APPLICATION FORM

ALBA MARINE SERVICES PRIVATE LIMITED

304, Wellington Business Park-II, Andheri - Kurla Rd, Near Marol Metro Station,
PHOTO
Marol, Andheri East, Mumbai, Maharashtra 400059
RPSL-MUM-162153 Valid till 28/04/2028

APPLICATION FOR RANK Chief Officer

1) NAME IN FULL EAIN KAUNG MYAT

(SURNAME) (FIRST NAME) (MIDDLE NAME)
2) DATE & PLACE OF BIRTH 28.08.1991 PWINTBUY, MAGWAY NATIONALITY MYANMAR
3) PERMANENT ADDRESS

PHONE NO / MOBILE NO. 0943053762

4) PRESENT ADDRESS B-58/5, 14th Street, Nawaday Garden Housing, Hlaing Thar Yar Tsp., Yangon

PHONE NO 0943053762 EMAIL [email protected]

5) MARITAL STATUS Married CHILDREN -
6) NEXT OF KIN/NOMINATIONAYE HNIN MAW RELATION WITH Wife
ADDRESS B-58/5, 14th Street, Nawaday Garden Housing, Hlaing Thar Yar Tsp., Yangon

NOK CONTACT NO 095004708

7) SEAMAN BOOK NO. 78323 DATE 18.07.2018 PLACE ISSUED DMA
VALID TILL 17.07.2028
8) PASSPORT NO. MF765499 DATE 01.04.2022 PLACE ISSUED MOHA, YANGON
VALID TILL 31.03.2027 9) USA VISA VALID TILL -
10) INDOS No. 11) YELLOW FEVER VACCINATION VALIDITY
Life Time

DATE OF
12) LICENSE (COC) CERTIFICATE NO DATE OF ISSUE EXPIRY PLACE OF ISSUE
NATIONAL 2DK003434 09.06.2023 24.03.2027 DMA
OTHER (KOREA COC) BS-D0-23-0912-00 22.09.2023 24.03.2027 Ocean & Fisheries (KOR)

13) Watch keeping certificates (For Rating only)

CERTIFICATE DETAILS DATE OF
CERTIFICATE NO DATE OF ISSUE EXPIRY PLACE OF ISSUE
COP ( Certificate of Proficiency) - II/5 or III/5 -
WK (Watch Keeping) - II/4 or III/4 -

DATE OF
OTHER CERTIFICATES HELD
14) CERTIFICATE NO DATE OF ISSUE EXPIRY PLACE OF ISSUE
A) PST 2DK003434 09.06.2023 24.03.2027 DMA
B) PSSR 2DK003434 09.06.2023 24.03.2027 DMA
C) EFA / MFA / MEDICARE 2DK003434 09.06.2023 24.03.2027 DMA
D) FPFF / AFF 2DK003434 09.06.2023 24.03.2027 DMA
E) STSD/ SSO 2DK003434 09.06.2023 24.03.2027 DMA
F) PSCRB 2DK003434 09.06.2023 24.03.2027 DMA
G) COP -
H) GMDSS 2DK003434 09.06.2023 24.03.2027 DMA
I) WK 2DK003434 09.06.2023 24.03.2027 DMA
J) ECDIS 2DK003434 09.06.2023 24.03.2027 DMA
K) ECDIS (MECYs – PM3D/PM3D2) ECTST-Mecys-190721 30.07.2021 - Mecys
L) ECDIS - JRC (JRC- JAN 701/901/901M/701B KJEC-001002-1810030001-C 03.10.2018 - KJ Engineering
M) ECDIS - JRC (JRC- JAN 9201/7201/7201S/92 KJEC-002002-2204260001-C 26.04.2022 - KJ Engineering
N) VALID DCE HELD -
O) OTHERS ( BTM/BRM/LCHS/ERC) 2DK003434 09.06.2023 24.03.2027 DMA
O) OTHERS

DATE OF
15) FLAG SEAMAN BOOK (CDC) DOCUMENT NO DATE OF ISSUE EXPIRY PLACE OF ISSUE
LIBERIA -
MARSHALL ISLAND -

16) BANK ACCOUT NO. -

ADDRESS -

Form No. G - 01 PAGE 1

 ALBA MARINE SERVICES PVT. LTD

VESSEL PERIOD MAINE ENGINEER

COMPANY NAME FROM TO TOTAL
NAME RANK TYPE GRT ENGINE TYPE BHP UMS
DD-MM-YY DD-MM-YY MONTHS DAYS
MULTIGATE (KLCSM) NEW HORIZON A/O BULK CARRIER 25189 03.08.2012 30.08.2013 12 27 Full Contract

MULTIGATE (KMTC) KMTC CHALLANGE 3/O CONTAINER 30374 04.01.2017 28.04.2017 3 24 Ship Sold

MULTIGATE (KMTC) KMTC HOCHIMINH 3/O CONTAINER 28927 23.05.2017 23.10.2017 5 0 Full Contract

MULTIGATE (KMTC) KMTC MUMBAI 3/O CONTAINER 51872 18.11.2017 27.03.2018 4 9 Ship Transfer

MULTIGATE (KMTC) SUNNY PALM 3/O CONTAINER 3996 27.03.2018 09.07.2018 3 13 Full Contract

JSM (TOSCO) BAO GUO 3/O BULK CARRIER 106367 26.10.2018 31.08.2019 10 5 Full Contract

JSM (KLCSM) WP AMBITION 3/O BULK CARRIER 31884 03.12.2021 10.03.2022 3 7 Ship Sold

JSM (KLCSM) SM GLADSTONE 3/O BULK CARRIER 93387 15.05.2022 08.02.2023 8 24 Full Contract

JSM (KLCSM) GLOBAL FRONTIER 2/O BULK CARRIER 33226 23.09.2023 29.01.2024 4 6 Ship Sold

Height : 170 Cm Weight : 60 Kg BMI :

Boiler Suit Size (S , M , L , XL , XXL) : L Shoe Size (6, 7, 8, 9, 10, 11) : 10

REFERENCE

NAME OF COMPANY PIC DESIGNATION CONTACT NO

I Hereby state that the above information is complete and true. I hereby give consent to enquire about my records from previous employment.
I Hereby allow ALBA MARINE SERVICES PRIVATE LIMITED to forward my Bio Data and documents to the Principal for approval and Employment as required.

DATE : 04.03.2024 SIGNATURE :

Form No. G - 01 PAGE 2