Name of Applicant:	Zulalov	Arif	Eldar oglu	Photo
(Surname)	(Given Name)	(Middle Name)
Rank Applied for:	3rd engineer
Date of Application:	18.01.2024
Direct Application:	Yes No (if No, indicate below the agency name)
Agency Name:
Availability:
Basic Information
Nationality	Azerbaijani	Mother Full Name
Religion	Islam	Sector / Sub caste
Date of Birth & Age	23.06.2001 ; 22	Place & Country Of Birth	Azerbaijan
Permanent Address	Azerbaijan,Baku
Telephone Numbers	Mobile Number	+994(51)6303710
Email	zulalovarif496@gmail.com	Skype ID
Marital Status(please mark)	Married ✅ Single Other:
Next of kin / Relative to be contacted (in case of emergency)	Name: Eldar Relation: Father
Contact Details: +994(70)2183838
Nearest International Airport, Country
Passport Number	C02808630	Date Issued	27.06.2020
Country of Issue	Azerbaijan	Expiry Date	26.06.2030
Seaman Book Number	DQK 025965	Date Issued	06.12.2023
Country of Issue	Azerbaijan	Expiry Date	06.12.2028
PPE Details
Boiler Suite Size	50	Safety Shoe Size	42
Certificate of Competency Details
Certificate Grade	Expiry Date
Certificate Number	Country Of Issue
STCW Regulation	Revalidation Date
Endorsement Number	Expiry Date
GMDSS Certificate Details
Certificate Number	Expiry Date
Endorsement Number	Expiry Date
Flag Documents (If the document is available, provide the expiry date)
COC	Endorsement	Seaman’s Book
Available	Expiry Date	Available	Expiry Date	Available	Expiry Date
St. Vincent	Yes No	Yes No	Yes No
Bahrain	Yes No	Yes No	Yes No
Panama	Yes No	Yes No	Yes No
Client Approval
Do you have the valid document for the below? If yes, indicate the issue date.
ADNOC Approval ARAMCO Approval	Yes No Issue Date: _____________________ Yes No Issue Date: _____________________
STCW Certificate Details All must be valid – If validity of certificate is not mentioned on the certificates, expiry dates to be considered as 3 years from date of issue of certificate.
Issue Date	Expiry Date	Issued At
Basic Safety Training	08.12.2023	07.12.2028	state maritime agency
Personal Survival Techniques	08.12.2023	07.12.2028	state maritime agency
Proficiency in Survival Crafts & Rescue Boats	11.05.2023	11.05.2028	STATE MARTITIME AGENCY
Basic / Advanced Fire Fighting	08.12.2023	07.12.2028	state maritime agency
Basic First Aid / Medical Care / Medical First Aid	08.12.2023	07.12.2028	state maritime agency
Personal Safety & Social Responsibility	08.12.2023	07.12.2028	state maritime agency
Automatic Radar Plotting Aid [ARPA]
Radar Observer Course [ROC]
Ships Security Awareness / Officer	27.11.2023	24.11.2028	state maritime agency
ECDIS
Bridge/Engine resource management	16.06.2023	16.06.2028	state maritime agency
Offshore Training Certificate Details
Issue Date	Expiry Date	Issued At
Basic/Advanced Offshore Safety
BOSIET - OPITO
H2S - OPITO
Safe Lifting
Safety Welding
With UAE Work Experience? Yes ✅ No If yes, From _____________ to ___________
No. of Years in UAE:
Type of Visa:
Reference From Last Two Employers [All details are Mandatory]
Company 1	Company Name (not the manning agents, must be Owners)
Contact Person Name	Designation
Contact Numbers	Country
Company 2	Company Name (not the manning agents, must be Owners)
Contact Person Name	Designation
Contact Numbers	Country

Record of Sea Service (Recent Vessel/MOU First)
Vessel Name	Company (Owners)	Rank	Type of Vessel	Propulsion type AZ, CPP	Flag	Area of operation	GT	Type of Engine	BHP	Bollard Pull	Sign on Date (DD:MM:YYYY	Sign of Date (DD:MM:YYYY)	Duration (Days : Month)
GENERAL ASADOV	ASCO	CADET	Passenger Ship	03.01.2020	21.02.2021
GENERAL ASADOV	ASCO	CADET	Passenger Ship	18.04.2021	25.06.2021
DELFIN	PERVIZ IKF	Oiler	General Cargo	04.07.2021	25.08.2021
EUPHRATES	MIDDLE EAST AIR DRILLING SERVICE	Oiler	PSV DP2	15.09.2021	08.02.2022
EUPHRATES	MIDDLE EAST AIR DRILLING SERVICE	Oiler	PSV DP2	29.03.2022	24.08.2022
EUPHRATES	MIDDLE EAST AIR DRILLING SERVICE	Oiler	PSV DP2	04.11.2022	17.04.2023
EUPHRATES	MIDDLE EAST AIR DRILLING SERVICE	Oiler	PSV DP2	08.07.2023	21.09.2023

Note: Type of Engines & BHP: Mandatory for Engineers

I hereby confirm that all the above furnished details are true.

Name: ________________________ Rank: _____________________ Signature:___________________________

DECK Officers Experience
Vessel Name	Charterer	Area of Operation (Oil field)	PERIOD OF OPERATION (in Months)
DP (TYPE OF OPERATION, HOURS)	SUPPLY	DSV	SURVEY	ANCHOR HANDLING	TOWING	SELF ELEVATING BARGE
ANCHOR TYPE	ANCHOR WEIGHT	BARGES	RIG MOVE	Propelled	None Propelled

Name: _______________________	Signature: ________________________	Date: __________________