FORM 29
(See Rule 72)
GOVERNMENT OF INDIA
MINISTRY OF PORTS, SHIPPING AND WATERWAYS
DIRECTORATE GENERAL OF SHIPPING
Application for Examination and Assessment for certificates under Merchant
Shipping (Standards of Training, Certification and Watch-keeping for Seafarers)
Application No. : AT/MMD(KO)/2025/10014107 Received Date :09/04/2025
A. Grade of Examination : First Mate of a Foreign Going Ship
Place of Examination : MMD KOLKATA
1. Full Name : AMRENDRA KUMAR
(Block letters)
2. Permanent Address : 851214, Khagaria,Bihar,India
AT/MMD(KO)/2025/10014107
3. Present Address : Vill Chaidhabannipo Babubagicha,Khagaria,851214 Bihar,India
4. Telephone Number : 9334204329
(with STD Code)
5. Nationality : INDIAN
(Proof to be produced)
6. Passport Number : Z7289566
7. Date and Place of Issue : 26/10/2023 At PATNA
8. Continuous Discharge : CL 51906
Certificate (C.D.C)
Number
9. Date and Place of Issue : 31/08/2004 At Kolkata
10. Date of Birth : 01/06/1985
(Proof to be produced)
11.Place of Birth : KHAGARIA
12.Personal Identification : MOLE ON RIGHT FINGER
marks
13. INDos No : 05YL0034
14. Email Id :
[email protected]Note : Any Person who makes, causes to be made or assists in making any false representation for the purpose of obtaining for himself /
B. DETAILS OF SCHOLASTIC EDUCATION :
(Separate sheets must be attached)
1.Scholastic Education Level : 10+2 (HSC/Intermediate/equivalent)
2.Principal Subjects : Math
3. Year of Passing : 2004
4. School/College/ Board : R.K.K.COLLEGE PURNEA BIHAR INTERMEDIATE EDUCATIN COUNCIL
5. Address of the Institution : PURNEA BIHAR
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C. DETAILS OF PRE-SEA TRAINING / MARINE ENGINEERING WORKSHOP :
(Separate sheet must be attached )
1. Training Institute : Maritime Education Training And Research Institute
2. Address of the Institution : Abhishek Point, 4th Floor, 152, S.P. Mukherjee Road, Kolkata ,Falta Industrial Growth Center
Sector IV, FALTA,
,700026 [email protected],033-24657162,03174-222069
3. Attended From : 01/03/2004 To 20/07/2004
4. Result : PASS
5. Courses Attended : Pre Sea Training for Rating
D1. DETAILS OF SEA-GOING SERVICE (FOR DECK DEPARTMENT PERSONNEL) :
Port of Trade: Period
Gross
Name of Registry/ NCV/ FG/
Type Tonnage Rank From To Remarks
Ship Official Coastal
Number Months
Days
M.T TOP GRAND Oil Tanker 30965 panama FG Second Officer 30/07/2024 03/02/2025 6 5
M.T ESTELLA Oil Tanker 28799 PANAMA FG Second Officer 14/02/2024 11/06/2024 3 27
M. T VIGOR Oil Tanker 160058 panama FG Second Officer 11/05/2023 03/07/2023 1 24
M. T VORAS Oil Tanker 157831 SAO TOME FG Second Officer 10/04/2023 10/05/2023 1 1
AT/MMD(KO)/2025/10014107
M. T VORAS Oil Tanker 157831 sao tome FG
Watch Keeping
Deck Officer
OINW or Third
officer
30/10/2022 09/04/2023 5 11
Watch Keeping
Deck Officer
M. T. HORNET Oil Tanker 149282 PANAMA FG 02/10/2021 02/06/2022 8 2
OINW or Third
officer
Watch Keeping
Deck Officer
M. T ABYSS Oil Tanker 58141 Vietnam FG 06/11/2020 19/04/2021 5 14
OINW or Third
officer
Watch Keeping
Deck Officer
M. T SARAK Oil Tanker 83616 quesm FG 06/11/2019 19/07/2020 8 14
OINW or Third
officer
Watch Keeping
M. T SEA SKY(EX SEA Chemical Tanker Deck Officer
4954 panama FG 05/10/2018 17/04/2019 6 14
DRAGON) OINW or Third
officer
Watch Keeping
Chemical Tanker Deck Officer
M. T SUN OCEAN 6149 panama FG 26/05/2018 20/08/2018 2 26
OINW or Third
officer
Watch Keeping
Deck Officer
M. T DARUSH Product Tanker 3764 TOGO FG 05/08/2017 26/08/2017 0 22
OINW or Third
officer
Watch Keeping
Deck Officer
M. V. VIR VARENYA Cargo Ship 7175 MUMBAI FG 04/02/2017 18/04/2017 2 13
OINW or Third
officer
Watch Keeping
Deck Officer
M. T GPT 1 Oil Tanker 28414 PANAMA FG 25/12/2015 26/06/2016 6 3
OINW or Third
officer
Special Category : 1.Nature
HONG of watch keeping - Assistant
M.T.RAINBOW QUEST Product Tanker 28547 FG AB 27/08/2010 28/06/2011 10 3
KONG Officer of Navigational
Watch,
Special Category : 1.Nature
M.V. MAERSK of watch keeping - Assistant
Container Ship 74642 392515 FG AB 15/05/2009 07/04/2010 10 24
KWANGYANG Officer of Navigational
Watch,
Special Category : 1.Nature
of watch keeping - Assistant
M.V. KUKAWA Bulk Carrier 13978 DOUGLAS FG AB 12/09/2007 12/06/2008 9 1
Officer of Navigational
Watch,
Special Category : 1.Trade
Area - Indian Coast,
Ordinary Seaman
M.T. HOPE ISLAND Product Tanker 569 PANAMA INC 04/09/2006 07/03/2007 6 4 2.Nature of watch keeping -
Assistant Officer of
Navigational Watch,
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Port of Trade: Period
Gross
Name of Registry/ NCV/ FG/
Type Tonnage Rank From To Remarks
Ship Official Coastal
Number Months
Days
Special Category : 1.Nature
Trainee Deck of watch keeping - Assistant
M.V. FORTUNE Bulk Carrier 2981 PANAMA FG 17/03/2005 26/11/2005 8 11
Rating Officer of Navigational
Watch,
E-1 REPORT ON STRUCTURED ON-BOARD TRAINING :
Phase No Date Of Name of Master Details Of Certificate Of Competancy
E-2 REPORT OF DESIGNATED COMPANY TRAINING OFFICER :
Signature :
Name : Certificate No. :
AT/MMD(KO)/2025/10014107
E-3 REPORT OF HEAD OF ASSESSMENT CENTRE :
Signature :
Name : Official Stamp :
F. REPORT OF ASSESSMENT CENTRE :
POST-SEA APPROVED EDUCATION AND TRAINING AT APPROVED INSTITUTION LEVEL
2M(Operational)/1M&M(Management)
Function /Part Institution From To Remarks
Indian Institute of Port Management (IMU Kolkata) 16-AUG-2011 15-DEC-2011
PHASE1 Hoon Maritime Institute 15-JUN-2022 14-SEP-2022
PHASE2 SEI Educational Trust 15-JUL-2023 14-OCT-2023
F-2 REMARKS OF HEAD OF ASSESSMENT CENTRE :
ELIGIBILTY FOR OPERATIONAL/MANAGEMENT LEVEL(Phase I & II)
ELIGIBILITY FOR WRITTEN FUNCTION I/II/III/ASM
ELIGIBILTY FOR ORALS FUNCTION I/II/III/ASM
* Online application may be provisionally approved subject to verification of Originals during Orals
Signature :
Name : Official Stamp :
G. PARTICULARS OF STCW CONVENTIONS MODULAR COURSES (POST-SEA) :
Period
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STCW Reg. /
Sr. Validity
Courses STCW Code Cert. No. Approved Institution
No.
No From To
3030086412210349(part
1 Refresher Training for Medical First Aid Hoon Maritime Institute 19-SEP-2022 19-SEP-2022 04-JUN-2026
B)
Refresher Training For Proficiency In PSCRB 30300862122104210(pa
2 Hoon Maritime Institute 17-SEP-2022 17-SEP-2022 27-JUN-2026
rt B)
30300861122104113(Pa
3 Refresher Training for Proficiency in PST Hoon Maritime Institute 17-SEP-2022 17-SEP-2022 28-JUN-2026
rt B)
303008612210349(partB
4 Refresher Training for Proficiency in FPFF Hoon Maritime Institute 16-SEP-2022 16-SEP-2022 07-MAY-2026
)
Refresher Training for Advanced Training in 3030086312210328(part
5 Hoon Maritime Institute 16-SEP-2022 16-SEP-2022 06-MAY-2026
Fire Fighting B)
BPMA/PSSR/4959/2016
6 Personal Safety & Social Responsibilities A-VI/1-4 BP Marine Academy 30-AUG-2016 01-SEP-2016
Electronic Chart Display and Information BPMA/ECDIS/472/2015
7 BP Marine Academy 23-NOV-2015 27-NOV-2015
Systems
Advanced Training for Chemical Tanker BPMA/CHEMCO/517/20
8 BP Marine Academy 02-DEC-2014 12-DEC-2014
Cargo Operations 14
Advanced Training for Oil Tanker Cargo BPMA/ATOT/872/2014
9 BP Marine Academy 17-NOV-2014 27-NOV-2014
Operations
10 Ship Security Officer BPMA/SSO/2506/2014 BP Marine Academy 13-NOV-2014 15-NOV-2014
11 General Operator`s Certificate for GMDSS KOL/R/933 Seacom Marine College 06-AUG-2012 23-AUG-2012 16-OCT-2022
12 Automatic Radar Plotting Aids A-II/1 L / 252 /04 Sensea Maritime Academy 17-FEB-2012 22-FEB-2012
13 Radar Observer Simulator A-II/1 K / 217 / 04 Sensea Maritime Academy 06-FEB-2012 16-FEB-2012
CMET /AFF 310 / 2805 Centre for Maritime Education And
AT/MMD(KO)/2025/10014107
14 Advanced Training in Fire Fighting A-VI/3 23-JAN-2012 28-JAN-2012
Training
CMET / MFA /338 /1255 Centre for Maritime Education And
15 Medical First Aid A-VI/4-1 16-JAN-2012 19-JAN-2012
Training
Proficiency In Survival Craft and Rescue BPMA /PSCRB /2390 /
16 A-VI/2-1 BP Marine Academy 23-DEC-2008 27-DEC-2008
Boats 2008
METRI /CERT /PST/ 054Maritime Education Training And
17 Personal Survival Techniques A-VI/1-1 24-JUN-2004 26-JUN-2004
/10 Research Institute
METRI /CERT /EFA/ 020Maritime Education Training And
18 Elementary First Aid A-VI/1-3 21-JUN-2004 22-JUN-2004
/10 Research Institute
METRI /CERT/FPFF/ Maritime Education Training And
19 Fire Prevention & Fire Fighting A-VI/1-2 17-JUN-2004 19-JUN-2004
025/10 Research Institute
H. PREVIOUS CERTIFICATE ( Issued in India or elsewhere, If none state so) :
If any time suspended or cancelled, state
Place & date of Examination
Number Certificate
Class /Grade
Details Examination Issue Date
Court of Authority
Date Cause
Second Mate of a Foreign Going
1 IF-31076
Ship
MUMBAI 30-JAN-2024
Second Mate of a Foreign Going 22-AUG-2019
2 IF31076
Ship
MUMBAI
Second Mate of a Foreign Going
3 IF-31076
Ship
MUMBAI 10-SEP-2014
I. DECLARATION TO BE MADE BY THE CANDIDATE :
I hereby declare that the particulars contained in the form are correct and true to the best of my knowledge and belief
and that the papers enumerated and sent with this form are true and genuine documents given and signed by the person
whose name appears on them. I further declare that Section D contains a true and correct account of my sea-going service
without exception and I make this declaration conscientiously believing the
AMRENDRA KUMAR The above declaration was signed in my presence.
Signature of the candidate Examiner of Masters and Mates
Mercantile Marine Department.........................District
J. REQUEST FOR ALLOTMENT OF SEATS FOR EXAMINATION :
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K 1. Sight Test :Date of Examination : _________________Result _____________Signature of Examiner
K 2. RESULT OF EXAMINATION :( for official purpose only) :
L. REPORT OF EXAMINATION CENTRE
1. I hereby certify that Amrendra Kumar has satisfactory produced testimonials and proof of sea-going
service/watch keeping service/approved workshop training as required for the grade.
2. The candidate complies with the examination of the Merchant Shipping Standards (Standards of Training
Certification and Watch-keeping for Seafarers) Rules, 1998 for the grade of First Mate of a Foreign Going Ship
3. The candidate has passed his examinations for the functions as under :
Function
Phase Level
Written Written Examiner Oral Oral Examiner
AT/MMD(KO)/2025/10014107
M. FOR THE CHIEF EXAMINER OF MASTERS AND MASTES
1. I hereby certify that Amrendra Kumar born at Khagaria on 01.06.1985 has satisfactory produced his testimonials and
proof of Sea-going Service/Watch Keeping Service.
2. The candidate complies with the Merchant Shipping (Standards of Training Certification and Watch-keeping for
Seafarers) Rules, 1998 for the grade of First Mate of a Foreign Going Ship
3. The candidate has passed the examination of the functions as under :
Phase Level Function Sign. of Examiner with Remarks
Written Oral
The candidate meets the requirements be eligible to be issued the Certificate of Competency as ...............................................
provisional certificate issued No.................................................................... on....................................................................
Examiner of Masters and Mates
Mercantile Marine Department
N. FINAL ASSESSMENT PRIOR CERTIFICATION
Medical Fitness
Pre-Sea Training
Structured on Board Training
Sea-Service Requirement
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Written Examination (Assessment)
Oral Assessment
Modular Courses
Eligibility
Certificate for Competency First Mate of a Foreign Going Ship as recommended by Mercantile Marine Department may be issued.
Assessor at Directorate General of Shipping for Masters and Mates.
Remarks_____________________________________________________________________
Chief Examiner
(Masters and Mates)
AT/MMD(KO)/2025/10014107
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