Magsaysay MOL Marine, Inc.

Information Update Sheet | FM-CMO-IUS-06-202001

INFORMATION UPDATE SHEET

To our Seafarers: It is very important to us to be able to connect with you and your family either while you are onshore or onboard. It will help us
also in updating your records in our database for our communication. Thank you very much for your time in accomplishing this form.

Name (Last, First, Middle)      

Place of Birth       Date of Birth       Sex      

Marital Status       Religion       Nationality      

Size of Protective Gear/Boiler Suit       Shoe Size       Rank      

Address (House No. Street/Barangay)       Zip Code      

City/Municipality/Town       State/Province       Country      

Email Address       Tel. No +63       Mobile No. +63      

Employment Number       Date Joined      

Birth Contact
Relationship Name (Last, First, Middle) Permanent Address Birth Place Email Add
Date Number/s

Father                                    

Mother                                    

Spouse                                    

Child 1                                    

Child 2                                    

Child 3                                    

Child 4                                    

Person to contact in case of emergency:

Name       Relationship      

Permanent Address.       Mobile No.       Email Address      

I hereby certify that the information provided herein are true and correct.

_____________________________________ ______________________
Signature over Printed Name Date