CHIEF MATE (FG) CHECK LIST MERCANTILE MARINE DEPARTMENT, MUMBAI DOCUMENTS TO BE SUBMITTED Fé ‘OR ASSESSMENT OF ELIGIBILITY FOR WRITTEN/ORALS _._ INDoS No — NAME - ee _—_— _—_—— =a ontcivat_} ‘ ENCLOSED | VERIFIED By sk PARTICULARS suoracory | tne not WeS/NO/Na | priverea igs : : __| vesimomna le T Written Assessment (PHASE-|) - [Form 29 Prat out of application submitted online using e-Samudra | form 7 [ 3. Tassessment online payment receipt printout copy Icocreevan pagescones 1 Passport relevant pages copies i Inds copy [2nd Mate £.G Coc. (issued by DGS) Copy. Sea service letters from the RPSL / Owner company (Original) Tree ‘Ord Bridge WKG duties Certificate issued by Master. j Voi Mesical cenvficate and eye sight test report | 11_Phase -1 Course Completion certificate issued by OGS approved institute { | au Written Assessment (PHASE-II) _ [12 [form 29 - Print out of application submitted onling using e-Semudra 1 | 13. |Assessment online payment receipt printout copy 1 COC relevant pages copies ee i Passport relevant pages copies | 16 Sea service letters from the RPCL/Owner company (Original) [3 [hecord ge WAG dts Coifeate sued by Mater 16 [Vaid Medical certificate and eye sight test report. | 19, [nase a Course Completion certificate issued by GS approved nature 7 - For Orals Assessment = 20 [Radar & Navigation Simulator (RANSCO) Course copy [21 [Ship Masters Medicare Course copy { 22. ]etectronc char Display and information Systems (ECDIES) course copy 4 [fame securt Ose 550) our copy Note: Originals of the above mentioned documents to be produced at the time of Assessment, Candidate's Signature:,_