APPLICATION FORM

 Name: Sergiy  Surname: Bilyy
 Date of birth: 23.09.1969  Place of birth: Doneck reg., Ukraine
 Permanent address: Ukraine
 Passport (OVIR): EA 180263  Place of issue: Mariupol  Date of issue: 30.08.2007  Valid until: 30.08.2017
 Seaman’s book: AB 281216  Place of issue: Mariupol  Date of issue: 18.02.2005  Valid until: 18.02.2010
 Citizenship: Ukraine  Expiry date of U.S. visa: 09.10.2012
 Marital Status  Single
 Next of kin: (name, pas. No)  
 Supported children under age of 18  
 (name, surname, date of birth)  
 Knowledge of English language  Satisfactory
 Education:  Qualification:  Date of Issue:
 Astrakhan Vocational School   motorman  03.08.1987

 Certificates of STCW 78/95

 No.

 Place

 Date of issue

 Expiry date

 Certificate of competency  00764/2003/06  Mariupol

18.12.2003

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 Endorsement STCW  00764/2003/06  Mariupol

24.09.2008

16.07.2013

 Personal Sea Survival techniques, fire prevention and fire fighting (A-VI/1)  108265-AS  Mariupol

16.07.2008

16.07.2013

 Advanced Fire Fighting   21391-AS  Mariupol

29.05.2009

29.05.2014

 Proficiency in Survival craft, Rescue Boats & Fast Rescue Boats (A-VI/2)  08093-AS  Mariupol

25.10.2006

25.10.2011

 Liberia Seaman's book   07614003  Liberia

10.11.2006

10.11.2011

 Tanker Familiarization   20885 HC  

05.06.2009

05.06.2014

Sea service (during five last years):

Name of vessel

Company

DWT

Flag

Type

Position

From

To

 Georgete K  Santos Maritime  34670  Piraeus  Bulk carrier

oiler

23.01.2004

17.12.2004

 Viktoria  A.M.Namikos  75524  Panama  Gen cargo

oiler

09.03.2005

17.10.2005

 Agaman  Komrowski  5562  Liberia  Container

oiler

23.10.2006

24.06.2007

 Pavian  Komrowski  74500  Netherlands  Gen cargo

oiler

18.11.2007

27.05.2008

 Narcea  ERSHIP  4790  Portugal  Oil Ch. Tanker

oiler

08.06.2009

23.12.2009

 Experience at sea: Since 1998

 Knowledge Personal Computer (Yes / No): No 
 Medical Certificate  Issued:  Place:  Exp.date:
 Vaccination for cholera valid until:  Vaccination for yellow fever valid until: 28.03.2011