Arpit Sood, a 23-year-old Indian national, has applied for the position of third officer/third officer with an availability date of September 1, 2016. He provides personal details like height, weight, passport and medical information. His employment history includes working as a deck officer on chemical tankers from September 2014 to December 2015. He affirms that all information provided is true and acknowledges that any false statements would disqualify him from employment.

1. APPLICATION FOR POSITION AS: ADD THIRD OFFICER/THIRD OFFICER
AVAILABILITY DATE: 01-SEPT-2016
Surname: SOOD First Name: ARPIT
Nationality: INDIAN Date of Birth: 02-06-
1993
Age: 23
YEARS
Place of Birth: PALAMPUR
KANGRA
OTHER PERSONAL DETAILS
HEIGHT: 171 cm WEIGHT: 66 kg COLOUR OF EYES: BLACK
COLOUR OF HAIR: BLACK DISTINGUISHING MARKS: STITCH MARK ON THE CHIN
Passport
Seaman’s Book (CDC)
Number Place of
Issue
Date of Issue Issuing
Authority
Date of
Expiry
Remark
MUM 236735
MUMBAI 30/05/2014 DG
SHIPPING
MUMBAI
29/05/2024
Medical Fitness Certificate
Date of Issue Date of Expiry
19 AUG 2014 19 AUG 2016
Yellow Fever Vaccination
Date of Issue Date of Expiry
17 FEB 2014 17 FEB 2024
* - Indicate either yes or no
Number Place of Issue Date of Issue Date of Expiry Issuing Authority Blank Pages
J7228182 SHIMLA 01/05/2012 30/04/2022
Passport Office
Shimla
20

2. Full address: HOUSE NO UPPER-7, WARD NO-7, GURUDWARA ROAD, PALAMPUR DISTT. KANGRA
HIMACHAL PRADESH (H.P)
Postal Code: 176061
Country: INDIA
E-mail id: arpitsood.official@gmail.com
Home telephone no: 01894-235826
Contact/Mobile phone: +91 9882332232, +91 9805254550, 91 7358433042
Domestic Airport: CHANDIGARH International Airport: NEW DELHI
Marital Status: SINGLE
Full Name of Next of Kin: ANIKA SOOD Relationship: SISTER
Address of Next of Kin: HOUSE NO 27, BINDRABAN COLONY PALAMPUR DISTT. KANGRA (H.P) 176061
Phone no. +91 9418377777
Dependents (if married)
Name Date of Birth Age Gender Relationship
Certificate of Competency (COC)
Grade Issuing
Authority
Number Date of Issue Date of Expiry Place of Issue
AVAILABLE FROM AUGUST
Dangerous Cargo Endorsements (DCE)
Type of
Endorsement
Grade / Level
I / II
Issuing
Authority
Number Date of Issue Date of Expiry
Chemical LEVEL 1 MMD NOIDA
D/C/1/D/14/213
38
20.08.2014 31.12.2016
Oil LEVEL 1 MMD NOIDA
D/O/1/D/14/213
37
20.08.2014 31.12.2016
Gas
* - Indicate either yes or no

3. Details of other marine courses / STCW short course certificate
Type of Marine Course Place of Issue Number Date of Issue Date of Expiry
GMDSS CHENNAI GOC-6-6642 01/04/2016
Basic Fire Fighting CHENNAI FPFF/8609/2013 09/01/2013
Shore Based Fire
Fighting
Adv / Oil Tanker
certificate
Adv / Chemical Tanker
Certificate
General OIL / Tanker
Familiarisation
CHENNAI OTFC/3935/2014 01/08/2014
General Chemical /
Tanker Familiarisation
CHENNAI CTF/B367/10 16/08/2014
Medical Care & First Aid
Basic Safety Training
Arpa & Radar Course CHENNAI
ROS C/B03/01
ARPA C/B03/01
22/01/2016
Proficiency in Survival
Craft & Rescue Boat
CHENNAI PSCRB/B533/22 29/01/2016
PSSR CHENNAI PSSR/9187/2013 12/01/2013
Bridge Team
Management
Ship Handling
ISPS – Ship Security
Training
ECDIS CHENNAI ECDIS/B132/11 05/02/2016
Others – Pls specify
STSC CHENNAI STSC/1052/2013 24/01/2013
EFA CHENNAI EFA/8796/2013 05/01/2013
PST CHENNAI PST/10028/2013 28/03/2013
AFF CHENNAI AFF/B534/24 05/03/2016
MFA CHENNAI MFA/B935/02 12/03/2016
SSO CHENNAI SSO/B436/09 16/03/2016
RUT FOR DECK
OFFICERS
CHENNAI
MMA/REF/02/01
0
16/04/2016
Employment History (Starting with Latest Sea Service)
* - Indicate either yes or no

4. From To
Total
MM/DD
Type of
voyage
Rank
TYPE OF VESSEL
Deck: Type / GRT
Engine: Type / BHP /
Main Engine
Company
Reason for
leaving
26.09.14 27.03.15 06/02 FG D/C
CHEMICAL TANKER/
5706
Herning shipping
Contract
finished
15.06.15 17.12.15 06/03 FG D/C
CHEMICAL TANKER/
5706
Herning shipping
Contract
finished
Medical History
Have you ever signed off from a ship due to Medical reasons?
(If Yes give details)
No
Name of Vessel Date of Occurrence
Brief Description of Illness / Injury / Accident
* - Indicate either yes or no

5. Have you ever suffered from any ailment or disease in the past that is likely to render you
unfit for sea service or likely to endanger the health/well being of others onboard?
(If Yes give details)
No
Do you have any bodily defects or deficiencies?
(If Yes give details)
No
Are you currently suffering from any ailment or disease that is likely to render you unfit
for sea service or likely to endanger the health/well being of others onboard?
(If Yes give details)
No
Are you addicted to alcohol or drug of any kind No
Are you suffering from an ailment that requires you to be on a long-term
treatment/medication?
(If Yes give details)
No
Have you ever been deported or banned from entering any country?
(If Yes give details)
No
Have you ever been convicted of a criminal or drug offence?
(If Yes give details)
No
Last drawn Total Monthly Salary(including Leave Pay, Overtime, Allowance, Bonus USD
I hereby affirm that all the 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.
Date 09/07/2016 Arpit Sood
*The company may contact my previous employer for references.
* - Indicate either yes or no

7. Do you have any bodily defects or deficiencies?
(If Yes give details)
No
Are you currently suffering from any ailment or disease that is likely to render you unfit
for sea service or likely to endanger the health/well being of others onboard?
(If Yes give details)
No
Are you addicted to alcohol or drug of any kind No
Are you suffering from an ailment that requires you to be on a long-term
treatment/medication?
(If Yes give details)
No
Have you ever been deported or banned from entering any country?
(If Yes give details)
No
Have you ever been convicted of a criminal or drug offence?
(If Yes give details)
No
Last drawn Total Monthly Salary(including Leave Pay, Overtime, Allowance, Bonus USD
I hereby affirm that all the 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.
Date 09/07/2016 Arpit Sood
*The company may contact my previous employer for references.
* - Indicate either yes or no