POS-FIL SHIP MANAGEMENT CORPORATION

7th Floor Jemarsons Place, 1626 Pilar Hidalgo Lim Street Malate Manila, Philippines 1004 P.O. Box 1560 Phones 516-8800 to 02 Email Add: smc@pos-fil.com SHIPBOARD EMPLOYMENT APPLICATION
POSITION APPLIED: A/B Able Seaman (1ST CHOICE) A/B Able Seaman (2ND CHOICE) DATE AVAILABLE: __Anytime This Nov. 2011__ PHOTO X 2) PHOTO (2(2 x 2 )

DATE APPLIED: _Nov. 21, 2011___

I. PERSONAL INFORMATION
NAME HEIGHT CITY ADDRESS PROVINCIAL RELIGION Capate
( LAST NAME )

Jefferson
( FIRST NAME )

Macabante
( MIDDLE NAME )

178cm WEIGHT 69kgs AGE 141c K7th St., Kamias, Quezon City, Metro Manila Purok 1, Lapuz St., San Roque, Cabiao, Nueva Ecija 3107 R. Catholic SSS 33-9348939-3 Kathryn Gail G. Capate House Wife 1

BIRTH DATE BIRTH PLACE 26 yrs. old

13-Sept.-1985 Cabanatuan City STATUS Married TEL. NO. 09217512892 TEL. NO. 09217512892 TIN Agustin A. Capate Lina M. Capate
Purok 1, Lapuz St., San Roque, Cabiao, Nueva Ecija 3107
( SPECIFY SIZES IF S / M / L / XL / XXL )

NEXT OF KIN
SPOUSE NAME OCCUPATION NO. OF CHILDREN FATHERS NAME MOTHERS NAME ADDRESS

EDUCATIONAL ATTAINMENT
COURSE BS Marine Transportation SCHOOL Technological Institute of the Philippines SCHOOL ADDRESS Quiapo, Manila
( CITY & PROVINCE )

WORKING GEARS
COVER ALL

XL XL WINTER JACKET 28 SHOES ( IN CMS ) WINTER BOOTS(CMS) 28

INCLUSIVE YEAR

2005-JUNE-2009-SEPT.

(YY/MM/DD - YY/MM/DD )

II.

LICENSES / ENDORSEMENT / BOOK / ID

LICENSES GRADE NUMBER 0713060049374 DATE ISSUED Dec. 17, 2007 EXPIRY DATE Dec 17, 2012

PHILIPPINE LICENSE COC / ENDORSEMENT PANAMA LICENSE / SBOOK PANAMA GMDSS / SBOOK GOC CERTIFICATE PASSPORT PHILIPPINE SEAMANS BOOK SRC ID US VISA MCV ( Maritime Crew Visa ) NAC CERTIFICATES

EB0238195 B1079013 0517808-05 20O7332217OO01/94224481

May 19, 2010 Oct. 5, 2011 Nov. 14, 2011 Nov. 29, 2007

May 18, 2015 Oct. 3, 2016 Nov. 27, 2012

BSC

PSCRB

AFF
ISSUED BY Manila Manila

MEFA

MECA

GTF
NUMBER

STOT

OTHERS:
ISSUED BY

III.

TRAINING CERTIFICATES
NUMBER 338834 227007 DATE ISSUED Dec. 11, 2007 Dec. 11, 2007 CERTIFICATE SSO AIS ERSC / ERM WATCHKEEPING CULINARY MSM/STEWARD WELDING YELLOW FEVER OTHERS: DATE ISSUED

CERTIFICATE BST W/ PSSR PSCRB AFF MEFA MECA ROC/ROP ARPA RSC INMARSAT GMDSS SSBT / BRM

QA 046293

Nov. 08, 2007

Nov. 2017

IV.

SEA SERVICE RECORD

FLAG PANAMA PANAMA PANAMA
SINGAPORE

NAME OF VESSEL M/V HOJIN M/V HOJIN M/V IWAMI M/V IMARI M/V KEY ACTION

SALARY RANK US$ $500 $900 $900 $900 $1200 D/BOY

TYPE OF VSL / ENG. PCC PCC

OS Gen.Cargo OS CONTAINER OS BULK AB

PANAMA

GRT HPOWER 57,871 12,175KW 57,871 12,175KW 14,162 6,480KW 18,602 13,753KW 43,024 8,250KW

EMBARKED TOTAL DISEMBARKED SERVICE Jan. 18, 2008 May 09, 2008 3M21D May 09, 2008 Aug. 28, 2008 3M20D Jan. 21, 2009 Sept. 28, 2009 8M7D June 22, 2010 Sept. 07, 2010 2M17D Jan. 14, 2011 Sept.10, 2011 7M28D

AGENCY PRINCIPAL NYK-Fil NYK-Fil

REMARKS Prom. OS Finished Cont.

NYK-Fil Finished Cont. NYK-Fil Finished Cont. NYK-Fil Finished Cont.

I HEREBY CERTIFY AND DECLARE THAT THE INFORMATION GIVEN BY ME IS TRUE AND CORRECT AND IF EVER FOUND TO BE FALSE IT WILL BE SUFFICIENT GROUND FOR DISMISSAL: WHO RECOMMENDED YOU TO THIS COMPANY? WALK-IN
DOC NO.: QR-RH-ASE-7512 REV NO.: 02 REV DATE: 19 MAY 2008

____________________________ SIGNATURE OF APPLICANT