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Sid Report

This document is an application form for a Seafarers Identity Document (SID) submitted by Abhishek Sanjeev, an Indian national born on February 12, 2003. It includes personal details, identification marks, and a declaration affirming the truthfulness of the information provided. The application also confirms that he has not previously applied for an SID and lists his contact information and address in Kollam, Kerala.

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3 views

Sid Report

This document is an application form for a Seafarers Identity Document (SID) submitted by Abhishek Sanjeev, an Indian national born on February 12, 2003. It includes personal details, identification marks, and a declaration affirming the truthfulness of the information provided. The application also confirms that he has not previously applied for an SID and lists his contact information and address in Kollam, Kerala.

Uploaded by

snairabhishek5
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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GOVERNMENT OF INDIA

MINISTRY OF SHIPPING

APPLICATION FORM FOR SEAFARERS IDENTITY DOCUMENT (SID)

READ THE INSTRUCTIONS CAREFULLY BEFORE FILLING THE APPLICATION FORM

APPLICATION NO:

16468062

INDOS & CDC Details

INDOS NO. : 24EM2482 Date of Issue :

CDC NUMBER : MUM 576197 ISSUING DATE : 25/11/24

CDC DATE OF EXPIRY : 24/11/34 ISSUING AUTHORITY :

PERSONAL DETAILS

NAME : ABHISHEK SANJEEV FATHER'S NAME : SANJEEV KUMAR G

SEX : Male DATE OF BIRTH : 12/02/03

NATIONALITY : Indian PLACE OF BIRTH : KOLLAM,KERALA

Email Address : [email protected]

Mobile No : 9544862754

A BLACK MOLE ON RIGHT ARM


Height : 173 Identification Marks :
INDEX FINGER

ADDRESS

House No. : ANAKKOTTU HOUSE

STREET : KOTTAMKARA VILLAGE POST TEHSIL : CHANDANATHOPE

DISTRICT : KOLLAM STATE : Kerala

PINCODE : 691014 PHONE No : 9544862754

NEAREST POLICE STATION : KUNDARA

have you ever applied for SID before Yes No

Have you been at any time debarred for obtaining


a. CDC Yes No

b. SID Yes No

Please select documents which you have


a. Passport Yes No

b. CDC Yes No
DECLARATION

1. I hereby declare that all the statements made in this application are true and complete to the best of my knowledge and
belief and nothing has been concealed/distorted.

2. I also affirm and declare that I have not previously been issued with a Seafarer's Identity Document (SID) and I have not
submitted an application for SID to any other Shipping Master in India.

3. I am aware that, if at any time, I am found to have concealed/distorted any material information and the Shipping Master has
reason to believe that I have obtained the SID by presenting false or erroneous information, my SID will be cancelled/
suspended forthwith as per the provision of Merchant Shipping (Seafarer's Identity Document) Rules, 2016, as amended.

Place : Signature of the Applicant :

Date : Name of the Applicant : ABHISHEK SANJEEV

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