BIO DATA AND APPLICATION OF VANKA SRINIVAS
1. Personal Data
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First Name : SRINIVAS |
Middle Name (s) : - |
Last Name / Surname : VANKA | |||
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Nationality (or current Citizenship) |
Country Of Origin |
Date of Birth |
Place / City of Birth |
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INDIAN |
INDIA |
29.03.1955 |
INDIA / CALCUTTA |
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Marital Status |
Gender: |
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MARRIED |
Male Female |
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Rank Applied For: |
Willing to accept lower rank? Yes No |
Available Date of Joining - 07.07.2018 |
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CHIEF ENGINEER |
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Primary / Permanent Address FLAT NO. D-1 , 3RD FLOOR , WOODBRIDGE APARTMENTS , |
lternative / Temporary Address: NOT APPLICABLE |
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OLD NO.1O / NEW NO. 19, VENKATRAMAN STREET , T.NAGAR , |
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City: CHENNAI |
Post Code: 600017 |
City: |
Post Code: |
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State: TAMIL NADU |
Country: INDIA |
State: |
Country: |
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Nearest Airport: CHENNAI |
Home Tel: 044-28152337 |
Phone: |
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Mobile Tel: 0091 9940655329 |
Fax: - |
Email: srinivanka@hotmail.com |
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Contact Method: Email |
Fax |
Mobile Number Home Phone |
Post |
2. Personal ID / Documents / Visa
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Type of Document / ID2 |
Country of Issue |
Number |
Date of Issue (DD / MM / YY) |
Issued at (Place) |
Valid Until (DD / MM / YY) |
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Seaman's Book (National) |
INDIA |
BY 53384 |
26/12/2014 |
MUMBAI | 25/12/2024 |
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Passport |
INDIA |
Z 1762535 |
18/02/2010 |
CHENNAI | 17/02/2020 |
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US Visa C1 / D |
INDIA |
20171011630001 |
13/4/2017 |
CHENNAI | 04/10/2022 |
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LIBERIAN CDC |
U.S.A. |
1300830 |
11/03/2016 |
VIRGINIA , U.S.A. | 11/03/2021 |
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PANAMA CDC |
PANAMA |
P0126610 |
14/12/2017 |
PANAMA | 03/12/2020 |
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MARSHALL ISLANDS CDC |
MARSHALL ISLANDS |
MH 218552 |
17/01/2011 |
MARSHALL ISLANDS | NO D.O.E. |
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PORTUGUESE CDC |
PORTUGUESE REPUBLIC |
96173932 |
22/06/2017 |
PORTUGUESE REPUBLIC | 03/12/2020 |
PAGE 2
3. Nominee / Next of Kin & Family Details
| Full Name of Nominee for compensation in case of fatality: | Relationship |
Gender: Male Female |
Nationality: INDIAN |
| VANKA GEETHA | SPOUSE | ||
| Address: FLAT NO. D-1 , 3RD FLOOR , WOODBRIDGE APARTMENTS , OLD NO.10 / NEW NO. 19, VENKATRAMAN STREET , | |||
| T.NAGAR , CHENNAI - 600017 | |||
| City: CHENNAI | Post Code: | 600017 | Country: INDIA |
| Email: geethavanka@gmail.com | Tel: 0091-44-28152337 | Mobile: +91 9841019126 | |
Select From: Spouse Partner Grand Parent Other Relative (Please Specify)
Family data:
| Relationship | First Name | Last Name | Date of Birth (dd/mm/yyy) | Passport No | Issued (dd/mm/yyyy) | Place | Valid Until (dd/mm/yyyy) |
| Spouse / Partner2 | GEETHA | VANKA | 12/09/1961 | H 3763970 | 15/07/2009 | CHENNAI | 14/07/2019 |
| Child M F | PRERANA | VANKA | '14/6/1992 | Z 3821476 | '24/03/2017 | CHENNAI | '23/03/2027 |
Indicate type of valid visa3 USA Canada Brazil Schengen UK Other
2Strike out inapplicable item 3Please consider period board
4. STCW-1978 (ammended 1995) Compliant Certificates / Courses and Other Qualifications:-
Add separate sheet if data exceeds space available)
| Description of Cert / Course | Country of issue | Number | Date of issue (DD-MM-YY) | Date of Expiry (DD-MM-YY) | Place of issue | Issuing Authority / (body |
| (A) Reg 1 | ||||||
| Personal Training Record Reg 1/14 | ||||||
| Medical Fitness Cert Reg 1/9 | ||||||
| (B) Reg VI/1 - Basic Safety Training | ||||||
| Personal Survival Techniques | INDIA | 3029 | 17/11/1990 | N.A. | NHAVA SEVA | T.S. RAHAMAN |
| Elementry First Aid | ||||||
| Fire Fighting & Fire Prevention | ||||||
| Personal Safety & Social Resp. | INDIA | PSSR/21/390 | 11/11/1998 | N.A. | CHENNAI | H.I.M.T. |
| (C) Reg VI/ 2-4 Additional Training | ||||||
| Proficiency in Survival Craft &Rescue Boat | ||||||
| Family Data: | ||||||
| Advanced Fire Fighting | INDIA | 8501 | 24/11/1990 | N.A. | NHAVA SEVA | T.S. RAHAMAN |
| Medical First Aid | INDIA | RMFA C/B22/MFA C/B22/02 | 04/07/2014 | 04/06/2019 | CHENNAI | H.I.M.T. |
| Medical Care (Master / C/O) | ||||||
| Advanced Fire Fighting & Fire Prevention and Fire Fighting | INDIA | R-AFF/B143/17 | 05/04/2015 | 05/03/2020 | CHENNAI | H.I.M.T. |
| P.S.C.R.B. & P.S.T. | INDIA | RPSCRB/B155/17 | 05/02/2015 | 05/01/2020 | CHENNAI | H.I.M.T. |
| SHIP SECURITY OFFICER | INDIA | RSSO/B68/SSO/B275/02 | 04/04/2014 | NO D.O.E. | CHENNAI | H.I.M.T. |
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(D) 4 Reg II / 1-4, III / 1-4 Others Certificate of Competency & Ratings Watch-keeping Certificate (Including flag state endorsements) |
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| C.O.C. (NATIONAL) [INDIAN] | INDIA | 95W-0975 | 11/10/2005 | 03/12/2020 | MUMBAI | M.M.D. INDIA |
| C.O.C. (PANAMA) | REPUBLIC OF PANAMA | 8324 | 14/12/2017 | 03/12/2020 | REP. OF PANAMA | REP. OF PANAMA |
| C.O.C. (MARSHALL ISLANDS) | REP. OF MARSHALL ISLANDS | 735344 | 17/01/2011 | NO D.O.E. | REP. OF MARSHALL ISLANDS | REP. OF MARSHALL ISLANDS |
| C.O.C. (LIBERIAN) | REP. OF LIBERIA | 1055608 | 02/07/2017 | 03/12/2020 | REP. OF LIBERIA | REP. OF LIBERIA |
| C.O.C. (PORTUGUESE) | PORTUGUESE REP. | 96173932 | 22/06/2017 | 03/12/2020 | PORTUGUESE REP. | PORTUGUESE REP. |
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4Enter here actual description given in the Competency Certificate / Watchkeeping Certificate held by you (E) Other mandatory/recommended Certificates / Courses - (as applicable) |
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| ARPA (Reg II/1 + Solas) | ||||||
| Certificate of Proficiency for SSO | ||||||
| Radar Observer Course | ||||||
| Radar Simulator | ||||||
| Bridge Team Management | ||||||
| RANSCO | ||||||
| Shiphandling Manoeuviring Simulator | ||||||
| Large Vessel Handling Simulator | ||||||
| Bridge Resourse Management | ||||||
| Safety Officer Course | INDIA | RSSO/B68/SSO/B275/02 | 04/04/2014 | UNLIMITED | CHENNAI | H.I.MT. |
| SPECIAL TRAINING FOR OIL TNKR | ||||||
| SPECIAL TRAINING FOR CHEMICAL TANKER | ||||||
| Energy Conservation | ||||||
| Environmental Awareness Course | ||||||
| MSI Management System | ||||||
| E.C.D.I.S | ||||||
| YELLOW FEVER | INDIA | - | 04/10/2017 | 04/09/2027 | CHENNAI | PORT HEALTH ORGANISATION |
| INDOS NO. | INDIA | 00EL 1334 | 09/06/2001 | - | MUMBAI | L.B.S. COLLEGE |
| Refresher & Updating Training | INDIA | CMC/REO/2015/B03/26 | 13/03/2015 | 03/12/2020 | CHENNAI | C.M.C., CHENNAI |
| Revalidation course | INDIA | REO/B94/07 | 19/08/2010 | - | CHENNAI | H.I.MT. |
PAGE 3
5. Sea Experience: (Last 10 years; Start the listing below with the most recent experience)
| Company | Flag & Vessel Name | Type(1) | GRT | DWT | Main Engine(2) | BHP | Rank | Date From dd.mm.yy | Date To dd.mm.yy |
| MSC SHIP MANAGEMENT | PANAMA / M.V. MSC MARIA LAURA | CON | 36389 | 42435 | SULZER 7RTA 84 | 28505 | C/E | 17.12.2017 | 20.02.2018 |
| MSC SHIP MANAGEMENT | LIBERIA / M.V. MSC JENNY | CON | 28397 | 32984 | SULZER 6RTA 76 | 21807 | C/E | 28.04.2017 | 06.08.2017 |
| MSC SHIP MANAGEMENT | LIBERIA / M.V. MSC RHIANNON | CON | 23652 | 23150 | SULZER 6RTA 72U | 24375 | C/E | 01.11.2016 | 24.02.2017 |
| Crowley Accord Mar. Mgmt | INDIAN / M.V. NAVDHENU SUN | B/C | 27198 | - | MAN B&W 6S50 MC | 9227 | C/E | 28.12.2015 | 13.05.2016 |
| MSI SHIPPING SVCS. | SINGAPORE / M.V. X-PRESS MAKALU | CON | 32161 | 38616 | MAN B&W 7S70 MCC | 29197 | C/E | 04.06.2015 | 18.09.2015 |
| MSI SHIPPING SVCS. | LIBERIA / M.V. ORE MUTUCA | B/C | 77096 | - | MAN B&W 5L80 MCE | 16900 | C/E | 22.05.2014 | 26.11.2014 |
| APEEJAY SHIPPING | INDIAN / M.V.APJ MAHAKALI | B/C | 36559 | - | SULZER 7 RTA 52 | 10200 | C/E | 22/11/2013 | 03/02/2014 |
| ELEGANT MAR. SVCS. | HONG KONG / M.V. PROMISE 1 | B/C | 22634 | - | B&W 6S 50 MC | 11640 | C/E | 03/05/2013 | 23/07/2013 |
| ELEGANT MAR. SVCS. | MALTA / M.V. OCEAN GARNET | B/C | 51209 | - | B&W 6S 50 MC | 16610 | C/E | 22/07/2012 | 23/11/2012 |
| ELEGANT MAR. SVCS. | BERGEN / M.V. SPAR VEGA | B/C | 32839 | - | B&W 6S 50 MC | 11666 | C/E | 28/07/2011 | 25/02/2012 |
| ELEGANT MAR. SVCS. | HONG KONG / M.V. MATUMBA | B/C | 31261 | - | B&W 6S 50 MC | 12000 | C/E | 28/12/2010 | 12/03/2011 |
| UNIVAN SHIP MGMT. | PANAMA / M.T. BAB ADEN | TNP | 3742 | - | AKASAKA UEC 60 LS | 3297 | C/E | 08/03/2010 | 05/07/2010 |
| UNIVAN SHIP MGMT. | PANAMA / M.T. GORGONILLA | CHM | 4959 | 8192 | B&W 5L 35 MC | 4418 | C/E | 06/10/2009 | 23/10/2010 |
| ELEGANT MAR. SVCS. | BERGEN / M.V. RAINBOW | B/C | 25676 | - | B&W 6S 50 MC | 11000 | C/E | 05/12/2008 | 29/05/2009 |
| UNIVAN SHIP MGMT. | PANAMA / M.V. OOCL XIAMEN | CON | 34610 | 43093 | B&W 8K 80 MC | 39265 | C/E | 08/11/2007 | 09/06/2008 |
| UNIVAN SHIP MGMT. | PANAMA/ M.V. COLUMBIAN EXPRESS | B/C | 12963 | - | SULZER 6 RTA 60 | 7050 | C/E | 28/10/2006 | 05/06/2007 |
| UNIVAN SHIP MGMT. | HONG KONG / M.V. PATAGONIA | B/C | 17075 | B&W 6S 50 MC | 7803 | C/E | '23.04.2006 | 11.07.2006 | |
| UNIVAN SHIP MGMT. | HONG KONG / M.V. OCEAN LOGGER | B/C | 16712 | B&W 6S 50 MC | 7803 | C/E | '29.11.2005 | 19.04.2006 | |
| UNIVAN SHIP MGMT. | PANAMA/ M.V. MSC VALERIA | CON | 12255 | MAN K7Z78 | 12250 | C/E | '27.12.2004 | 16.08.2005 | |
| UNIVAN SHIP MGMT. | PANAMA/ M.V. MSC ILARIA | CON | 20408 | SULZER 6RND 90 | 23200 | C/E | '22.09.2004 | 13.11.2004 | |
| UNIVAN SHIP MGMT. | HONG KONG / M.V. SALOMA | B/C | 9529 | B&W 6S 50 MC | 5633 | C/E | '03.10.2003 | 13.05.2004 | |
PAGE 4
6. Medical History:
All previous illnesses other than minor afflictions should be started below or updated . If not previously disclosed, the Company is
entitled to refuse any reimbursement of medical coasts, claim for treatment or for any other insured benefits.
(A) Have you ever signed off a ship due to medical reasons? Blood Type:
If yes, please provide following details (if space is insufficient, attach additional sheets): Yes No O +VE
| Name of Vessel | Date of occurrence | Place of occurrence |
| N.A. | N.A. | N.A. |
Brief description of illness/injury/accident
NOT APPLICABLE
(B) Have you undergone any operation in the past? Yes No If yes, please provide following details:
| Details of operation | Date | Period of disability | Present condition |
| HERNIA ON THE LEFT SIDE | 1997 | 4 WEEKS | SATISFACTORY (NO PROBLEMS) |
| HERNIA ON THE RIGHT SIDE | 2007 | 4 WEEKS | SATISFACTORY (NO PROBLEMS) |