APPLICATION FORM

Rank CHIEF OFFICER Date of birth 19-DEC-1985

Surname KULYUK Place of birth UKRAINE, ODESSA reg. B-DNESTROVSKIY
First name YURIY Home address UKRAINE, ODESSA reg. B-DNESTROVSKIY
Patronymic ALEKSEY Mobile +380639977211
Personal details

Marital status MARRIED E-mail [email protected]

Next of kin/relationship/address/phone KULYUK SVETLANA / MOTHER / UKRAINE , ODESSA reg. B-DNESTROVSKIY / +380633949934
Test Marlins Test CES Height 183 Clothes size 52 Hair color BLOND
Language knowledge (english) good
Result 100% Result 90% Weight 85 Shoes size 43 Eye color BLUE
Education (University, College) Year of graduation Speciality
Kyiv State Maritime Academy After Hetman Petro Konashevich-Sahaydachniy 2014 Navigation
Maritime College Named After O.I.Marinesko of National University "Odessa Maritime Academy" 2011 Navigation
Bilgorod-Dnistrovsky Sea Fishing College 2006 Technician-Mechanic
Document Grade Number Place of issue Issued date Expire date
Seaman's book AB 623314 ILLICHIVSK 04.06.2018 04.06.2023
Passport (foreign) FN325860 UKRAINE 07.08.2017 07.08.2027
USA Visa C1/D KYIV 11.09.2017 07.09.2027
AUSTRALIA VISA (AIR TRAVEL) class ZM 22.12.2017 22.12.2020
Documents

CAYMAN ISLANDS ENDORSEMENT CHIEF MATE 15.09.2018 13.11.2020

CAYMAN ISLANDS SEAMAN'S BOOK 15.09.2018
MARSHALL ISLANDS ENDORSEMENT CHIEF MATE 22.02.2016 13.11.2020
MARSHALL ISLANDS GMDSS ENDORSEMENT 22.02.2016 13.11.2020
MARSHALL ISLANDS RECORD BOOK 22.02.2016 21.02.2021
PANAMA ENDORSEMENT CHIEF MATE 24.08.2016 13.11.2020
PANAMA GMDSS ENDORSEMENT 24.08.2016 13.11.2020
PANAMA SEAMAN'S BOOK 25.08.2016 13.11.2020
CERTIFICATE OF COMPETENCY of CHIEF MATE 00753/2015/03 ILLICHIVSK 14.12.2015 13.11.2020
GMDSS 00491/2015/03 ILLICHIVSK 14.12.2015 13.11.2020
RADAR, ARPA 3096 ILLICHIVSK 02.11.2015 02.11.2020
ECDIS 5544 ILLICHIVSK 02.11.2015 02.11.2020
BRIDGE TEAM & RESOURCE MANAGEMENT (MANAGEMENT LEVEL) 6971 ILLICHIVSK 30.10.2015 30.10.2020
BASIC SAFETY TRAINING 31077 ILLICHIVSK 26.10.2015 26.10.2020
SURVIVAL CRAFT & RESCUE BOAT 24562 ILLICHIVSK 27.10.2015 27.10.2020
Certificates

ADVANCED FIRE FIGHTING 17654 ILLICHIVSK 29.10.2015 29.10.2020

MEDICAL FIRST AIDS 7768 CHORNOMORSK 17.02.2017 17.02.2022
MEDICAL CARE 3886 ILLICHIVSK 30.10.2015 30.10.2020
DESIGNATED SECURITY DUTIES 2459/2018 ODESSA 21.08.2018
SSO 3357 ILLICHIVSK 23.10.2015 23.10.2020
PHYSICAL EXAMINATION REPORT ODESSA 24.07.2019 23.07.2021
YELLOW FEVER ODESSA 07.10.2014 07.10.2024
D & A TEST ODESSA 24.07.2019 23.07.2021
HAZMAT/Carriage of dang.&hazard.subst. 11514 ILLICHIVSK 02.11.2015 02.11.2020
HAZMAT training program "C", title 49 (USA) 11514 ILLICHIVSK 02.11.2015 02.11.2020
Type Specific ECDIS Training
Special training & Other courses

ECDIS FURUNO FEA2107 / FEA2807 08.01.2014

ECDIS FURUNO FMD3100 / FMD3200 / FMD3200BB / FMD3300 01.04.2019
ECDIS JRC JAN7201 / JAN7201S / JAN9201 / JAN9201S 24.08.2018
ECDIS JRC JAN7201 / 9201 20.12.2017
JRC ECDIS 24.07.2015
Other courses
BRIDGE RESOURCE MANAGEMENT VLADIVOSTOK 23.01.2017
CARGO HANDLING CONTAINER VLADIVOSTOK 20.10.2011
ELECTRIC COURSE ODESSA 23.08.2017
BEHAVIOR BASED SAFETY ODESSA 24.12.2016
CARGO HANDLING PCC ODESSA 10.02.2017
Type of vessel Owner's name Date Date
Name of vessel Flag Rank
Gross Tonnage Crew management company from to
CONT MOL Mitsui O.S.K. Lines
MOL MAXIM MARSHALL ISLANDS Chief Officer 10.10.2019 12.12.2019
78316 ATIS LTD
CONT MOL Mitsui O.S.K. Lines
MOL MAXIM MARSHALL ISLANDS 2nd Officer 02.08.2019 10.10.2019
78316 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
ELEGANT ACE CAYMAN ISLANDS 2nd Officer 14.10.2018 02.03.2019
58939 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
HEROIC ACE PANAMA 2nd Officer 12.01.2018 03.05.2018
56439 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
ETERNAL ACE PANAMA 2nd Officer 03.03.2017 11.07.2017
59022 ATIS LTD
Previous experience

PCC MOL Mitsui O.S.K. Lines

PROMINENT ACE PANAMA 2nd Officer 07.08.2016 29.11.2016
57789 ATIS LTD
CONT MOL Mitsui O.S.K. Lines
MOL MATRIX MARSHALL ISLANDS 2nd Officer 30.01.2016 16.05.2016
78316 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
ETERNAL ACE PANAMA 2nd Officer 11.06.2015 14.10.2015
59022 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
ETERNAL ACE PANAMA 2nd Officer 14.10.2014 20.02.2015
59022 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
PROMINENT ACE PANAMA 2nd Officer 08.03.2014 08.06.2014
57789 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
PROMINENT ACE PANAMA 3rd Officer 28.01.2014 08.03.2014
57789 ATIS LTD
CONT MOL Mitsui O.S.K. Lines
MOL PERFORMANCE PANAMA 3rd Officer 01.05.2013 10.09.2013
74071 ATIS LTD
PCC MOL Mitsui O.S.K. Lines
PLANET ACE PANAMA 3rd Officer 15.08.2012 06.02.2013
38349 ATIS LTD
CONT MOL Mitsui O.S.K. Lines
MOL PERFORMANCE PANAMA 3rd Officer 07.12.2011 18.05.2012
74071 ATIS LTD
Nationality of crewmembers sailed with: FILIPINO, RUSSIAN, PANAMIAN Your comments:
Remarks:

Recommendations: Through phone call to last management company min wage 3800$
Phone of last shipowner (Crew company) Crew management company ATIS LTD. +38(048)237-62-28 / +38(048) 237-87-05 expected wage 5500$
Others: Web site: atis.od.ua; e-Mail: [email protected]; Crew Manager Sergey Melnik +380688248611 expect.duration 4 month
readiness to work end of may
Date 5/4/2020 Signature of applicant Chief Officer / Yuriy Kulyuk / Sign.