APPLICATION FORM
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APPLICATION FORM |
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| Name: Oleg | Surname: Baranov | ||||||
| Date of birth: 08.06.1976 | Place of birth: Ukraine | ||||||
| Permanent address: Odessa, Ukraine | |||||||
| Passport (OVIR): EA 132868 | Place of issue: Odessa | Date of issue: 15.08.2007 | Valid until: 15.08.2017 | ||||
| Seaman’s book: AB 400127 | Place of issue: Odessa | Date of issue: 23.02.2009 | Valid until: 23.02.2019 | ||||
| Citizenship: Ukraine | Expiry date of U.S. visa: 03.2014 | ||||||
| Marital Status | Married | ||||||
| Next of kin: (name, pas. No) | wife - Baranova Olga | ||||||
| Supported children under age of 18 | 1. Baranova Julia - 13.06.1998 | ||||||
| (name, surname, date of birth) | 2. Baranova Ulyana - 04.2008 | ||||||
| Knowledge of English language | Good | ||||||
| Education: | Qualification: | Date of Issue: | |||||
| Odessa Secondary Marine School | Navigator | 14.07.2004 | |||||
| Odessa National Maritime Academy | Navigator | 2008 | |||||
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Certificates of STCW 78/95 |
No. |
Place |
Date of issue |
Expiry date |
| Certificate of competency | 00353/2009/08 | Odessa |
25.03.2009 |
--- |
| Endorsement STCW | 00353/2009/08 | Odessa |
25.03.2009 |
29.01.2014 |
| Personal Sea Survival (ÁÆÑ)(A-VI/1) | 0583/2009 | Odessa |
29.01.2009 |
29.01.2014 |
| G.M.D.S.S. General Operator (A-IV/2) Certificate | 00355/2004/03 | Odessa |
29.07.2004 |
--- |
| G.M.D.S.S. General Operator (A-IV/2) Endorsement | 00355/2004/03 | Odessa |
25.02.2009 |
29.01.2014 |
| Radar Observation and Plotting (A-II/1,2) | 10912-2009 | Odessa |
22.01.2009 |
22.01.2014 |
| Automatic Radar Plotting Aids (ARPA) (A-II/1,2) | 10912-2009 | Odessa |
22.01.2009 |
22.01.2014 |
| Carrying dangerous & hazardous cargo (B-V/4, B-V/5) | 0121/2009 | Odessa |
26.01.2009 |
26.01.2014 |
| Advanced Fire Fighting (A-VI/3) | 0350/2009 | Odessa |
29.01.2009 |
09.01.2014 |
| Proficiency in Survival Craft, Rescue Boats & Fast Rescue Boats (A-VI/2) | 0469/2009 | Odessa |
28.01.2009 |
28.01.2014 |
| Ship's Medical Care (A-VI/4-2) | 10575 M/T | Odessa |
22.01.2009 |
22.01.2014 |
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Tanker Certificates: |
. |
. |
. |
. |
| Chemical Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 02232B | Odessa |
02.03.2009 |
02.03.2014 |
| LPG carrier (Advanced and Familiarization, A-V/1, p.2-7) | 01599B | Odessa |
02.03.2009 |
02.03.2014 |
| Oil Tanker (Advanced and Familiarization, A-V/1, p.2-7) | 01491B | Odessa |
02.03.2009 |
02.03.2014 |
Sea Service (during five last years):
|
Name of vessel |
Company |
DWT |
Flag |
Type |
Position |
From |
To |
| Lighting | North Atlantic Shipping |
4000 |
North Korea |
Gen. Cargo |
2-nd Off |
08.11.2004 |
03.05.2006 |
| Mina | Pilot Shipping |
3000 |
Malta |
Gen. Cargo |
2-nd Off |
04.10.2005 |
29.07.2006 |
| Oceanview | Roko Shipping |
3500 |
St. Kitts & Nevis |
Oil Tanker |
2-nd Off |
05.12.2006 |
28.05.2007 |
| Marim | Admibros |
4500 |
Cyprus |
Ch. Tanker |
2-nd Off |
11.2007 |
04.2008 |
| Atalandi | Minerva |
105000 |
Greece |
Oil Tanker |
2-nd Off |
06.2008 |
12.2008 |
| Apolytares | Minerva |
317000 |
Greece |
VLCC |
2-nd Off |
04.2009 |
09.2009 |
| Experience at sea: Since 1998 | Knowledge Personal Computer: Yes | |||
| Medical Certificate: | ¹ | Issued: | Place: | Exp. date: |
| Vaccination for cholera valid until: | Vaccination for yellow fever valid until: 04.03.2012 | |||