Checklist of MEO Class IV

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Directorate General of Shipping EAC Branch

CIIECK LIST FOR MEO CLASS IV


NAME OF MERCANTILE MARINE
DEPARTMENT
Fotto*tng Docu*""ts Are Required to be submitted For MEO CLASS IV Part A Exemptiop & faft B Examination
and Assessment Requirements
Photo Copy Of Each Document must be Self Atteste
Name Of The Candidate: Date:

PART A EXEMPTION & EXAMINATION.


S.NO NAME OF DOC.UMENTS YES/NO REMARKS
I Copy of CDC- (1" & LastPage) aodlrel9Yq4 :grytcg lages.
2. Copv ofPassport. (1" & Last Page)
J. Coov of INDOS No. Certificate
4. Fees - Evidence ofFees Paid
Copy of Education Qualification. As applicable
6. Copy ofPre Sea course
7. Copy of Valid Medical Fitness Certificate (DGS Approved Doctor)
DOCUMENTS TO BE SHOWN -PLEASE FILL IN TIIE CERTIFICAIE NO
NAMEOF
S No. Details of documentS' CERT NO
INSTITUTE
l. Original of STCW Course as follows:-
i) Personal Survival Techniques or Refresher if more than'5 years old
Fire Prevention & Fire Fighting or Refiesher if more than 5 years
ii) ,
old
iiD 'Elementary First Aid valid within 5 years
iv) PSSR within 5 years or Refresher
v) STSDSD
Sigrrature of Veriffing DA' Approving Authority

Based on above information the candidate is exempted from PART A/ Eligible to appear in part A,

PART B EXAMINATION AND ASSESSMENT REQUIREMENTS


Original Sea Services letter issued by the Owner / RPSL address to
I concerned PO MMD YES AIO REMARKS IF ANY
, Copy of Sea Service Testimonials. Indicating Article / Propelling time
3. Copfr"f ,qrticle of Agreem€nt / Form 3A
4. Coov of CDC includine relevant pages of sea service-
5. Siehtine of Orieinal TAR BOOK.
6. Copv of Seafaren Profile for checking Data
Evidence ofFees Paid
DOC B OWN -PLEASEFILLINTHE FICATE NO
sNo NAME OF DOCUMENT CERT NO NAME OFINSTITUTE
I Original of Engine Room Simulator Course. (Done after the required sailing)
) Orieinal of STCI$/ Course as follows:-
il | pSCnS valid within 5 yrs or refresher
ii) | Advance Fire Fiehtine Valid within 5 years or refresher
iii)'l Medical First Aid vAiO wittrin last 5 years
iv) I SSO or STSDSD
Sigrature of the Candidate DATE

Signature ofthe Verifing DA APPROVING AUTHORITY DATE

wPIF-7.5-2A-03-MEO-CLry OTST JAN 2OI5 REV OO

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