800.00


Processing Charge (Service Provider) 16.00
Total Payable: 816.00 Bank Signature & Seal

Please submit DoS, Bank & Candidate copies to Bank during payment and get these copies signed and sealed by
Bank. Then submit the DoS copy to Counter.

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