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SINGHAI MARINE SERVICES SY FiBFSES SEAFARER’S APPLICATION FORM MA BR ‘Ths apoleation form serves to provide with i information oF the Applicant and wil be teated ar personal record should the Aspicant be employed. AFL IATEHAAG SARE. MAMEAIABI IT AEB AI ‘Aopicant is required to complete all pars in BLOCK CAPITALS, Copies ofall corificates, Seaman's book, passport and appraisal from the ‘previous companies (if any) are tobe atached. BHR ATER AS 7 IAS HH LUT eT As LE ERAN ‘oplcan st beat least 38 years of ame foray postion appli. FEE AONERDIRATT LU) 18 | POSITION APPLIED FOR: - | Date: ‘FiIR% CHIEF COOK Hii: 11/08/2023 PERSONAL DETAILS TARE Sas ‘Surmame & ‘Middle Name | LastName % Nationality [5% SuAMSOL BArARIN STALE MALAYSIN | Date of Birth 11171110) Place of Birth ii‘ ii Religion 5 ‘Age Fe | Af (aes ROAR COMPOR MusuM 50 Cobur | Height/weight ‘Safety Shoe Size Overall Size Marital Status ae (ieee eee Seas See ht 17cm Fr ox Divorce Passport Number Tesuing Authority ‘Date of Tesue | Date of Expiry FS RK SRAM SAME ASAS971 Wancsa HASU "avesy20z 1/09/2006 ‘Seaman's Book Number Issuing Authority ‘Datectissue | Dateof Exmiry | COC Grade HS BRK BRAM EEL AEE ‘SM6717 PORT KLANG 16/11/2012 Mobile Phone Number House Telephone Number | Email Address Hometown Airport FS EGE | 6014257344 Beyarsoi21@gmelicom | na uma ry | ed

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