& NAME FATHER’S NAME PRESENT & PERMANENT ADDRESS APPLYING FOR SEAMAN : MOMIN KHAN : SARAFAT KHAN : VILL-UTTAR GAZIPUR, P.O-NAHAZARI, RESUME P.S-BISHNUPUR; DISTRICT- SOUTH 24 PARGANAS KOLKATA 700104 DATE OF BIRTH 14/11/2001 CONTACT NO. : 7278096488 EMAIL ID : KHANMOMINO229@GMAIL.COM MARITAL STATUS INMARRIED NATIONALITY : INDIAN EDUCATION QUALIFICATION : HIGHER SECONDARY LANGUAGE KNOWN : BENGALI, ENGLISH & HINDI DOCUMENT DETAILS DOCUMENTS NUMBER _ | DATE OF ISSUE | DATE OF EXPIRY PLACE PASSPORT V6018597 25/01/2022 24/01/2032 KOLKATA INDIAN CDC KOL 134148 | 23/11/2022 22/11/2032 KOLKATA INDOS 222P5702 | 09/09/2022 NA KOLKATA sID 32812240 | 09/12/2022 08/12/2032 KOLKATA COVID-19 15" VACCINATION | 85936304522 | 30/09/2021 NA ANGERBERIA SC COVID-19 2° VACCINATION | 85936304522 | 26/12/2021 NA ANGERBERIA SC PRECAUTION DOSE 85936304522 | 02/02/2023 NA ANGERBERIA SC COURSES DETAILS COURSE NAME CERTIFICATE NO. | DATE OF ISSUE | DATEOF EXPIRY | PLACE PST '30301261012201623 | 05/11/2022 NA KOLKATA FPFF 30301261012201623 | 05/11/2022 NA KOLKATA EFA '30301261012201623 | _ 05/11/2022 NA KOLKATA PSSR 30301261012201623 05/11/2022 NA KOLKATA STSDSD 3030116621220209 | 04/11/2022 NA KOLKATA WATCH KEEPING RFNW/1012142 11/10/2023 05/10/2028 PANAMA. SEA EXPERIENCE NAME OF COMPANY NAME OF VESSEL | — RANK SIGN ON SIGN OFF AYAN MARINE SERVICE MV MEDHA SEAMAN | 12/02/2022 | 12/12/2022 SAHARA MARINE SERVICE | M.\VSUPREME | SEAMAN | 15/12/2022 | 30/09/2023 DATE : 12/10/2023 MOMIN KHAN PLACE : KOLKATA SIGNATURENatonatly SERIE H.]Pansport Mo WON VY 6948597 14/11/2001 a Pc th : UTTAR GAZIPUR,WEST BE sae sor Pace tte KOLKATA Momn Khan — maw Bev omar e 25/01/2022 24/01/2032 P< INDKHAN< E-mail id - ayanmarineservice22@gmail.com GSTIN : 19AGHPA9908J1Z3. Date TO WHOME SO EVER IT MAY CONCERN This is to certify that Mr. MOMIN KHAN, Date of birth 14.11.2001, Son of Sarafat Khan. Vill- Uttar Gazipur, Post - Nahazari, P.S- Bishnupur, Dist- South 24 Parganas, West Bengal - 700104. Holding Indian PASSPORT No.- V 6018597, Aadhaar No.- 296205361258. Has served on board as SEAMAN and his service as details below : jod OF Servi Sl | Vessel Name | mono. | fal) oy | Gar | nar | Period Of Service _| month | Day No. No. FROM TO o1.| mvmeoua | sesases | MOM" | sooxe | 1352] 577 | 12.02.2022 12.12.2022] 09 | 00 Total in Words : Nine Month Only. Total Service 09 | 00 The service shown in the certificated exclusive of all types of availed by crew. During his tenure o service we was found, © Ability - Very good © Conduct - Very good © Sobriety - Strictly sober During the period of his services we found Mr. MOMIN KHAN hard working and honest to his Responsibilities. We wish him Good Luck and success in his Future.Mob.: 9734103148 / 7908551401 samy, SAHARA MARINE SERVICE Ya) All Type of Marine Craft & Crew Suppliers Vill - Durgapur, P.O.: Noorpur P.S.: Ramnagar, 24 Pgs (S). Pin- 743368, ‘West Bengal E-mail id- saharamarineservice@gmail.com GSTIN -19BPUPS4605H1Z9 Ref. Wo: 36/05/2023, 24 DateA0:.40..2.023.. TO WHOM SO EVER IT MAY CONCERN ‘This isto certify that Mr. MOMIN KHAN, Date of birth 14.11.2001, Son of Sarafat Khan, Vill - Uttar Gazipur, Post ~ Nahazari, P.S— Bishnupur, Dist - South 24 Parganas, West Bengal 700104. Holding Indian PASSPORT No. ~ V 6018597, Indian CDC No. ~ KOL 134148, INDOS No. ~ 222P5702 and Aadhaar No. ~ 296205361258. Has served on board as SEAMAN and his service as details below = Si] VesselName ]IMONo.| Offical | BHP | GRT | NRT | Period OfService | Month | Day No. _No. [From 0 on. | Mav supreme | 9688984 | we-1558 | 400x2 | 1368 | 577 | 15.12.2022 | 30.09.2023 | 09 _| 17 otalin Words : Nine Months Seventeen Days Only. Total Service 09 | 37 ‘The service shown in the certificate is exclusive of all types of leave availed by the crew. During his tenure of service we was found, © Ability - Very good ‘© Conduct - Very good © Sobriety - Strictly sober of his services we found Mr. MOMIN KHAN Hard working and honest to his During the p Responsibilities. We wish him Good Luck and success in his Future. For SAHARA MARINE SERVICE