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FAIR SPIRIT SHIPPING LTD.

Head Office: # 3 Regina Elsabeta Blvd. Zip Code 900733 CONSTANTA - ROMANIA Web Site: www.fairspirit.ro E-mail: fairspiritshipping@gmail.com Phone / Fax: + 40 241 541 340 / + 40 241 541 380 Mobile: + 40 722 543 591 WE HELP OUR CUSTOMERS TO BE MORE PRODUCTIVE

APPLICATION FORM

(SEA STAFF) STAFF)

Available Salary expectation

12.10.2011 800E

(This paragraph to be fulfilled by crewing agencys officer only)

SEAFARER
INDENTIFICATION DETAILS: LICENSED RANK : O.S LICENSE STCW CODE : PERSONAL DETAILS MARITAL STATUS DATE OF BIRTH PASSPORT NO. SEAMANS BOOK ENGLISH LANGUAGE OTHER LANGUAGE HEIGHT OVERALL USA VISA-VALIDITY MARRIED 10.10.1960 050200296 7154GL YES GREEK 171 RELIGION PLACE OF BIRTH VALIDITY VALIDITY PHONE / MOBILE FAX / E-MAIL WEIGHT SHOE SIZE STUDIES ORTODOX tULCEA 07.06.2015 28.08.2013 0745026033 TUDOR.CHIRIAC@YAHOO.COM 83 KG 42 12 CLASS FIRST NAME SURNAME NATIONALITY CHIRIAC TUDOR ROMANIAN

PRESENT ADDRESS Str.ALUNISULUI NR.12 BL.F2 SC.A AP.19 NEXT OF KIN NAME & ADDRESS : CHIRIAC DANIELA NEXT OF KIN PHONE NO. : 0746033800 WIFE & CHILDREN NAME & SURNAME 1.Chiriac Daniela 2.CHIRIAC OLIMPIU-DUMITRU 3. CHIRIAC ANDREEA LAVINIA 4. 5. STR.ALUNISULUI NR.12 BL.F2 SC.A AP.19

DATE OF BIRTH 01.06.1969 01.03.989 14.12.1994

PLACE OF BIRTH TULCEA TULCEA TULCEA

RELATIONSHIP MARRIED

DOCUMENTS / CERTIFICATES ROMANIAN LICENSE CERTIF. COMPETENCY ROMANIAN S. BOOK OTHERS ENDORS OTHERS BOOK OTHER ENDORSMENT DP COURSE TANKERS OIL TANKERS CHEMICAL TANKERS

NO. T000815 43L

ISSUED 12.06.2009

VALIDITY 12.06.2019

AUTHORITY ROMANIAN ROMANIAN ROMANIAN

PLACE OF ISSUED TULCEA

FTK STK STK

ROMANIAN ROMANIAN ROMANIAN

Fair Spirit Shipping Ltd.

www.fairspirit.ro

LIQUEFIED GAS TANK FAST RESQUE BOARS RANK: NAME:

STK BRS

ROMANIAN ROMANIAN

SURNAME:

RECORD OF PREVIOUS SEA SERVICE * Please start nominate as first as backward COMPANY (OWNER) / FLAG (LAST 6 COMPANIES) GRIMALDI GRIMALDI GRIMALDI GRIMALDI ROM TRUST RANK SHIPS PARTICULARS NAME GRANDE DETROIT GRANDE ANGOLA EUROCARGO SALERNO GRANDE LAGOS HIGH RIDER TYPE RO/RO RO/RO CNTR RO/RO RO/RO OIL TANKER GRT 38651 47330 20775 44410 25800 MAIN ENG/H.P. 11060 19040 12510 11060 2397 DATES FROM 24.01.2010 27.11.2008 14.01.2008 30.03.2007 27.09.2006 TO 11.03.2010 30.06.2009 11.06.2008 14.10.2007 22.11.2006

O.S O.S O.S O.S O.S

I.M.O. UP-DATED COURES *CERONAV -ROMANIAN MARITIME TRANING CENTER - CONSTANTA NO. / SERIES FIRE PREV. AND FIREFIGH. PREVENTION OF POLLUTION MEDICAL FIRST AID TRANSP. AND HANDLING D.G. RADAR PLOTTING ARPA RADAR, BRIDGE TEAM. ARPA SIMULATOR MARITIME ENGLISH, PROBL PROF. FAST RESCUE BOATS ADVANCED FIRE-FIGHTING ADVANCED MEDICAL CARE GMDSS G.O.C. BRIDGE TEAM MANAG. PERSONAL SAFETY(PSSR) TANKER FAM. INERT GAS SYSTEM (I.G.S.) SPEC. OIL TANKER OPERAT. CRUDE OIL WASHING (COW) GAS TANKER FAM. CHEM. TANKER FAM. SAFETY EQUPMENT ON TANK SPEC. CHEMICAL TANKERS SPEC. LIQUIFIED GAZ TANK. PERS. SURVIVAL TECHNIQUE 0010200 0007714 0010200 0007714 CERTIFICATES DETAILS PLACE OF ISSUED DATE VALIDITY ISSUED DATE GALATI GALATI GALATI GALATI 17.07.2009 23.07.2009 17.07.2009 23.07.2009 17.07.2014 23.07.2014 17.07.2014 23.07.2014 A-II/1;A-II/2;A-III/1; A-III/2 A VI / 4-1 A-II/1; A-II/2 A I / 12; A II / 1 A I / 12; A II / 2 0004683 GALATI 29.07.2009 23.07.2014 A-III/1 ; A-III/2 A-VI / 2-2 A VI / 3 A VI / 4-2 A IV / 2 A II / 2 A- VI / 1-4 A V / 1; 1 - 7 A V / 1; 8-14 A V / 1.12 STCW95 CODE

0010200

GALATI

17.07.2009

17.07.2014

AV/1 A V / 1; 15-21 A V / 1; 22-34 A VI / 1-1

Fair Spirit Shipping Ltd.

www.fairspirit.ro

PROF. IN SURV. CRAFT RO-RO PASSENGER SHIPS SHIP SECURITY OFFICER ENGINE TEAM MANAGEMENT ENDORSEMENT

0014685

GALATI

31.07.2009

31.07.2014

A A A A A

VI / 2-1 V / 2;1 up to A V / 2;5 V / 3;1 up to A V / 3;5 / 13.2 III / 2 ; A VIII / 2

Fair Spirit Shipping Ltd.

www.fairspirit.ro