Application for Employment

DDATE DECEMBER 4, 2023

PERSONAL DATA a
t
e
POSITION APPLIED FOR ABLE BODIED SEAMAN
NAME PAIT JUNIE MADRIA
LAST NAME FIRST NAME MIDDLE NAME
CONTACT ADDRESS 1407-ROOM 2B ANACLETO STREET BRGY. 334 BAMBANG STA. CRUZ MANILA
PROVINCIAL
BIRTHDAT ADDRESS MARCELINA BAYUGAN,CITY
E OCTOBER 27, 1980 AGE 40 BIRTHPLACE MARCELINA BAYUGAN,CITY STATUS MARRIED
NAME OF SPOUSE EDELYN B. PAIT ADDRESS/CONTACT NO. 1407-ROOM 2B ANACLETO STREET BRGY. 334 BAMBANG STA. CRUZ MANILA/ 09279869997

NAME OF CHILDREN & AGE FATHER’S NAME DECEASED OCCUPATION DECEASED

1 N/A MOTHER’S NAME DECEASED OCCUPATION DECEASED
2 N/A SSSADDRESS/TEL NO. N/A
3 N/A NO. 3376387399 PAGIBIG 1210-0213-1760 PHILHEALTH 01-050941202-8
4 N/A TIN NO.
CITIZENSHI 281-305-861-000 HEIGHT 170cms WEIGHT 76kgs. SEX
5 N/A P FILIPINO RELIGION CHRISTIAN

EDUCATIONAL ATTAINTMENT :
5cup

NAME OF SCHOOL YEAR/S ATTENDED DEGREE OBTAINED

ELEM. LAPANA ELEMENTARY SCHOOL 1987-1993 GRADUATE
HS FATHER URIOS HIGH SCHOOL 1993-1998 GRADUATE
COLLEGE BOHOL INSTITUTE OF TECHNOLOGY- IC 2001-2004 COMPLETED ACADEMIC REQUIREMENTS
1
TRAVEL DOCUMENTS

SIRB NO. C0893738 DATE ISSUED/BY AUGUST 18,2016 /MARINA MANILA DATE VALID AUGUST 16,2026
PASSPORT P7219237A DATE ISSUED/BY MAY 18,2018 /DFA NCR WEST DATE VALID MAY 17,2028

HAVE YOU BEEN ISSUED A VISA OR VISAS? N/A WHAT COUNTRY? N/A
PLS SPECIFY TYPE/S OF VISA/S AND DATE VALID N/A

LICENSES – FOREIGN / LOCAL

DATE
NUMBER CAPACITY ISSUED VALIDITY
Marina COC NONE NONE NONE NONE
Marina COE NONE NONE NONE NONE
PANAMANIAN LICENSE N/A N/A N/A N/A
OTHER LICENSE : (SPECIFY)
MBER 4, 2023

ADRIA
LE NAME

MARRIED
MBANG STA. CRUZ MANILA/ 09279869997

CEASED
CEASED

01-050941202-8
MALE
RISTIAN

OBTAINED
ADUATE
ADUATE
EMIC REQUIREMENTS

AUGUST 16,2026
 MAY 17,2028

VALIDITY
NONE
NONE
N/A
 SEA SERVICE RECORD
DAY/MONTH/YEAR NO. OF REASON FOR TYPE MAIN ENGINE
NAME OF VESSEL RANK FROM TO MONTHS LEAVING GRT OF VESSEL FLAG MAKE HP KW
ZAMIL 62 A/B 03/09/2014 02/03/2015 6 MONTHS END OF CONTRACT 1,330 AHTS BAHRAIN 2,600
ZAMIL 14 A/B 1-Jul-2015 27/11/2015 4 MONTHS END OF CONTRACT 1,600 AHTS BAHRAIN 2,600
ZAMIL 403 A/B 2-Feb-2016 24/07/2016 5 MONTHS END OF CONTRACT 1,600 AHTS BAHRAIN 3,650
ZAMIL 12 A/B 20/09/2016 11/03/2017 6 MONTHS END OF CONTRACT 1,500 AHTS BAHRAIN 3,500
ZAMIL 24 A/B 22/05/2017 07/10/2017 5 MONTHS END OF CONTRACT 701 AHTS BAHRAIN 2,600
ZAMIL 59 A/B 17/12/2017 15/04/2018 4 MONTHS END OF CONTRACT 1,330 AHTS BAHRAIN 3,500
ZAMIL 06 A/B 5-Aug-2018 25/10/2018 3 MONTHS END OF CONTRACT 1,267 AHTS BAHRAIN 3,250
ZAMIL 503 A/B 20/05/2019 20/09/2019 4 MONTHS END OF CONTRACT 1,933 AHTS BAHRAIN 4,150
ZAMIL 504 A/B 5-Jan-2020 30/07/2020 6 MONTHS END OF CONTRACT 1,933 AHTS BAHRAIN 4,300
ZAMIL 57 A/B 30/07/2020 24/01/2021 6 MONTHS END OF CONTRACT 1,514 AHTS SAUDI ARABIA 3,650
HERMIT BRILLIANCE A/B 21/10/2021 02/21/2022 4 MONTHS END OF CONTRACT 2,428 AHTS Liberia 9,000
HERMIT BRILLIANCE A/B 1-Jun-2022 31/08/2022 3 MONTHS END OF CONTRACT 2,428 AHTS Liberia 9,000
HERMIT BRILLIANCE A/B Dec 22 2023 5/5/2023 4 MONTHS END OF CONTRACT 2,428 AHTS Liberia 9,000
HERMIT BRILLIANCE A/B Aug-17-2023 11-20-2023 3 MONTHS END OF CONTRACT 2,428 AHTS Liberia 9,000

NOTE: ALSO INCLUDE LANDBASED WORK EXPERIENCE IF APPLICABLE

TRAINING CERTIFICATES NUMBER DATE ISSUED VACCINATIONS

BASIC TRAINING BT-19B244-15 DEC. 04 2019 YELLOW FEVER
SSAT-SDSD 27-266526 SEPT. 19, 2014 HEPATITIS A(MEVAC A)
PSCRB 02-121602 FEB. 27, 2021
RFPNW II/4 25-130545 DEC. 02, 2015
ASD II/5 28-66712 DEC. 04, 2015
NAV WATCH DWK-1618-11-2008 NOV. 03, 2008
 NAME OF NAME OF NATIONALITY OF
AGENCY PRINCIPAL SALARY MASTER/CH. ENGR TRADE AREA
JDA INTER-PHIL SAUDI CONFIDENTIAL RUSSIAN/INDONESIAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL EGYPTIAN/FILIPINO MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL EGYPTIAN/INDONESIAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL UKRAINIAN/EGYPTIAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL AZERBAIJAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL UKRAINIAN/EGYPTIAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL EGYPTIAN/INDONESIAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL RUSSIAN/INDONESIAN MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL RUSSIAN/FILIPINO MIDDLE EAST
JDA INTER-PHIL SAUDI CONFIDENTIAL EGYPTIAN MIDDLE EAST
TSM FRENCH CONFIDENTIAL POLAND CONGO
TSM FRENCH CONFIDENTIAL POLAND CONGO
TSM FRENCH CONFIDENTIAL POLAND CONGO
TSM FRENCH CONFIDENTIAL POLAND CONGO

CCINATIONS NUMBER DATE ISSUED

014952 MAY 14, 2017
FCN-000013951 DEC. 02, 2019
 PART VII – ADDITIONAL PERSONAL INFORMATION
NAME OF ALLOTTEE : EDELYN B. PAIT RELATIONSHIP: WIFE
ADDRESS : 1407-ROOM 2B ANACLETO ST. BRGY. 334 BAMBANG STA. CRUZ, MANILA NAME & ADDRESS OF BANK: LANDBANK

NAME OF BENEFICIARY / IES RELATIONSHIP ADDRESS

EDELYN B. PAIT WIFE STA. CRUZ MANILA
 WIFE
LANDBANK

DDRESS
A. CRUZ MANILA