FOR TOP OFFICERS LAST 10 YEARS, junior officers and ratings last 5 years

APPLICATION FORM / PERSONAL DATA

Surname: Balaban

Name: Taras

Date of Birth: 12.05.1985

Place of Birth / City & Country:

Nationality:

Ukraine, Turiysk

Ykrainian

Permanent address: Ukraine, Kherson, Kol’tsova 41, fl.131

Phone(home):

+380552319858

+380553730720

Height:185

Colour of eyes:

green

Mob. Phone:

+380507817125 +380632604840

Weight:90

Colour of hair:

brown hair

e-mail:

taras_balaban@mail.ru

Civil Status

Married Single divorced

Next of kin

Address next of kin:

Relation-mother

Ukraine, Kherson reg. Lazurnoe, str.Sadova 70

Name: Balaban Elizabeth

Nbr of Children:None

Phone: +38956800060

Nearest airport:

Odessa IA

POSITION: Able seafarer deck (АВ)

WELDER: Yes No

DOCUMENTS

NUMBER

ISSUED

VALID

COUNTRY, CITY

NATIONAL PASSPORT

МО №933506

04.10.2001

-------------

Ukraine, Skadovsk

INTERNATION PASSPORT

EK № 780304

15.02.2010

15.02.2020

Ukraine, Kherson

NATIONAL SEAMAN’ S BOOK

AB №494084

02.07.2012

02.07.2017

Ukraine, Izmail

CERTIFICATE OF PROFICIENCY

№ 10028/2014/11

07.03.2014

-------------

Ukraine, Kherson

SAFETY FAMILIARIZATION, BASIC TRAINING AND INSTRUCTION FOR ALL SEAFARES

№ 14018

15.01.2014

15.01.2019

Ukraine, Nikolaev

DESIGNATED SECURITY DUTIES OF SHIPBOARD PERSONNEL

№ 0047/MPS

14.02.2014

14.02.2019

Ukraine, Kherson

PROF. IN SURVIVAL CRAFT

№9840

15.01.2014

15.01.2019

Ukraine, Nikolaev

ADVANCED FIRE FIGHTING

№ 272/MPS

14.02.2014

14.02.2019

Ukraine, Kherson

HEALTH CERTIFICATE

№ 020889

27.01.2014

27.01.2015

Ukraine, Kherson

YELLOW FEVER VACCINATION

№ 012094

31.05.2012

31.05.2022

Ukraine, Kherson

SECURITY-RELATED TRAINING AND INSTRUCTION FOR ALL SEAFARES

№ 9011

15.01.2014

15.01.2019

Ukraine, Nikolaev

TRAINING IN CARRYING OF DANGERROUS AND HAZARDOUS SUBSTANCES

№ 7202

15.01.2014

15.01.2019

Ukraine, Nikolaev

SHIP’S WELDER

№ 001051/12KH

25.09.2012

25.09.2014

Ukraine, Kherson

SEA SERVICE:

FOR TOP OFFICERS LAST 10 YEARS, junior officers and ratings last 5 years

TYPE OF VESSEL

NAME OF VESSEL

GRT/DWT

ENG. TYPE

HP

FLAG

NAME OF COMPANY

RANK

PERIOD OF SERVICE FROM / TO dd/mm/yy / dd/mm/yy

GENERAL CARGO

TAVR

2342/

48 NVD

UKRAINE

PE “LARTIS”

OS

10.07.2012

18.12.2012

RESEARCHING VESSEL

TAVR

2342/

48 NVD

UKRAINE

MARIN-SERVIS LTD

OS

25.04.2013

24.12.2013

REMARKS

At the time mentioned the m/v Tavr was in the Sevmorgeo JSC scientific party at sea seismic explorations in the Pacific Ocean, searching for oil and natural gas fields on the shelf of the Republic of Ecuador, taking part in the projects of Sevmorgeo JSC and «SIPEC», and Sevmorgeo JSC and «PETROAMAZONAS ЕР» companies.

ENGLISH:

GOOD

SATISFACTORY

MODERATE

POOR

Date: 2015-12-24; view: 1059