ePariksha ID: 16EL2892/JUN/6384

Personal Details

Full Name: SINGH ABHINAY KUMAR Nationality: INDIAN Center: Mumbai

Passport No Place of issue Date of issue Passport valid till
P1510820 LUCKNOW 01 Jul 2016 30 Jun 2026
Personal Marks: NA Gender: Male Marital Status: Un-Married
Date of Birth: 10 Jul 1994 Place of Birth: Deoria State: Uttar Pradesh
INDOS No: 16EL2892 EXN-45 No: C.D.C. Number: MUM280489
Date of issue: 31 Aug 2017 Place of issue: MUMBAI
Permanent Address: 144,LAR VILL AND POST KHEMADEI, Present Address: 144,LAR VILL AND POST KHEMADEI,
SALEMPUR,DEORIA,UTTAR PRADESH - 274508 SALEMPUR,DEORIA,UTTAR PRADESH - 274508
Telephone No: - Mobile No: 7408984817
Email ID: abhisng5193@gmail.com Alternate Email ID:

Fee Details
Assessment Fee

Receipt No Date Fee Amount Bank

QUR27681610371 24 Jun 2019 3000

Scholastic Education

Stream No.(As Per META manual):

(Copies of supporting document from Class X onwards must be GME
attached.)
Scholastic Education Level: 10th, 10+2, Graduate

Note : Any person who makes, causes to be made or assists in making any false representation for the purpose of obtaining for

himself/ herself or any other person a Certificate, shall be liable for prosecution under Section 182 & 420 of the Indian Penal Code

1860

Pre-Sea Training

Training Institute: TS Rahaman

Training Institute Indos: 009
TRAINING SHIP RAHAMAN NHAVA PANVEL TALUKA DIST
Address of the Institute: RAIGHAD 410206 MAHARASHTRA
Telephone No: 02227212800 Fax No: 02227212495
booking.rcamsar@tsrahaman.o Result: pass
Email ID: rg Grade as stated in record
Attended Period From : 01 Nov 2016 To: 31 Oct 2017

Copies of Supporting Document Must be attached.

Structured On Board Training

1
 Designated Training Officer Details of Certificate of
PHASE No. Date of Completion (Ship / Company) Competency
PHASE 2-As Trainee Engineer 13 Mar 2019 VSHIPS INDIA PVT LTD NA
Officer

Sea Going Service

Name of the ship

No of Testimonial and whether steam Off No./IMO No. KW Trade Rank
or motor vessel
1 MV RAHI 9451757 18660 Foreign Going JUNIOR ENGINEER
Date Article Period
From To From To
25 Aug 2018 21 Jan 2019 -- --
QSS 114
Name of the ship
No of Testimonial and whether steam Off No./IMO No. KW Trade Rank
or motor vessel
2 MV RAHI 9451757 18660 Foreign Going JUNIOR ENGINEER
Date Article Period
From To From To
22 Jan 2019 13 Mar 2019 -- --
QSS 47

STCW Courses

STCW Regulation/ Period

STCW Approved Institution
STCW Code A From To
Institute Indos: 009
ELEMENTARY FIRST AID 2010
TS Rahaman 12 Jun 2017 14 Jun 2017
Institute Indos: 009
PERSONAL SURVIVAL TECHNIQUES 2010
TS Rahaman 10 Jul 2017 12 Jul 2017
Institute Indos: 009
FIRE PREVENTION AND FIRE FIGHTING 2010
TS Rahaman 13 Jul 2017 15 Jul 2017
Institute Indos: 009
STSDSD 2010
TS Rahaman 24 Jul 2017 25 Jul 2017
Institute Indos: 009
PERSONAL SAFETY AND SOCIAL RESPONSIBILITIES 2010
TS Rahaman 15 Jun 2017 17 Jun 2017
Institute Indos: 012
MEDICAL FIRST AID 1978
BP Marine Academy 08 Apr 2019 11 Apr 2019
Institute Indos: 012
ADVANCED FIRE FIGHTING 1978
BP Marine Academy 16 Apr 2019 20 Apr 2019
Institute Indos: 012
PSCRB 1978
BP Marine Academy 02 Apr 2019 06 Apr 2019

Level Applied:

Signature of
Date Function Candidate
24 Jun 2019 3,4B,5,6 True

Certificate of Competency held, if any:

Certificate Details:
Place of Examination: Date of Examination: --
Class / Grade: Date of Issue: --

2
If at any time suspended or cancelled, state
Court Authority: Cause:
Date: --

Approved Courses

Remarks
Function / Part Institution From To Stating Grades in
Assessment
ENGINE ROOM
SIMULATOR OERC Academy 23 Jul 2019 25 Jul 2019 PASS
OPERATIONAL LEVEL

Declaration:

I hereby declare that the particulars contained in the form are correct and true to the best of my knowledge and belief and that the
papers enumerated and sent with this form are true and genuine documents given and signed by the person whose name appears
on them. I further declare that Section F contains a true and correct account of sea-going service without exception and I make this
declaration conscientiously believing the same to be true.