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Anglo Eastern Group

Kindly affix a regular & recent passport
License No. RPSL-MUM-088 valid until 31-01-2017 size PHOTOGRAPH
Tel : (91-22) 61124600 Fax : (91-22) 61124650
E-Mail : manning.bom@angloeasterngroup.com
APPLICATION FORM
Date Applied 18-Feb-18 Application No
Rank Applied For CHIEF OFFICER Date Of Availability 20-Mar-18
PERSONAL DESCRIPTION AND INFORMATION
Given Name
(First / Middle) ANIKT Last Name VYAS Country Res. INDIA
Height (cm) 180 Weight (Kg) 68 BMI
Date of Birth 06-APRIL-199 Place JAIPUR Nationality INDIA

68/25 PRATAP NAGAR JAIPUR

Address
City JAIPUR Pin Code 302033 State RAJASTHAN

Contact Details Mobile No :

E-Mail INDOS 08NL1832

Marital Status Last Salary Drawn 8200 USD Nearest Airport JAIPUR
Last Employer
Company Name Name of Person & Designation Phone Number
SHIPPING CORPORATION OF INDIA CAPTAIN RAJESH KUMAR/ VP FLEET PERSONEL
Refer 2 Senior Officers you have sailed with
Name Company Rank Contact No
CAPTAIN SARDAR SINGH SCI MASTER
CAPTAIN CARL J DABREO SCI MASTER
EDUCATIONAL BACKGROUND [ please include pre-sea training ]
Academic
Last School / College
Qualification BSC MTI SCI
Pre Sea Training MTI Apprenticeship SCI
TRAVEL DOCUMENTS
Documents Number Place of issue Date of issue Date of Expiry
Passport Z2800416 JAIPUR 14/02/2014 13/02/2024
CDC(National) MUM163920 MUMBAI 6-Oct-09 5-Oct-19

U.S. Visa C1/D

Yellow Fever H287456 MUMBAI 11-Nov-09 10-Nov-19

Flag CDC/COC Liberian Panama Marshall Islands Bermuda Bahamas

Licence Grade - [Description] Country of issue Number Date of Issue Date of Expiry

1 M FG MUMBAI IF020855 31-01-2017 21-12-2021

* Applied for Higher License or Revalidation

Date of
DCE Number Date of Issue Place of Issue
Expiry
PETROLEUM mum17003500 12-Feb-17 12-Feb-22 NOIDA
CHEMICAL
GAS

SEA SERVICE
DECK Total
Vessel Name Vessel Type Company Name Rank From To
GRT DWT TEU Mnts Days
M.T BHAIRAVI CHEMICAL 8625 SCI FORBES TNO
1 16.12.2009 17.08.2010

SWARNA KRISHNA OIL/CHEM 42845 SCI TNO

2 14.10.2010 26.08.2011

VISHVA DIKSHA BULK 33185 SCI 3O

31.10.2012 21.12.2012

Form : AEI-FPD 01 Revision : 5 Page : 3 Issue date : 23 Jul 13

 VISHVA VIJAY BULK 44010 SCI 3O
24.05.2013 09.01.2014

DESH SHOBHA OIL/CHEM 81334 SCI 2O

20.06.2014 11.04.2015

SWARNA KRISHNA OIL 42845 SCI CO

01.04.2017 07.07.2017 3 7
DESH BHAKT OIL 61978 SCI CO
31.08.2017 15.01.2018 4 16

CONT TANKER
VESSEL TYPE OSV CEME / BULK GENC
/RORO/PCC TANK/PRT CHEM LNG / LPG TOTAL
RANK M D M D M D M D M D M D M D
Mstr/C.Eng.
Ch.Off. /2.Eng. 7M 21 D 7M 21 D
2nd.Off./3.Eng 10 M
3rd.Off./4.Eng 9M
R/Off./El.Off.
AE/O
Cdt/Jr.Eng. 10 M 8M
Rating
Total
SUMMARY OF KNOWLEDGE AND EXPERIENCE ACQUIRED [Give a brief resume of your Career and Experience at Sea, e.g. Type of
Ships, Engines, Specific Trades (E.G. ICE / Lighterage etc.), reactivation, New Buildings, Shore Experience, Computer Knowledge etc.]

VALUE ADDED EXPERIENCE / TRAINING

Yard delivery Major Conversion Dry Dock

Y Y Gantry / Self Unloader Crane / Grab
ME / RT Engine Framo Pump Ice Navigation
BTM Course
STCW
Experience Experience Y Experience Y Upgradation Y

Office Comments

Form : AEI-FPD 01 Revision : 5 Page : 4 Issue date : 23 Jul 13

Form : AEI-FPD 01 Revision : 5 Page : 5 Issue date : 23 Jul 13
Form : AEI-FPD 01 Revision : 5 Page : 6 Issue date : 23 Jul 13
Form : AEI-FPD 01 Revision : 5 Page : 7 Issue date : 23 Jul 13
Form : AEI-FPD 01 Revision : 5 Page : 8 Issue date : 23 Jul 13
Form : AEI-FPD 01 Revision : 5 Page : 9 Issue date : 23 Jul 13
CANDIDATES SUMMARY OF KNOWLEDGE AND EXPERIENCE CONTD.
SUMMARY OF KNOWLEDGE AND EXPERIENCE ACQUIRED [Give a brief resume of your Career and
Experience at Sea, e.g. Type of Ships, Engines, Specific Trades (E.G. ICE / Lighterage etc.), reactivation,
New Buildings, Shore Experience, Computer Knowledge etc.]

Page 5 [Annex] SEL / REV-02 / 01-AUG-05