P.T. KARYA SUMBER ENERGY .

JL .KOPI NO 2F, JAKARTA BARAT.

CREW PERSONNAL DATA PT. KSE

Name : FELIX KRISTIANTO

Department : ENGINE
Place & Dates Of Birth : TANGERANG, 08 JANUARY 1997
Sex : MALE
Religion : KATOLIK FOTO SERAGAM KSE
Rank : 4TH ENGINEER
Home Address : PONDOK ALAM PERMAI, BLOK D4 NO.16 KEL. ALAM JAYA
KEC. JATIUWUNG. KOTA TANGERANG. BANTEN
No HP.WA / Email : 081380027712

NEXT OF KIN
Name :NATALIA SUGUARTININGSIH
Adress : PONDOK ALAM PERMAI, BLOK D4 NO.16 KEL. ALAM JAYA
KEC. JATIUWUNG. KOTA TANGERANG. BANTEN
Contact : 082249039985

PERSONNAL DATA
NO NAME DOCUMENT NO DOCUMENT TGL ISSUED REMARK
1. KTP 3671020801970002 28-05-2018
2. NPWP 63.480.020.5-402.000 24-02-2022
3. BPJS KESEHATAN 21072321181 01-09-2021
4. VAKSINASI 1 & 2 24003121/24201221 29-06-2021/27-07-2021 SINOVAC
5. NO REKENING 734901003492504 BRI
SCHOOL
NO NAME OF SCHOOL DATE OF ENTRY GRADUATE DATE IJAZAH
1. SD 2003 2009 DN-30 DD 0076753
2. SMP 2009 2012 DN-30 DI 0006388
3. SMA/STM/SMK 2012 2015 DN-30 MK 0007753
4. KULIAH 2015 2018 ATT 3
DOCUMENTS
NO NAME OF DOCUMENTS CERTIFICATE NUMBER PLACE, DATE OF ISSUED EXPIRY
1 PASSPORT C9680130 TANGERANG,06-07-2022 06-07-2027
2 SEAMAN BOOK E132002 TANJUNG PRIOK, 01-10-2021 01-12-2023
3 ATT 3 6211572678T32418 BP2IP TANGERANG, 12-11-2018
4 ENDORSEMENT ATT III 6211572678T32418 BP2IP TANGERANG, 19-11-2018 19-11-2023
5 ATT II
6 ENDORSEMENT ATT II
CERTIFICATE OF PROFICIENCY
NO TYPE OF CERTIFICATE CERTIFICATE NUMBER PLACE,DATE OF ISSUED EXPIRY
1 BST 6211572678012420 TANGERANG, 26-11-2020 26-11-2025
2 SCRB 6211572678042418 TANGERANG, 07-12-2018 07-12-2023
3 AFF 6211572678062421 TANGERANG, 15-09-2021 15-09-2026
4 MFA 621157678072422 TANGERANG, 28-07-2022 28-07-2022
5 MC 6211572678082418 TANGERANG, 13-07-2018 13-07-2023
6 SAT 621157678312422 TANGERANG, 28-07-2022 28-07-2027
7 SDSD
8 ERM 6211572678272418 TANGERANG, 13-07-2018 13-07-2023
9 ERS
10 CMHBT 6211572678172417 TANGERANG, 29-03-2017 29-03-2022
11 ISM CODE 0039.06.16 TANGERANG, 26-12-2016
SEA SERVICE EXPERIENCE
Type of DWT / GT FLAG Periode
No Ship Name Company Rank
Vessel ENGINE/HP From To
MV.ENERGY PT.KARYA SUMBER ENGINE 08-04- 09-04-
1 BULK CARRIER 43.022 GT/11.390 HP PANAMA
PROSPERITY ENERGY CADET 2017 2018
MV. SRI
PT. KARYA SUMBER 12-12- 05-02-
2 WANDARI BULK CARRIER 39.045 GT/9.340 HP INDONESIA 4E
ENERGY 2018 2020
INDAH
MV. SRI
PT. KARYA SUMBER 05-02- 05-10-
3 WANDARI BULK CARRIER 39.045 GT/9.340 HP INDONESIA 4E
ENERGY 2020 2020
INDAH
PT. KARYA SUMBER 01-11- 01-06-
4 MV. DK 02 BULK CARRIER 25.807 GT/9.620 HP INDONESIA 4E
ENERGY 2020 2021
MV. HABCO PT. HABCO 21-08- 12-03-
5 BULK CARRIER 17.979 GT/6.150 HP INDONESIA 4E
PIONEER TRANSMARITIMA 2022 2022