CURRICULUM VITAE

PERSONAL DETAILS

Full Name MOHAMAD SIMON

Place,date of Birth Kampung Baru, 04 July 1996
Nationality Indonesia
Sex/Height/Weight/Blood Male/163 cm / 58 Kg /”A” Coverall = M Shoes = 41
Marital Status Single
Religion Moslem
Address Kampung Baru Kab. Penajam Paser Utara, Kalimantan Timur
Country Indonesia
Phone Mobile +6282256647458
Email mohamadsimon2@gmail.com

Personal Document Number Place Of Issued Date Of Issued Date Expiry

st
Passport C 4020018 Makassar Jul 01 , 2019 Jul 01st, 2024
Seaman Book F 253272 Makassar Aug 23rd, 2019 Aug 23rd, 2022

CERTIFICATE OF COMPETENCY

Certificate Certificate Number Place of Issued Date of Issued

Engine Officer Class IV (Operational) 6211440973T40619 Jakarta Aug 19th, 2019

Endorsement Class IV (Operational) 6211440973TD0619 Jakarta Aug 22nd, 2019

CERTIFICATE OF PROFICIENCY

Certificate Certificate Number Place of Issued Date of Issued

Basic Safety Training (BST) Revalidation 6211440973010619 Barombong May 04th, 2019
Proviciency In Survival Craft and Rescue Boat
6211440973040617 Barombong Jul 06th, 2017
(PSCRB)
Advance Fire Fighting (AFF) 6211440973060616 Barombong Nov 23rd, 2016
Medical First Aid (MEFA) 6211440973070617 Barombong May 03rd, 2017
Medical Care On Board Ship (MC) 6211440973080617 Barombong Jul 06th, 2017
Security Awareness Training (SAT) 6211440973310616 Barombong Nov 14th, 2016
Engine Room Resource Management (ERM) 6211440973270619 Barombong Apr 30th, 2019
Basic Training for Oil and Chemical Tanker
62114409732390619 Barombong Jul 16th, 2019
Cargo Operations (BOCT)
Advanced Training for Oil Tanker Cargo
62114409732410619 Jakarta Jul 23rd, 2019
Operations (AOT)

SEA SERVICE EXPERIENCE

Type of Sign
Name of Ship Flag GT / HP Rank Name of Company
Vessel On/Off
207 / 10-10-2017
TB. Perkasa I Indonesia Tug Boat 2x1100 HP
Engine Cadet PT. KSA
15-10-2018

I hereby affirm that all the information provided by me in this form is true and correct to the best of my acknowledge.

Best Regards,

MOHAMAD SIMON