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- Shipboard Officer / Personnel / Crew
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POSITION
Position Applied for : THIRD ENGINEER
Are you willing to accept a lower rank?NO YES / NO
Date of Availability: 01/01/2017
PERSONAL DETAILS
1. GENERAL
Date of Birth:12/12/1979 Place of Birth: GONDIA Nationality: INDIAN
Post code: 400607 No.: 02266732640
Present address: SAME AS ABOVE
Post code: No.:
Civil Status : Single / Married / Separated / Divorced / Widowed.---MARRIED
Height : 172 Cm Weight : 65 Kg
Boiler Suit Size LARGE Shoe Size :8
2. FAMILY DETAILS.
Full Name of Next of Kin : YUWRAJ N. BANSODKAR Relationship : FATHER
Address of Next of Kin : SAME AS ABOVE
Post code:
Contact telephone numbers: No.: 022-66732640 No.: +91-9892594872/7039306727/9930775872
Family Data Name Date of Anniversary D.O.B PPT. No. D.O.I P.O.I D.O.E ECNR
WIFE POOJA S. BANSODKAR 30/MAY/2013 28/09/1986
FATHER Y. N. BANSODKAR 12/07/1948
MOTHER USHA Y. BANSODKAR 31/07/1953
SISTER NILISHA Y. BANSODKAR 11/01/1982
BROTHER OJAS P. GONDANE 09/02/2003
3. MEDICAL HISTORY
(a).Have you ever signed off from a ship due to Medical reasons,(If Yes give details) No
Name of the Vessel : NA Date of Occurrence :NA
Brief description of Illness / Injury / Accident :NA
(b). Did you suffer or Are you Presently suffering from any disease likely to render you unfit for service at sea or likely to endanger the Health of others on board. Yes / No: NO
(c). Are you addicted to alcohol or drugs of any kind? Yes / No: NO
(d).Have You suffered from Following?
Malaria Diabetes Epilepsy Nervous Disability Hepatitis of any kind
Yes / No: NO Yes / No:NO Yes / No: NO Yes / No:NO Yes / No:NO
(e) Did You ever undergo psychiatric treatment? Yes / No:NO
TRAVEL DOCUMENTS & VISA
Passport No: Date of Issue Place of Issue Date of Expiry ECNR Blank Pages
P1315061 09/05/2016 THANE 08/05/2026 YES YES
U.S.VISA MUI Membership No. D.O.E.
Any Other VISA
ACADEMICS & PROFESSIONAL QUALIFICATIONS
1. EDUCATIONAL BACKGROUND.
School / College From To Highest Qualification attained.
K.J. SOMAIYA COE, MUMBAI UNIVERSITY AUG-1999 NOV-2005 B.E. MECH.
2. PRESEA TRAINING / APPRENTICE SHIP.
Name of Institute / College From To Grade / Marks Type of Degree
M.E.R.I. MUMBAI 01/01/2007 31/12/2007 FIRST CLASS/ DIST. G.M.E.
CERTIFICATIONS & COURSES
1. CDC DETAILS.
Seaman’s Book Number Date of Issue Place of Issue Date of Expiry
Indian MUM 151549 28/01/2008 MUMBAI 27/01/2018
Liberian
Panamanian
Marshall Islands
Bahamas
Vanuatu
IOM
Bermuda / Maltese
Others
2. INDOS DETAILS.
INDOS Number
07EL0547
28/MAY/2007
MUMBAI NA
3. LICENSES.
License Grade Number Date of Issue Place of Issue Date of Expiry
Indian CLASS IV 95Z-11411 28/01/2015 MUMBAI 12/12/2019
U.K.
Singapore
Australian
Liberian
Panamanian
Vanuatu
I O M
Bermuda
4. DETAILS OF COURSES & CERTIFICATES.
Course Type Number Date of Issue Date of Expiry Issued By
FPFF FPFF/0474 15/12/2007 - M.E.R.I. MUMBAI
Proficiency in Survival Craft Rescue Boat 090045 16/01/2009 - L.B.S NAUTICAL COLLEGE
Medical First Aid SMI/MFA/1425/2009 24/01/2009 - SNS MARITIME INST.
Personal Survival & Social Responsibility (PSSR) PSSR/0474 15/11/2007 - M.E.R.I. MUMBAI
Engine room Simulator(OP. LEVEL) 070229 07/07/2007 - L.B.S NAUTICAL COLLEGE
Oil Tanker Familiarisation (OTFC) SMI/OTF/3809/2008 01/02/2008 - SNS MARITIME INST.
TASCO 130001 21/02/2013 - L.B.S NAUTICAL COLLEGE
Engine Room Simulator(MGMT. LEVEL) 130028 22/03/2013 - L.B.S NAUTICAL COLLEGE
Yellow Fever 22415 05/01/2008 04/01/2018 MUMBAI
STSDSD MA/DSD/34/793 19/11/2013 - MARINERS ACADEMY
Refresher and Updating Training Course RUPE-A/720/2014-15 13/12/2014 - OERC ACADEMY
Engine room Simulator(MGMT. LEVEL) 130028 22/03/2013 - IMU LBS CoAMS&R
Augmentation of fire fighting SMI/AUG/FPFF/379/2015 13/02/2015 - SNS MARITIME INST.
Advanced Fire Fighting(Refresher) RAFF/12/38/15/14 20/12/2014 19/12/2019 YAK MGMT. & MEC
SSO BPMA/SSO/2647/2014 17/12/2014 - B.P. MARINE ACADEMY
PST PST/0474 25/12/2007 - M.E.R.I. MUMBAI
PSCRB(Refresher) PSCRB®/15/001 03/012015 - NAMAC MUMBAI
GASCO BPMA/GASCO/21/2015 02/02/2015 - B.P. MAR. ACADEMY
Advanced Fire Fighting 4418 14/02/2009 - T.S. CHANAKYA
ELEMENTARY FIRST AID EFA/0474 16/11/2007 - M.E.R.I. MUMBAI
5. DANGEROUS CARGO ENDORSEMENTS
Types Grade / Level
I / II Number Date of Issue Place of Issue D.O.E
OIL II M/O/2/E/13/24202 22/11/2013 MUMBAI 21/11/2018
CHEMICAL I M/C/1/E/08/432774 07/02/2008 MUMBAI 17/01/2013
GAS I M/G/1/E/15/27343 18/02/2015 MUMBAI 17/02/2020
PREVIOUS SEA SERVICE
( Date commencing from FIRST vessel )
S.No. Name of Owners / Manager Name of Vessel Built Year Type DWT
Or
GRT BHP Engine Type UMS
Y / N Rank From To Total
MM/DD Reason for S/Off
1. S.C.I. LTD. M.T. PALANIMALAI 1994 CHEMICAL TANKER 21035 6310 MAN B&W, 2STROKE 6S60MC N 5EO 20/02/2008 20/11/2008 9M/1D CONTRACT COMPLETE
2. S.C.I. LTD. M.V. DAKSHINESHWAR 1984 BULK 28739 10800 MAN B&W, 2STROKE 6LMC N 3EO 17/08/2010 01/06/2011 9M/13D CONTRACT COMPLETE
3. S.C.I. LTD. M.T. DESH SAMMAN 2010 OIL TANKER 64397 15820 MAN B&W, 2STROKE
6S60 MCE Y 4EO 09/11/2011 21/06/2012 7M/12D CONTRACT COMPLETE
4. S.C.I. LTD. M.T. SWARNA GANGA 2010 OIL TANKER 42845 15500 MAN B&W, 2STROKE 7S60 MC
Y
3EO 04/12/2013 18/02/2014 2M/14D COMPASSIONATE SIGN OFF
5. S.I.S. LTD M.T. ORCHIDS 1986 OIL TANKER 17612 8042.9 SULZER WARTSILA RTA 58 N 3EO 26/03/2014 01/11/2014 7M/6D CONTRACT COMPLETE
6. S.I.S. LTD M.T. ORCHIDS 1986 OIL TANKER 17612 8042.9 SULZER WARTSILA RTA 58 N 3EO 03/03/2015 02/06/2015 2M/30D MUTUAL AGREEMENT
7. S.I.S. LTD M.T. PRUDENT 1991 PRODUCT/OIL TANKER 28223 11150 MAN B&W 6S50 MC N 3EO 15/08/2015 05/02/2016 5M/21D MUTUAL AGREEMENT
8. S.I.S. LTD M.T. PRUDENT 1991 PRODUCT/OIL TANKER 28223 11150 MAN B&W 6S50 MC N 3EO 07/09/2016 10/10/2016 1M/3D MUTUAL AGREEMENT
9. S.I.S. LTD M.T. ORCHIDS 1986 OIL TANKER 17612 8042.9 SULZER WARTSILA RTA58 N 3EO 14/10/2016 21/11/2016 1M/7D CONTRACT COMPLETE
SALARY DRAWN: 2.0 LAC INR /MONTH EXPECTED SALARY: 3.5 LAC INR/MONTH
MISCELLANEOUS
1. DECK OFFICERS.
Bulk: Type of cargo carried
Product: Type of cargo carried
Chemical: Type of cargo carried
Tanker: Type of pumps
2. ENGINEERS.
Automation. (Type) UMS/NON UMS
Cranes. (Type)
Grabs. (Type)
3. ELECTRICAL OFFICERS.
Automation. (Type)
NOR Control System. (Type)
Cranes Hydraulics, Electro Hydraulics. (Type)
PLC. (Type)
4. GENERAL TRADING AREA OF VESSELS
FOREIGN GOING( NEW ZEALAND,AUSTRALIA,MORROCCO, EGYPT,CHINA, SINGAPORE,ETC) AND COASTAL(INDIAN COASTLINE)
5. OIL MAJOR INSPECTIONS.
CDI Yes / No
PortState Control. (Please Specify) YES, AMSA.
Others. (Please Specify) SHELL VETTING(twice)
6. DRY DOCKING EXPERIENCE.
REFERENCES
Name of company S.I.S. LTD
Reference Person SUNIL U. GONDANE (CHIEF OPERATIONS OFFICER)
Address : S.I.S. LTD, 7TH FLOOR, TIMES SQUARE, SAKI NAKA, ANDHERI, MUMBAI 400069
No. 022-29203268
No. 09820234226
DECLARATION
I hereby affirm that all this information provided by me in this application is true and correct to the best of my knowledge and belief; further, that no Certificate of competency or License issued to me has ever been Revoked or Suspended. I also certify that my medical history contained above is True and any false statement or undisclosed material information about past illness or injury will disqualify me from any employment benefits and claims.
Date01/01/2017 Rank_3EO ____ Signature of Seaman __SD/-
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View Contact InformationTHANE, MAHARASHTRA,
