Herald MARITIME SERVICES PVT LTD.

Pre-Engagement Checklist Form : HMS002

Rev.No: 00
Date: 01.07.2017
NAME : RANK : DATE:
SHIP : INDOS NO : PORT :

YES /
NO CREDENTIALS CERT NO ISSUE DATE EXPIRY DATE REMARKS
NO
1 0.1 PASSPORT
02 BLANK PAGES IN PASSPORT
03 U.S. VISA
04 . SCHENGEN VISA
2 01.INDIAN CDC
02. ILO 108 STAMP
3 CERTIFICATE OF COMPETENCY
0.1 INDIAN /UK/AUS/SIN

4 TANKER ENDORSEMENT
0.1 OIL ( BASIC / MANAGEMENT)
0.2 CHEM ( BASIC / MANAGEMENT)

5 RATING WATCH KEEPING - NAVIGATION/ENGINE

6 COP - NAVIGATION/ENGINE

7 COOKERY CERTIFICATE
8 YELLOW FEVER VACCINATION
9 STCW COURSES
0.1 EFA/MFA/MEDICARE
0.2 P S T.
0.3 PSC RB
0.4 AFF / FPFF
0.5 PSSR
0.6 TASCO / OTFC
0.7 CHEMCO / CTFC
0.8 TANKER AUGMENTATION COURSE
0.9 GMDSS G.O.C
1.0 GMDSS STCW ENDORSEMENT
1.1 ARPA & ROC / RANSCO
1.2 HIGH VOLTAGE COURSE

10 NON STCW COURSES

0.1 SSO / STSDSD
0.2 BRIDGE TEAM MGT.
0.3 ECDIS
0.3 TYPE SPECIFIC ECDIS
0.4 BRIDGE / ENGINE RESOURCE MGT.
0.5 SHIP MAN SIMULATOR / ENGINE SIMULATOR
0.6 SHIP SAFETY OFFICER COURSE & RA
0.7 MAIN ENGINE COURSE / G6 INTEGRATED
0.8 MARINE AUTO & CONTROLS
0.9 HYDRAULIC COURSE FOR ENGS
1.0 L C H SIMULATOR (OPER / MGT)
1.2 FRAMO
1.3 NABCO/ VOC
1.4 ELECTRICAL FAM. FOR ENGS / ACCIDENT INV
1.5 ELECTRONICS FOR ENGS.
1.6 PRE SEA TRAINING / REVALIDATION COURSE
1.7 AB / MM COURSE
AAA. The seafarer affirms his willingness to embarked / be engaged on vessels planned for him by HP/HC and that
he has not been subjected to exploitation with regards to the offer of engagement on particular ship or by
Particular company.
BBB The Seafarer affirms that he has not been exploited on issues arising out of joining advances or any
Other financial transaction between the shipowner and the seafarers which is handled by HMS.
CCC Seafarer hereby declares that no fees or other charges for recruitment or for providing employment to
the seafarer has been borne directly or indirectly, in whole or in part, by the seafarer
DDD. Seafarer agrees to carry all original certificates with him on board and will be presented to Master when required.
EEE. Seafarer hereby confirms that he holds authentic License/STCW courses. Incase the Issuing
authority has any reservations, the seafarer will be liable for all the consequences, including expenses

CHECKED BY : ______________ SEAFARER : _______________

DATE : ______________ DATE : _______________

 Herald MARITIME SERVICES PVT LTD.
Pre-Engagement Checklist Form : HMS002
Page 2 Rev.No: 01
Date: 01.07.2017

THIS PAGE TO BE COMPLETED PRIOR JOINING

YES
NO No ISSUE DATE EXPIRY DATE REMARK
CREDENTIALS /NO

10 OTHERS
0.1 BIO DATA APPROVED BY HO

11 FLAG STATE DOCUMENTS

(NIS/ PANAMA /MARSHALL ISLAND
BAHAMA / MALTA /CYPRUS )
0.1 CERT OF COMPETENCY
0.2 GMDSS
0.3 CDC
0.4 TANKER ENDORSEMENT – OIL
0.5 TANKER ENDORSEMENT – CHEMICAL
0.6 STCW ENDORSEMENT

12 0.1 MEDICAL (ILO)

0.2 MEDICAL FLAG STATE
0.3 D AND A TEST
0.4 ABDOMEN SONOGRAPHY

13 VESSEL FAMILIARIZATION & SCOPE OF DUTIES

ADVISED

14 WORKING GEAR ISSUED

15 AGREEMENT STUDIED AND ACKNOWLEDGED

16 CONTRACT OF EMPLOYMENT SIGNED & RECEIVED

17 TRAVEL ARRANGEMENTS
0.1 VISA / OK TO BOARD
0.2 FLT DTLS TO AGENTS/VSL
0.3 LETTER/DOCUMENTS FOR
THE MASTER
0.4 AIRTICKET

18 DG PROFILE UPADATED/SUBMITTED TO OFFICE

20 VESSEL MLC COMPLIANCE STATUS ADVISED

10 UNION MEMBERSHIP

NOTE: BY SIGNING BELOW THE SEAFARER CONFIRMS THAT HE HAS READ AND UNDERSTOOD
RELEVANT CBA.

Head (Personnel Department) : ____________________ Seafarer: _____________________

Date : ____________________ Date: ____________________

 Herald MARITIME SERVICES PVT LTD.
D/A UNDERTAKING BY SEAFARER

I, CAPT / MR. __________________________ RANK _______________ ( APP.NO._______)

HEREBY STATE THAT I HAVE READ AND UNDERSTOOD THE DRUG AND ALCOHOL

POLICY OF THE PRINCIPALS. I ALSO DECLARE THAT I WILL ABIDE BY THE ABOVE

MENTIONED POLICY AND WILL UNDERGO, ROUTINE AS WELL AS UNANNOUNCED

DRUG ALCOHOL TESTS CARRIED OUT BY THE OWNER’S REPRESENTATIVE / PORT

STATE AUTHORITIES.

SIGNATURE _____________________

COUNTERSIGNED
FOR HMS ______________________
 Herald MARITIME SERVICES PVT LTD.

ANTI-PIRACY BEST MANAGEMENT PRACTICES

BRIEFING

DECLARATION BY SEAFARER

I, CAPT / MR.___________________________ RANK ______________ APP.NO.__________

HEREBY STATE THAT I HAVE READ AND UNDERSTOOD THE ANTI-PIRACY

INSTRUCTIONS AS GIVEN IN THE OWNER’S REPRESENTATIVE’S QUALITY

MANAGEMENT MANUAL AND FLAG STATE NOTIFICATIONS RELEASED

TILL DATE.

I DECLARE THAT I WILL ABIDE BY THE MENTIONED POLICY AND WILL DEPLOY

ALL SUCH ANTI-PIRACY MEASURES AS WILL BE ADVISED BY THE OWNER’S

REPRESENTATIVE / PORT STATE AUTHORITIES / FLAG STATE AUTHORITIES

SIGNATURE _____________________

DATE _____________________

COUNTERSIGNED
FOR HMS ______________________

DATE _____________________
 NEXT – OF – KIN DETAILS HMS Form.no: HMS/001
APP.NO: ______________ Rev.No : Rev/00

NAME:
Rev.Date______________________
: 09/02/2009 __RANK: ___________ VESSEL: _____________ DATE: ______________

PP.NO: ____________________CDC.NO: _____________ INDOS.NO: _______________ DOB:____ ________

______________________________
NATIONALITY: ____________________________ ADDRESS :
________________________________________________________________

TEL.NO: ___________________ MOB: _________________________ E-MAIL __________________________

__________________________

I) NAME OF NEXT-OF-KIN : ___________________________________

RELATIONSHIP : ___________________________________
PERCENTAGE OF
COMPENSATION : _________________
ADDRESS : ___________________________________
___________________________________
___________________________________
TELEPHONE.NO (RES) : ___________________________________
TELEPHONE.NO (OTHER) : ___________________________________
MOB.NO : ___________________________________
E-mail : ___________________________________

II ) NAME OF NEXT-OF-KIN : ___________________________________

RELATIONSHIP : ___________________________________
PERCENTAGE OF
COMPENSATION : _________________
ADDRESS : ___________________________________
___________________________________
___________________________________
TELEPHONE.NO (RES) : ___________________________________
TELEPHONE.NO (OTHER) : ___________________________________
MOB.NO : ___________________________________
E-mail : ___________________________________

III ) NAME OF NEXT-OF-KIN : ___________________________________

RELATIONSHIP : ___________________________________
PERCENTAGE OF
COMPENSATION : _________________
ADDRESS : ___________________________________
___________________________________
___________________________________
TELEPHONE.NO (RES) : ___________________________________
TELEPHONE.NO (OTHER) : ___________________________________
MOB.NO : ___________________________________
E-mail : ___________________________________

CHILDREN:
NAME OF FIRST CHILD : ___________________________________ DOB __________ SEX _____

NAME OF SECOND CHILD : ___________________________________ DOB __________ SEX _____

NAME OF THIRD CHILD : ___________________________________ DOB __________ SEX _____

SIGNATURE OF APPLICANT : ________________________ DATE OF SUBMISSION : _________________

COUNTERSIGNED BY (FOR OFFICE USE ONLY) : ______________________________

NOTE :
THE COMPANY WILL NOT BE HELD RESPONSIBLE FOR ANY FALIURE ON PART OF THE SEAFARER TO INFORM
ANY CHANGE IN NEXT-OF-KIN DETAILS. THE ONUS OF INFORMING SUCH CHANGES RESTS WITH THE SEAFARER.