CREW LIST FormNo F 619

COMPANY WORK FORM File No M 32 l

Issue No / Date B- 16104/1 8

Authorised By MD
CREW LIST [lMO FAL Form 5l
This form is to be completed on arrival and departure

Anival
I I Name ofShip

l\4ale Passport 22161369 INDIA 15-APr22 11-Nov-20 6"0" lorn 6P1

1 GUPTA Vikas Master Indran 06-Aug-70 LUcKNow, urrAR PRAoESH

4 Male Passport 24896029 INDIA 20-Mar28 01-Nov-20 1r;6;

2 KANE Carlton Lester Ch Off Indian 17 -Mar7 MUMBAI, IVIAHARASHTRA
1 8-Jun-29 30-Jul-20 qsqnis6 15. 6p1
Bilawal ACO Pakistani 18-Feb-90 BHIMBERAJK,PAK Male Passport AY4185713 PAKISTAN
3 GHAFOoR 12-Feb-23 30-Jul-20 qsgnlqn 1s 9p1
Danish 2nd Off Pakistani 04-Feb-87 KARACHI, PAK l\4ale Passport AD1460232 PAKISTAN
4 ATIO 12-Jun-22 q"rn;on b, 6P1
Sagar Pradeep 2nd Oll 06-Aug-86 MUMEAl, NIAHARASHTRA Male Passport 22417372 INDIA 05-SeP-20
5 PAWAR Indian

Sahil 3rd Off 06-Feb-93 cHANDIcARH, cHANDIGARH Male Passport U7442377 INDIA 29-SeP-30 01-Nov-20 1r;61
6 SAHNI Indian
21-Jun-27 11-Nov-20 guo"
SParsh TNO 06-Feb-00 JAMMU JAMM! AND GSHMIR Male Passport 23781224 INDIA 1o.n 6p1-
7 GUPTA Indian
18-Oct-22
l\4anjit Ch Eng 26-Feb-59 YoLcAMP,HIMAcHALPRAoESB Male Passport 22445331 rNPIA 05-SeP-20 X"rnlon 1r. 6P1-
s SINGH Indian
29-Aug-21 05-Sep-20 g"un;on 1t, gpg
Rajko 2nd Eng Hryatsko 17-Mar63 ZADAR Male Passpori 042802654 CROATIA
9 BACALJA 02-SeP-30 01-Nov-20 666;
3rd Eng Pakistani 06-Jul-86 KARACHI, PAK N4afe Passpo(l ADo772624 PAKISTAN
1o |\4ANDRE Humair Aslam
gP.
John Gumawa 3rd Eng 14-Feb-74 BATAD ILOILO Male Passport P90133604 PHILIPPINES 03-Oct-28 07-Feb-20 6uo"1oryn
11 DADIVAS FiliPino
g"O"1o*n 9P1
Male Passpoil 73 6598642 RUSSIA 21-Nov-24 11-Nov-20
12 BARINOV Vadim 4th Eng Russian 08-Oct-95 RUSSIA
Male Passport 25844021 INDIA 19-Jan-30 05-SeP-20 q"rn;on 1. 61.
13 VISHWAKARMA Lal Chand Gas Eng -Matr86 urrAR
01 SULTANPUR, PRADESH
Indian
Male Passport 23269923 INDIA 02-Jul-25 05-Sep-20 Reunion ls, oPL
14 PATHAK Din Dayal ETO lndian O1-JUn-59 BALLIA, UTTAR PRADESH

lvlale Passport 24718557 INDIA 24-Jan-29 05-SeP-20 6.un;on 1r, 6P1

15 MUTHUKUI,IARASAI$Y vignesh Add ETO lndian 28-Jul-86 MAYIHDUDURAI TAMILNAoU

Male Passport 73'1371581 RUSSIA 09-Oct-23 03-Nov-20 1r;6;

16 FEDOTOV Nikita Ass ETO Russian 05-Jun-97 RUSSIA
Male Passport F8589184 UKRAINE 23-Jun-25 03-Nov-20 1r;6;
17 NIKOLAIEV Yevhen Fitter Ukrainian 1 1-May-87 UKR
Male Passport P71 159644 PHILIPPINES 17-Dec-28 30-Jul-20 q"q6;enls 9P1
18 CRUZ Jerno Tandoc Bosun Filipino 19-Dec-72 LINGAYEN PGN
lvlale Passport P46232258 PHILIPPINES 29-Jan-30 30-Juf20 q"rn;on 1. 9P1
19 BANMG Sceptre Pahati ASD Filipino 13-May-89 VICTORIA LAGUNA
Male Passport P4281 628 PHILIPPINES 01-Jan-30 07-Feb-20 63061ery6 9p1-
20 Dll\,lMNO Jun Geron ASD FiliPino O4-Jan-82 BATANGASCITY 1

Male Passport P52492978 PHILIPPINES 21 -Jun-30 05-Sep-20 p"un;on 1.. 9p1-

21 EGONIO Edison lvlarasigan ASD Filipino 15-Jan-93 TAGAYTAYCITY
Male Passpotl P45282248 PHTLIFPINES 23-Jan-30 26-Feb-20 6uo" 1o*n 6P1
22 LOPENA Brian Andaya ASD Filipino 18-Nov.87 CABUYAO LAGUNA
Male Passport P3852761B PHILIPPINES 14-Nov-29 07-Feb-20 capeTown oPL
23 PEDRONAN Freddie Ambalan ASD Filipino 05-Sep-88 CALAYANCAGAYAN
03-SeP-22 26-Feb-20 6"o"1otn9P1
lvlale Passport P4251052A PHILIPPINES
24 MONTERDE Rechard Olingay ASD Filipino 17-Aptr80 VILLABA LEYTE
22-Nov-29 26-Feb-20
Jhezel Clarence Pablo ASD Filipino 22-DEC-76 TAYUG PANGASINAN lvlale Passport P3943245B PHILIPPINES 6"o"1ot"n 6p1
25 DUCUT 03-Dec-28 g"os1o*n9P1
NWR Filipino 22-Jul-95 ALCALA PGN Male Passport P9802578A PHILIPPINES 26-Feb-20
26 RONQUILLO Jhomer Goliat 22-Aug-29
NWR FiliPino 11-Ocl-92 DIPOLOG CITY Male Passport P28376438 PHILIPPINES 11-Nov-20 6so61qq6 9P1
27 CAI\IBONGGA Francis Angas 12-Jan-22
Kim Pidlaoan DC 03-Oct-97 DAGUPAN CITY Male Passport P162'17404 PHILIPPINES 11-Nov-20 capeTown oPL
28 SUNGA FiliPino
15-Nov-22 q"rn;on
Ramel Senanin ASE Filipino '11-Sep-74 ANINI-Y ANTIQUE Male Passport P50614314 PHILIPPINES 05-SeP-20 1t. 6P1
29 SANANA 2O-Jun-28 lotn
Joeiie Lucena ASE Filipino '1
1-Dec-81 BOMBON CAM SUR Male Passport P76124534 PHILIPPINES 07-Feb-20 6"0" 9P1
30 RILLON 22-Mar-29
Felix Jordan ASE Filipino 04-May-68 S BARBARA ILOILO Male Passport Pl 1622098 PHILIPPINES 11-Nov-20 6"0"1oryn 9P1
31 HINGCo 03-SeP-30 11-Nov-20 capeTown oPL
27-Od-94 l\ilale Passport P54719828 PHILIPPINES
32 IANCHINGCO Mharc Justin Rigo EWR Filipino QUEZON CITY

Patrick Ducala EC Filipino 09-Jul-94 0IGOS DVO DS Male Passport P3055334A PHILIPP INES 15-MaY-22 11-Nov-20 Cape Town oPL
33 VIRAN 26-Nov-21 08-Dec-19 51nr"oor"
Diogenes l\4elecio Cook 06-Aptr85 CALAPE BOHOL lvlale Passport P10164594 PHILIPPINES
34 CUBIO FiliPino
21-Feb-30 30-Jul-20 q"qn;..;t
lvlale Passport P49149868 PHILIPPINES 6P1
35 DEL ROSARIO Archie Jav Santiago Cat Boy Filipino 13-Aug-79 QUEZON CITY
23-Aug-28 6"0"1o*n
Kenneth Pamfilo Cat Boy Filipino 16-Dec-92 BATANGAS CITY Male Passport P8478999A PHILIPPINES 11-Nov-20 6P1
36 PEREZ 25-APr22
Jefry l\4ae Geputango Cat Boy 28-Aug-92 TBOLI S COTABATO Male Passport P28315394 PHILIPPINES 11-Nov-20 Gpg 16sn 6P1
37 ALAMADA Filipino

i-. out" -d .ignurut" by Master autliorised'agent or oficer

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