GOVERMENT OF INDIA

MINISTRY OF SHIPPING
DIRECTORATE GENERAL OF SHIPPING

Application for Certificate of Competency (CoC)

Application No. : COCN/MMD(K)/2022/10001262

Application Date : 31-JUL-2022
Office Applied To : MMD KANDLA

Personal Details
Name of the Candidate : AAKARSH MITTAL

Date of birth : 01-DEC-1987 Gender : Male

Place of birth : GWALIOR INDOS No. : 05NL1233
Nationality : INDIAN Colour of eyes : BLACK
Height ( in cms ) : 165 Colour of hair : BLACK
Identification Marks : SPOT ON RIGHT SIDE OF NOSE
CDC No. : MUM 139154 CDC Issue Date : 13-MAR-2018
CDC Expire Date : 12-MAR-2028 CDC Issue Place : MUMBAI
Seat Booking Details
Grade : Master of a Foreign Going Ship
Stream

Application Date
COCN/MMD(K)/2022/10001262
: First Mate (FG)

: 26-AUG-2019 Application No. : SB/MMD(K)/2019/10000916

MMD Applied to : MMD KANDLA
Details of CoC as GMDSS Radio Operator issued by MMD
CoC as GMDSS Certificate No. : GMDSSDEL19007007
Issued Date of CoC as GMDSS Certificate : 24-SEP-2019
Valid Date of CoC as GMDSS Certificate : 23-SEP-2024

Result Details
Sr. No. Function Part/Phase Paper Written/Oral MMD Month-Year Result

1 Advanced Shipboard Management Advanced Shipboard Management Written MMD(K) SEP-2019 Pass

2 Advanced Shipboard Management Oral-ASM Oral MMD(K) JUL-2022 Pass

Modular Course Details

Sr. No. Course Certificate No. From Date To Date Comment

1 Advanced Training in Fire Fighting CMET/AFF/180/980 20-JUL-2009 25-JUL-2009

NATCOM/ECDIS/144/
2 Electronic Chart Display and Information Systems 26-MAY-2014 30-MAY-2014
2014
MMTI/PSCRB/5477/20
3 Proficiency In Survival Craft and Rescue Boats 22-SEP-2009 26-SEP-2009
09
Refresher and Updating Training Course for Nautical
4 154/9908/0273 04-MAY-2015 08-MAY-2015
Officers
Refresher Training for Advanced Training in Fire Fighting 10301163122105010 (
5 08-JUL-2021 08-JUL-2021
Part 'A' )
1030116212210508 (
6 Refresher Training For Proficiency In PSCRB 07-JUL-2021 07-JUL-2021
Part 'A' )

7 Ship Manoeuvering Simulator 103007026191021 24-JUN-2019 28-JUN-2019

8 Ship Security Officer SSO13923 26-DEC-2013 28-DEC-2013

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 Address Details
House No. : GH3-704, TOWER G Street : CLASSIC RESIDENCY
Village/Post Office : RAJ NAGAR EXTENSION District : GHAZIABAD
State : UTTAR PRADESH Pin Code : 201002
Email Address : aakarshmittal0410@gmail.com Mobile No. : 8929878376
Medical Certificate Details
Name of the Doctor : DR.A.K.GUPTA DGS Approval No. for Doctor : ND/DEL/04/2015
Place of issue of Medical : NEW DELHI Date of issue of Medical : 22-JUL-2022
Certificate Certificate

Fees Details
Amount (Rs.) : 3000 Payment Mode : ePayment

Payment Date : 31-JUL-2022 Reference No : WAXG1311307620

Attached Documents
Sr. No. Documents to be uploaded

1 Scan copy of signed online application

Passport size (3.5 cm X 3.5 cm) photograph with clear white background face covering 70%
2

3 Scanned signature of seafarer

4 Scanned Certificate of CoC as GMDSS Radio Operator issued by MMD

5 Self attested scan copy of Medical Fitness Certificate from DGS Approved Doctor

6 Self attested scanned copy of EXN45

Scanned copy of Certificates of Modular ,Updating training course(as applicable) and B.Sc.Nautical Science (As applicable) in one pdf file.
7

8 Scanned copy of valid passport

COCN/MMD(K)/2022/10001262 Declaration
I hereby declare that all the statements made in this application are true and complete to the best of my knowledge and belief and
nothing has been concealed/distorted.

I Agree.
Place : Signature of the Applicant : ..................................................
...............................
Date : 31-JUL-2022 Name of the Applicant : AAKARSH MITTAL

SPECIMEN SIGNATURE OF THE APPLICANT

(Signature are to be confined to each of the boxes)

1 2

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