Documents Required For Assessment - Check List For 2mfg 1mfg And Master Fg 03032016 (2) 3jd6w

Directorate General of Shipping, EAC Branch

Documents to be submitted for Assessment of Eligibility for Writtens/Orals Name of the MMD: Checklist Rev.2 dtd 03.03.2016 Candidate Name: ___________________________ INDOS No. ________________________ DOB: _______________ Candidate Mobile No. ______________________ Email id: _____________________

Grade: Master / ASM (F.G) SNO

Particulars

1

For Written Assessment Assessment online payment receipt printout copy

2

Form-29 (previously called as Form-15) - Print out of application submitted online using e-Samudra (Colour Photograph in light back ground )

3

Sea service letters from the Indian ship owners / RPSL agencies - addressed to the Principal Officer, MMD (original)

4 5 6 7 8 9 10 11

Article of agreement copies for service in Indian ships* Form -3A copy in case of service in foreign flag ships copy* Bridge WKG duties certificate issued by Master copy CDC relevant pages copies Valid Medical certificate and eye sight test report (Copy only) port - First and last page copy only. Chief Mate F.G COC (issued by DGS) copy ASM (FG) course completion certificate issued by DGS approved institute(copy) For Orals Assessment

12 13 12 15

Seat Booking online payment receipt printout copy Ship Security Officer course certificate copy ECDIS course certificate copy Ship Manouvering Simulator (SMS) course copy

For making an application for COC 16 Certificate of Competency as GMDSS Radio Operator Refresher training in PSCRB and PST (Required only if the initial course certificates are 17 more than five years old) Refresher training in AFFF and FPFF (Required only if the initial course certificates are 18 more than five years old) Refresher and updating training course for deck officers - management level - 11 days (Applicable for all the candidates obtained their first mate FG COC under the STCW 19 1995 syllabus) *Note: If sea service is shown in the Master Checker then AOA and Form 3A will not be required

Candidate's Signature ____________________

Enclosed Original photocopy verified by YES/ NO / the Principal NA Yes/No/NA

Directorate General of Shipping, EAC Branch

Documents to be submitted for Assessment of Eligibility for Writtens/Orals Name of the MMD: Candidate Name: ___________________________ Checklist Rev.2 dtd 03.03.2016 INDOS No. ________________________ DOB: _______________ Candidate Mobile No. ______________________ Email id: _____________________

Grade: Chief Mate (F.G) SNO

Particulars

1

For Written Assessment (Phase I) Assessment online payment receipt printout copy

2

Form-29 (previously called as Form-15) - Print out of application submitted online using eSamudra (Colour Photograph size: in light blue back ground )

3 4 5 6 7 8 9 10 11

Sea service letters from the RPSL/Owner company (original) Article of agreement copies for service in Indian ships* Form -3A copy in case of service in foreign flag ships copy* Valid Medical certificate and eye sight test report (Copy only) Bridge WKG duties certificate issued by Master (copy) CDC relevant pages copies port first and last page only copy 2nd Mate F.G COC (issued by DGS) copy Phase I course completion certificate issued by DGS approved institute (copy)

For Written Assessment (Phase II) 12 Assessment online payment receipt printout copy (previously called as Form-15) - Print out of application submitted online using e13 Form-29 Samudra (Colour Photograph size: in light blue back ground ) 14 15 16 17 18 19 20

Sea service letters from the RPSL/Owner company (original) Article of agreement copies for service in Indian ships* Form -3A copy in case of service in foreign flag ships copy* Bridge WKG duties certificate issued by Master (copy) CDC relevant pages copies port relevant pages copies Phase II course completion certificate issued by DGS approved institute (copy) For Orals Assessment

21 22 23 24 25

Seat Booking online payment receipt printout copy Radar & Navigation Simulator (RANSCO) course copy

DGS approved ECDIS course copy Ship Security Officer course (SSO) copy Ship Masters Medicare (Medicare) course copy *Note: If the sea service is shown in the Master checker then the copy of AOA and Form 3A not required

Candidate's Signature ____________________

Enclosed Original photocopy verified by YES/ NO / the Principal NA Yes/No/NA

Directorate General of Shipping, EAC Branch

Documents to be submitted for Assessment of Eligibility for Writtens/Orals Name of the MMD: Checklist Rev.2 dtd 03.03.2016 Candidate Name: ___________________________ INDOS No. ________________________ DOB: _______________ Candidate Mobile No. ______________________ Email id: _____________________ Grade: Second Mate (F.G) SNO

Particulars

1

For Written Assessment Assessment online payment receipt printout copy

2

Form-29 (previously called as Form-15) - Print out of application submitted online using e-Samudra (Colour Photograph in light back ground )

3

Sea service letters from the Indian ship owners / RPSL agencies - addressed to the Principal Officer, MMD (original)

4 5 6 7

Article of agreement copies for service in Indian ships Form -3A copy in case of service in foreign flag ships copy SSTP completion certificate, in case of DNS candidates Valid Medical certificate and eye sight test report (Copy only)

8

Essential pages of Cadets Record Book for DNS and B.Sc candidates. (Original CRB will be verified during the oral examination)

9 10 11 12 13 14 15 16 17 18

Record of 6 M bridge WKG duties documented in approved record book copies DGS approved Pre-sea course completion certificate copy HSC/XIIth STD/Degree Mark sheet copy Personal Survival Techniques course copy Elementary First Aid course copy Fire Prevention and Fire Fighting course copy Personal Safety and Social Responsibility course copy CDC relevant pages copies port first and last page and relevant pages copy Indos copy Second Mate (FG) 4 months functions course completion certificate with the result of 19 Internal Assessment copy (NA for 3 or 4 year B.Sc NS/NT/BE -Marine candidates)

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Additionally for the candidates from the Rating Stream: Letter of eligibility issued by the MMD copy Foundation course certificate from Institute copy NWKO-NCV Course completion certificate from Institute copy NWKO-NCV certificate from Institute copy For Orals Assessment

24 25 26 27 28 29 30 31 32

Seat Booking online payment receipt printout copy Radar Observer and ARPA Simulator (ROC-ARPA) course copy Proficiency in survival craft rescue boats courses (PSC-RB) course copy Advanced Fire Fighting (AFF) course copy Medical First Aid (MFA) course copy Electronic Chart Display and Information System (ECDIS) course copy Global Maritime Distress and Safety System (GMDSS) course copy Designated Security Duties (STSDSD) or Ship Security Officer (SSO) course copy Degree certificate for B.Sc NS /MS/NT/BE Marine (Provisional or Final degree) copy Candidate's Signature ____________________

Enclosed Original photocopy verified by YES/ NO / the Principal NA Yes/No/NA