APPLICATION FORM

Position Applied For: Master

Personal Data
Surname:LUCIO First Name:MELCHOR Middle Name:GALORIO

Place of Birth:Bayugan Age:48 Sex

Date of Birth:JANUARY 04,1971 Male
Agusan del sur
Blood Type: B Height: 5 ‘6 Weight (kg):78 Eye color:Black Religion: Christian

Permanent Address:17 ZONE 10BagongSilang, Iligan City/Lanao del Norte Zipcode:9200

Tel./Mobile No.09211827538/09551128636 E-mail Address:melabs_lucio@yahoo.com

Contact Address: 17 Zone 10 BagongSilang,Iligan City/Lanao del Norte Tel. No.:63 2245097

SSS No.:08-0936482-4 PhilHealth No.19-0895420097 PAG-IBIG No.:1210-0016-6926 TIN:200-962-173

Civil Status:Married No. of Children:1

Spouse’s Name:Jocelyn P. Lucio Date Married:October 10,2002 Tel./Mobile No.:09551128636

Date of Birth:April 10, 1976 Place of Birth:Lala ,lanao del Occupation:Chief Officer
Norte
Father’s Name:Rodulfo C. Lucio(Deceased)

Address:

Mother’s Name:Maiden:Irene AbcedeGalorio

(Deceacsed
Address:CatianMoncayo Davao del Norte

Name of Children:
Child1:Bridget Dorothy P. Place & Date of Birth: Child3: Place & Date of Birth:
.Lucio BaroyLanao del Norte
Sept. 08,2005
Child2: Place & Date of Birth Child4: Place & Date of Birth:

Next of Kin:Jocelyn P. Lucio Date of Birth: April 10,9176 Relationship: WIFE

Address of Kin: 17 Zone 10 BagongSilang,Iligan City Tel. No.(:63) 2245097

Educational Attainment Attendance Year: Name Of School

Highest Educational Attainment: Associate in Marine Misamis Institute of Technology /
1994- 1997
Transportation Ozamis City ,Misamis Occidental
Highest Educational Attainment: Bachelor of Science in Marine Misamis Institute of Technology /
2000-2001
Transportation Ozamis City ,Misamis Occidental
Vocational : Basic Computer ICI (ILIGAN COMPUTER
2009
INSTITUTE
Documents Number Date Issued Expiry Date Place of Issue
Cagayan de oro
1. Seaman’s Book (SIRB) C0905074 16 Dec.2016 14 Dec.2026
City/Marina
Cagayan de oro
2. Philippine Passport EC5251466 08 Sept.2015 07 Sept 2020
City/DFA
3. Domestic-Certificate of Competency(D-COC) Capacity / Master 19 Feb 2019 19 Feb 2024 Marina/Mla
VISAS
4. US Visa C1/D 20130845460004 26 Mar.2013 24 Mar.2018 Manila/DFA
FLAG STATE ENDORSEMENT
5. Liberia, Panama,Marshall Island,Hongkong
National Certificates
6. Seaman’s Registration Certificate (SRC) CDO3524-97 04 Mar 04,2013 None POEA/ Ortigas
7. Certificate of Competency (COC) 34-25880 18 Dec.2018 13 Dec.2023 Manila/ Marina
8. Certificate of Endorsement (COE) 40-25876 18 Dec.2018 13 Dec.2023 Manila/Marina
9. General Operator Certificate (GOC) 46-68005 18 Nov.2016 18 Nov.2021 Manila/Marina
STCW/ Specialized Courses( COP)
10. Basic Safety Training (BST) 24-109714 18 Nov.2016 18 Nov.2021 Manila/Marina
11. Proficiency in Survival Craft (PSCRB) 15-144888 18 Nov.2016 18 Nov.2021 Manila/Marina
12. Fast Rescue Boat 16-11323 18 Nov.2016 18 Nov.2021 Manila/Marina
13. Advance Training in Fire Fighting (ATFF) 17-119041 18 Nov.2016 18 Nov.2021 Manila/Marina
14. Medical First-Aid (MEFA) 18-222845 18 Nov.2016 18 Nov.2021 Manila/Marina

15. Medical Care (MECA) 19-63878 18 Nov.2016 18 Nov.2021 Manila/Marina

16. Ship Security Officer SSO) 22-20400 18 Nov.2016 18 Nov.2021 Manila/Marina
17. General Tanker Familiarization (GTF) 8-63498 02 Oct.2008
18. Specialized Training for Oil Tanker 9-19493 12 Jan.2009
Deck Certificates
MBTRU-173-14-
19. UpdatingTraining for Basic Safety 02 Jul.2014 None Manila/SIMS
3828
MBTU-173-14-
20. Refresher Training for Basic Safety 03 Jul.2014 None Manila/SIMS
3828
21. Medical Emergency –Basic Training 001671 06 Jan. 1997 None Ozamiz/MIT
22. Personal Survival 001671 06 Jan. 1997 None Ozamiz/MIT
23. Basic Fire Fighting 001671 06 Jan. 1997 None Ozamiz/MIT
24. Personal Safety and Social Responsibilities 001567 08 May 1999 None MIT/Ozamiz
25. Proficiency in Survival Craft& Rescue Boats
PSCC-0890-01 07 Sept.2001 None IDESS/Subic
(PSCRB)
MPFRB-131-12-
26. Proficiency In Fast Rescue Boats 22 Dec.2012 None Manila/Sims
5269
27. Advance Training in Firefighting AFF-080202952 16 Feb.2008 None Manila/ PNTI
28. Medical First- Aid MF070228 14 Feb.2007 None Manila/Maritas
29. Medical Care MECA-090433 30 Oct.2009 None Manila/Exact
30. Ship Security Officer SSO055/0911/01 06 Nov.2009 None Manila/Meridian
31. Ship Safety Officer SSOC047 22Oct. 2009 None Manila/Meridian
32. General Tanker GTF-0183-00 17 Jan.2000 None Manila/Admiral
33. Specialized Training for Oil Tanker STOT-080354A 26 Nov.2008 None Manila/Exact
34. Radar Observer Course (ROC) 000237 24 May 1999 None Ozamiz/MIT
35. Automatic Radar Plotting Aids (ARPA) 12206-07 31 Mar.2007 None Manila/FMFI
36. Radar Simulator Course (RSC) RS01-002-07 25 Jan.2007 None Manila/MTCP
37. INMARSAT IN080118 11 Jan.2008 None Manila/Maritas
38. GMDSS GM080166 18 Jan. 2008 None Manila/Maritas
39. SRRO SR0712113 21 Dec.2007 None Manila/Maritas
40. ECDIS (Generic) ECDS/0810-473 31 Oct.2008 None Makati/Newsim
ECDIS-040117-
41. ECDIS(Generic ) Edition 2012 27 Jan.2017 None Cebu/Far –east
0044PM
42. ECDIS Specific (JRC) 18 Sept.2012 None Makati/Veritas
43. Bridge Resource Management (BRM) SSBT/0701-008 06 Jan.2007 None Makati/Newsim
44. Bridge Team Management (BTM) BTM/0810-156 24 Oct.2008 None Makati/Newsim
45. Ship Handling and Maneuvering SHM-090251PM 16 Oct 2009 None Manila/Exact
46. MLC F1 Updating ACC 2014-115 09 Nov.2016 None Cebu/Newsim
47. MLC F3 Updating ACC-2014-115 14 Nov. 2016 None Cebu/Newsim
48. MLC F1 ACC2011-211 10 Augt.2012 None Makati/Newsim
49. MLCF2 MLCDF2A-CD 07 Dec.2012 None Cagayan/Newsim
50. MLCF3 AC2011-211 24 Augt.2012 None Makati/Newsim
51. Cargo Handling and Care of Cargo DU8M-3995 23 Feb.2007 None Manila/NMP
MCRD-041-13-
52. Crowd Management 09 Augt.2013 None Manila/Sims
15
53. Crisis Management MCRS-032-1320 16 Augt. 2013 None Manila/Sims
54. Practical Fire Fighting PFFC-0322-01 18Augt.2001 None IDESS/Subic
55. Shore –Based Fire Fighting FTPC-0584-01 15 Augt 2001 None IDESS/Subic
56. Gas Measurement Course GMC 2009-436 23 Oct.2009 None Makati/Philcamsat
57. Hazmat 2015-1555 01 Dec.2015 None Manila/ISNTC
58. Human Relationships 002655 06 Jan.1997 None Ozamiz/MIT
59. PADAMS 001070 04 May.1999 None Ozamiz/MIT
60. Deck Watchkeeping 001955 30 Dec.1996 None Ozamiz/MIT
Common Certificates
61. MAIVI1207648 20 July 2012 None Manila/Maritas
62. MARPOL 73/78 Annex I
63. MARPOL 73/78 Annex II
L. Vaccination
Validity: Life
YellowFever 22 Sep 2009
time
Other Couse and Certificates
FDC1M2013-
Training Course for Instructor IMO Model 6.09 22 Mar.13 None NMP/ Makati
0633
PDC2T2016-
Training Course for Assessors IMO. Model 3.12 28 Oct.16 None NMP/Tacloban
00072
Simulator Course for Instructor IMO.Model 6.10 SBT-3729 08 June 18 None
MMAP/Manila
Ship Stability and Trim 17 Dec. 2015 None Keel Marine
IA-ACC 2014-
Certificate of Accreditation of Instructor 23 Sept 2014 23 Sept 2-019 Marina
2383

For the Following Maritime Training Courses Instructor

1. BASIC TRAINING
a) Basic Training Personal Survival Techniques
b) Fire Prevention and Fire Fighting
c) Personal Safety and Social responsibility
2. Advance Training in Fire Fighting
3.)Proficiency in Survival Craft and Rescue Boat(other than Fast Rescue Boat)
4.Consolidated Marpol 73/78,Annexes I-VI
5. Ship Security Officer
6. Ship Security Awareness Training and Seafarers with Designated Security Duties
7.Cargo Handling and Care of Cargo
8.Prevention of Alcohol and Drug Abuse in the Maritime Sector
9.Ratings Forming Part of Navigational watch

For the Following Maritime Training Courses Assessor:

1. Basic -Training Personal Survival Techniques

2. Basic-Training Fire Prevention and Fire Fighting
3. Basic- Training Personal Safety and Social Responsibility
4. Advanced Fire Fighting
5. Proficiency in Survival Craft and Rescue Boats(Other than Fast Rescue Boats)
6. Ship Security Officers
7. Ship Security Awareness Training and Seafarers with Designated Security Duties
8. Ratings Forming Part of Navigational Watch
Sea Experience: most recent experience on the top
Type Main engine Signed on Signed off Total
Name of Vessel Rank Flag Manning Agency Remarks
Gross Tonnage Horsepower (dd/mm/yy) (dd/mm/yy) Months
MITSUI MAN
BULK B&W 6S50MC-
27/Feb/2018 5 mo&9
1. MV SWAN CM C x 1Set Panama Bright Maritime Corp. 18/Sep/2017
days Finished Contract
29,961 9,480 Kw
Mitsui Man
BULK 2&1/2 Sold Ship/change
2. MV NIKA C/M B&W LIBERIA Bright Maritime Corp. 29/Mar/2017 14June/17
month Manning Epsilon
30,011 7,800 kw
Man B&W
BULK 15/ 8 mo.&
3 .MV SAM FALCON C/M Hyundai LIBERIA Bright Maritime Corp. 24 Sept.16 Finished Contract
Jan/2016 9 days
22,137 6480 KW
Man B&W
GEN. CARGO
4. MV GINGA 2/M sulser HONGKONG Tutela Marine Inc 26Augt.2014 03 June 15 9 month Finished Contract
7,170 3,900 KW
Man B&W
GEN. CARGO
5. MV ASIAN NAGA 2/M sulser PANAMA Tutela Marine Inc 26Augt.2013 27 April.14 8 month Finished Contract
9,984
Crude Tanker Man B&W 30Sep 2012 31 Oct.2012
6.MT Almi Sky 3/M LIBERIA Michaelmar Phil Inc 1 month Shipyard/ Sea Trial
84,216 16260 KW
Man B&W
Crude Tanker Finished Contract
7.MT SEACREST 3/M Hyundai Marshall Island Michaelmar Phil Inc 26 Nov.11 29 May.12 6 month
Beaching/Scrap
79,718 20,000KW
Man B&W
Crude Tanker
8.MT SEA WAVE 3/M Hyundai Marshall Island Michaelmar Phil Inc 31 Jan.11 23 Mar.11 3 Month Finished Contract
79,718 20,000KW
Man B&W
Crude Tanker Finished Contract
9.MT LOW RIDER 3/M Hyundai Marshall Island Michaelmar Phil Inc 02 Oct.10 20 Jan.11 4 Month
Lay up Anchor
79,718 20,000KW
DeiselMan
Prod. Tanker Finished
10.MT Arcadia 3/M B&W Valleta Michaelmar Phil Inc 09 Nov.09 09 May.10 6 Month
Contract/Change Crew
28,017 9,267 KW
DeiselMan
Crude Tanker
B&W
11.Overseas JosefaCamejo 3/M Marshall Island OSG 10 Jan.09 01 Augt09 7 Month Finished Contract
62,385 19,640KW

DeiselMan
Prod. Tanker OSG/Merging
12,Overseas Rimar AB B&W Marshall Island 03 Aprl.07 23 Nov.07 8 Month Finished Contract
Michaelmar
28,357 7,572KW
 Prod. Tanker STX Man B&W
OSG/Merging Finished Contract
13.Overseas Alcmar AB Marshall Island 01 May.06 09 Dec.06 7 Month
Michaelmar
30,018 9,623 KW
Man B&W
Prod. Tanker
Samsung 10
14,MT JACAMAR AB PANAMA Michaelmar Phil Inc 10 Feb,04 04 Dec.04
month Finished Contract
60,504 19,460KW
Mitsui Man
Crude Tanker
B&W
15.MT CITY UNIVERSITY AB PANAMA Michaelmar Phil Inc 14 Nov.02 08 Augt.03 9 Month
Finished Contract
24,584 9,610KW
Man B&W
Prod. Tanker
Samsung 10 Finished Contract
16.MT JACMAR AB PANAMA Michaelmar Phil Inc 01,Oct.01 23 Jul.02
month
60,504 19,460KW
Mitsui Man
Prod. Tanker
B&W
17.MT FULMAR D/cadet CYPRUS Michaelmar Phil Inc 28 Jan.00 28 Jan.01 1 Year
Finished Contract
25,368 9,610