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APPLICATION FORM

 Name: Sergiy  Surname: Tymchenko
 Date of birth: 04.02.1972  Place of birth: Russia
 Permanent address: Odessa, Ukraine
 Passport (OVIR): KE 474424  Place of issue: Odessa  Date of issue: 16.12.1996  Valid until: 16.12.2006
 Seaman’s book: AB 2639344  Place of issue: Odessa  Date of issue: 18.07.2003  Valid until: 18.07.2008
 Citizenship: Ukraine  Expiry date of U.S. visa: NO
 Marital Status:  Divorced
 Next of kin: (name, pas. No)  Mother - Nadezhda Tymchenko -
 Supported children under age of 18  1. NO
 (name, surname, date of birth)  2.
 Knowledge of English language:  Good
 Education:  Qualification:  No Diploma:  Date of Issue:
 High Marine Technical School # 26  Cook  D 648828  24.05.1993

Certificates of STCW 78/95

No.

Place

Date of issue

Expiry date

 Certificate of competency (Ship's cook)

00138/2003/03

Odessa

31.03.2003

31.03.2008

 Endorsement STCW

00138/2003/03

Odessa

31.03.2003

31.03.2008

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

0189/2003

Odessa

05.02.2003

05.02.2008

Sea service (during five last years):

Name of vessel

COMPANY

DWT

Flag

Type

Position

From

To

 1. ASTRA  Karavella

-

Bagama

pass.

Ass. Cook

09.1995

11.1997

 2. KOKER   Golden Carriers Co.

-

Panama

tanker

Steward

02.1999

10.1999

 3. EPOS  Good Faith Sh. Cosa

-

Panama

bulker

Ass. Cook

03.2000

09.2000

 4. IRIS  Silver Cruise Corp.

-

Kingstown

pass.

Cook

20.07.2003

07.11.2003

 5. JASMIN  Silver Cruise Corp.

-

Kingstown

pass.

Cook

21.04.2004

01.12.2004

 Experience at sea: from 1994  Knowledge Personal Computer (Yes / No): no
 Medical Certificate  ¹  Issued: 19.04.2004  Place: Odessa  Exp.date: 19.04.2005
 Vaccination for yellow fever valid until:  25.09.2008

Ready to work from:  ANY TIME

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