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Additional information

APPLICATION FORM

Position:
Surname: Tymofieiev
Name: Iurii
Middle name:
Date and country of birth: 14.09.1991 IZMAIL
Nationality: UKRAINIAN
Home address: IZMAIL
Phone: [open contact info](look above in the "contact info" section)
e-mail: [open contact info](look above in the "contact info" section)

Next of kin name:
Relationship:
Next of kin address: / Phones:
Marital status: Single
Children under 18
(name / date of birth): , ,
Brown
Colour of Eyes: Blue
Height: 1.70
Weight: 71
Size:
Shoes: 42
Education:
Level of English:
US visa Number:
Issue:
Expiry:
Place of Issue:
SEA SERVICE
Vessel name (y. b.)
Rank
Vessel type
DWT
M/E type (model)
M/E (HP)
Owner
(manager)
Sign on

Flag

Sign off
Aspro
OS
Phnom Penh
4273

2x872kwt
Concord shipping corp
14.06.2011

Dry cargo

20.03.2012
Ekaterina
AB
panama
1836

2x515
Efem shipping and traiding s.a
28.11.2013

General cargo

25/01/2014
Ekaterina
AB
panama
1836

2x515
Efem shipping and traiding s.a
17/02/2014

General cargo

17/08/2014
Volga 4006
AB
Bassetere
4911

1776
Albros shipping and traiding ltd
31.10.2015

General cargo

10.03.2016

PASSPORTS

Number
Issued
Expiry
Place of issue
National Passport

Seaman Book
Ab 545594
05/03/2015
05.03.2020
Izmail
International Passport
Ek519137
29.09..2009
29.09.2019
5101
CERTIFICATES
Certificates (Qualification)
Number
Place of issue
Issued
Expiry
Certificate Of Competency (Grade):
13041/2015/01
Izmail
05.08.2015

Endorsement (Grade):

Basic Safety Training STCW 78/95
3199u
Izmail
16.04.2013
16.04.2018
Advanced Fire Fighting
11801/2015-A
Izmail
09/07/2015
09.07.2020
Proficiency in Survival Craft
3362
Izmail
09.03.2015
09.03.2020
Fast Rescue Boats

HEALTH CERTIFICATE

23.06.2016
23.06.2017
Hazardous Cargoes
2209u

17.04.2013
17.04.2018
Designated security duties of shipboard personnel
11382/14

01.04.2014
01.04/2019
Radar Navigational used ARPA

AIS

ECDIS

security awareness training for all seafarers
9700/14

01.04.2014
01.04.2019
safety familiarization basic training and instruction for all seafarers
16622/2015-A

18.06.2015
18.06.2020
Ship Handling Arrangements

Large Ship Handling

Yellow Fever

Bridge/Engine Team Management

Maintenance of Electrical & Electronic Equipment

Tanker Familiarization

Oil Tanker

Chemical Tanker

Gaz Tanker

Inert Gaz System

Crude Oil Washing

Ro-Ro
11870/mps

03/07/2012
03/07/2017
Passenger Ships

Other:

Other:

FLAG STATE DOCUMENTS (PASSPORTS, ENDORSEMENTS)
Passport, Licence
Number
Issued
Expiry
Flag State
Seaman Book

Endorsement

Seaman Book

Endorsement

Seaman Book

Endorsement