Application Form / Personnel Data Update Form

Post applied for:

CHIEF ENGINEER/Technical Suprintendent

Willing to accept lower rank ?

no

Available From:

9/1/2017

PERSONAL PARTICULARS (AS IN PASSPORT)

First Name

Middle Name

Last Name/Surname

MANEYKANDAN

LASKSHMANAN

Nationality

INDIAN

Date of Birth

21/01/1978

P l a c e o f B i r t h

PORT BLAIR

Height

154

Weight

Smoker / Nonsmoker

(In CMS)

(In KGS)

78

NONSMOKER

Boiler Suit

XL

Shoe

Yellow Fever Valid till:

Size :

Size :

8

22/11/2021

Permanent Address :

B/0 L.KRISHNAMURTHY

Present Add:

PIGMY AGENT ,SYNDICATE BANK

PORTBLAIR

DO

City :

ANDAMAN

Telephone :

9626467400

City :

Post Code :

744101

Post Code :

E-Mail :

MARINEMANI@YAHOO.COM

Telephone :

Document

No.

Issued

Place

Valid Untill

Passport : Country

z2737439

11/28/2013

PORTBLAIR

Nov-23

Seamans Book (CDC) : National

MS14580

8/3/2001

PORTBLAIR

3/8/2026

Seamans Book (CDC) : Norwegian

Seamans Book (CDC) : Liberian

Seamans Book (CDC) : Panamian

Seamans Book (CDC) : Marshall Island

MH388283

2-Jan-13

Other (CDC) :

Liberia

21-Mar-13

Nov-23

Valid US Visa C1/D

Yes

Valid Until :

Passport ECNR:

Yes

Next to Kin:

V.PRIYA

Relationship :

WIFE

DOB :

20/06/1985

Address :SHREE ASTA LAKSHMI ILLAM,CHATHAM OFFSHORE ROAD,HADDO,A&N ISLANDS-744102

Telephone :

9176528829

………………..Family Data………………..

Relationship

First Name

Last Name

DOB

Passport No

Place Issued

Valid Untill

Spouse

VISWANATHAN

PRIYA

20/06/1985

Child M

LAKSHMANAN

HARSHID

11/10/2012

Child F

SAI SRADHA

SHREE

8/24/2016

Indicate Type of Valid Visa :

USA

CANADA

BRAZIL

UK

OTHERS

Please consider period on board

ACADEMIC QUALIFICATION

Diploma / Degree

Institution / University

Year of Passing

Class

B.E

MADURAI KAMARAJ UNIVERSITY

1999

1ST

TRAINING & APPRENTICESHIP

Diploma / Degree

Institution / University

Year of Passing

Class

HINDUSTAN SHIPYARD LTD

2000

1ST

CERTIFICATES / COURSES :

Highest Competency Certificate Held :

Issuing Authority

Grade

Certificate No.

DOI

Place Issued

Valid Untill

National (Country)

INDIAN

CLASS 1

95W-6589

20-12-2010

CHENNAI

5/14/2020

Liberian

Panamian

Marshall Island

Norwegian

Hongkong

CLASS 1

NL091834

16-Aug-15

HONG KONG

16-Aug-15

Others

SINGAPORE

CLASS 1

COE-E0074016

5TH APR 2012

SINGAPORE

16-Aug-15

LIST OF S.T.C.W. / OTHER COURSES DONE

Courses

Cert No.

Date of Issue

Place of Issue

1) Advanced Fire Fighting

AFF/B06/04

13-07-02

HIMT,CHENNAI

2) Fire prevention & Fire Fighting

FPFF/B84/17

18/10/00

HIMT,CHENNAI

3) Proficiency in Survival Craft & RB

PSCRB/0302/2002

19/07/02

AMET,CHENNAI

4) Personal Survival Techniques

PST/B140/06

21/10/00

HIMT,CHENNAI

5) Elementary / Medical First Aid

MFA/B199/06

6/7/2002

HIMT,CHENNAI

6) Ship Capt. Medical (Medicare)

7) CHEMCO

SCTO/2394/2009

28/05/2009

OERC MUMBAI

8) Chemical Tkr Familiarisation Course

CTF/01/035/225

5/10/2001

CMA,CHENNAI

9) TASCO

TASCO/B75/06

14/10/06

HIMT,CHENNAI

10) Oil Tkr Familiarisation Course

TFC/B92/4

27/10/01

HIMT,CHENNAI

11) PSSR

PSSR/B270/09

21/10/00

HIMT,CHENNAI

12) LCHS : (Management / Operational)

13) GMDSS

14) Ship Manouvering Simulator Courses

15) Radar Observer Course / ARPA

16) Radar Simulator Course

17) C.O.C. Revalidation Course

18) Other (Specify)

PSF/B170/721

20/10/06

CTM/CHENNAI

19) INDOS NO.

99EL4552

MUMBAI

Dangerous Cargo Certification :

1. Endorsement on NATIONAL Certificate

Level

Number

DOI

Place Issued

Valid Untill

Petroleum

MANAGEMENT

DCE02CHN16001070

24-Oct-16

CHENNAI

24-Oct-21

Liquified Gas

Liquid Chemicals

MANGEMENT

DCE02CHN16001071

24-Oct-16

CHENNAI

24-Oct-21

2. Endorsement / Cert. Obtained (Liberian,

Level

No. / Issuing

DOI

Place Issued

Valid Untill

etc.) qualifying as (Capacity)

Authority

CHEMICAL AND OIL

MANAGEMENT

TEM-0007303

20-Dec-10

SINGAPORE

31-Dec-16