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T:+35725882230| F:+35725882599
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(
1)Seaf
arerAppl
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cat
ion
Appl
i
cantI
nfor
mat
ion
Ful
lName: D.
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LAVILLA REUBEN JR A 31 DECEMBER 1991
Last Fi
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Addr
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St
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LAMBUNAO ILOILO 5042 PHILIPPINES
Town/Ci
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ePhone: 09956442362 Bi
rt
h: LAMBUNAO ILOILO
Email
: reubendecember31@gmail.com
LandLi
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Wei
ght(
kg)
:
Hei
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cm)
: 160 62
Mar
it
alSt
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MERRAID Nati
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FILIPINO

Dat
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Ty BULK,CONTAINER
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Posi
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ORDINARY SEAMAN

Near
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Cont
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ber ✔ssenger: MSTeams: Zoom:Other:               
: FBMe

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Document Doc.# I
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Passpor
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Document Doc.# I
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1.RATING FORMING PARTS OF NAV. WATCH 25-136602 15 JAN. 2016 UNLIMITED PHIL.
2.COP BT BT200041204521 19 MAY 2021 20 MAY 2026 PHIL.
3. COP PSCRB PSCRB200026133621 19 MAY 2021 19 DEC. 2025 PHIL.
4.COP SDSD W/SSA 27-433232 12 NOV.2015 UNLIMITED PHIL.
5. CON. MARPOL I-VI 015844 11 DEC. 2015 UNLIMITED PHIL.
6. HAZMAT HHA-IH-542AM/PM 04 DEC. 2015 UNLIMITED PHIL.
7. MARITIME ENGLISH 104645 22 SEP. 2017 UNLIMITED PHIL.
8.

9.

10.
11.

12.

13.

14.

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16.

17.

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 SeaSer
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STAR SCARLETT 9567051 LIBERIA 91,971 16,860 MAN B&W o/s 24.05.21 29.04.22 AUGUSTEA SHIP MANNING
PHIL.(+639173187557)

STAR SCARLETT 9567051 MALTA 91,971 16,860 MAN B&W

D/C 05.06.19 12.08.20 AUGUSTEA SHIP MANNING
PHIL.(+639173187557)
FORTUNE LEGACY CEB1006926 PHIL. 972 1,492 D/C 04.03.14 25.03.15 FORTUNE SEA CARRIER

3/
6
(
2)NextofKi
n(N.
O.K.
)Nomi
nat
ion

Seaf
arerDet
ail
s(2A)
             
Fir
st
Fami
l
yName:  LAVILLA  
Name: REUBEN JR    
Rank: ORDINARY
  SEAMAN   D.
O. : 31.12.91
B.      
             
NOTES:
Nominatedper
sonsmustbei ncompli
ancewit
hinherit
anceandot herappropr
iat
enati
onallaws.Thedocumentisv
alidasfrom t
hedatestat
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for
mi ncl
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ngallsubsequentassi
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tisyourresponsi
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tytoprovideanyupdatedinf
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dualsdefi
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on1B.Thismayal soincl
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ormationforper
sonsnominatedprev
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signed,andsubmit
tedunderthesecir
cumstances.

Iher
ebynomi natet
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owingindi
vidual(
asstat
edin2B)asthepointofcontacti
ncaseofanemergencyandthebenef
ici
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whosestat
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pri
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gni
ngthisform.

Seaf
arer
'sSi
gnat
ure: Dat
e&Pl
ace: 03 NOV. 2022 ILOILO
   
           

N.
O.K.Det
ail
s(2B)
           

Fami
l
yname:  
LAVILLA   Fi
r IMEY
stName:  
Ti
tl
e  
  D.
O. 19.10.94
B.  
Relati
onshi
pto
WIFE
   
seafarer
:        
             
Resi
dence:   BRGY. BAGONGBONG LAMBUNAO
   

ZI
Pcode:   5042 Ci
ty:   ILOILO Count
ry:  PHIL
Phone(
LandLi
ne)
:  
  Mobi
l
ePhone:   09165755256
Emai
l
:    
             
Chi
l
dren'
sDet
ail
s(2C)
 
Thef
oll
owi
ngi
nfor
mat
ioni
srequi
redf
ori
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ancepur
poses
No.ofChi
l
dren(
present
lyunder21y
ear
s): 3   
Speci
fyD.
O.B.andnameofeachchi
l
dher
e:
1. FAITH ALLEAH LAVILLA 02.03.2013  

2. SOFFIA KZHENIA EMMANUELLE LAVILLA 27.12.2017

 

3. RAVEN LAVILLA 10.04.2018

 
 
       
NextofKi
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TOBEREVI
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Forf
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 Ourdat aprotecti
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 GDPRenqui r
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:GDPR@mar l
owgroup.
com

4/
6
            
DECLARATI
ONOFCONSENT
   
     
Inaccor dancewi thr egul ation( EU)2016/ 679oft heEur opeanpar li
amentandoft hecounci l of27Apr il2016ont hepr otect ion
ofnat uralper sonswi t
hr egar dt opr ocessi ngofper sonal dat aandt hef reemov ementofsuchdat aandr epealingdi rect ive
95/ 46EC( GDPR) .Iher ebygi v emyex plici
tconsentf ort hecompany( asdef inedi ntheseaf arer ’
sempl oymentagr eement ),to
hold, process, store,transf er,transmi tandusemyper sonal inf or
mat ion( asst at edint hisf orm)f orthepur poseofi nsur ance
claimsmadei nli
ghtofani ncident( acci dentori l
lness) .Iacknowl edget hatIhav ether ightt oaccesssuchper sonal dat aas
keptbyt hecompanyaboutmeandIhav ether ightt ocor rectsuchi nfor mat ionwhenappr opr i
at eev i
dencecanbepr ov ided
aboutt hei nfor mationbei ngi ncor rect.Iacknowl edgemyr esponsi bi l
ityt opr ov ideanyupdat edi nformat i
ont ot hecompany ,
whi chr equi r
esmyr ecor dshel dbyt hecompanyt obe- correct ed.Iunder standt hatunt i
lthecompanyr eceiveswr i
tten
not i
fi
cat ionf rom meofanychangest obemade, thatt hecompanyshal lassumet hatal li
nf ormat i
ont heyhav eaboutmei nit
s
recor dsi scor rect.Iunder standt hatthecompanywi llprov ideandsubmi tmyper sonal det ailstoi nsurancecompani esf orthe
pur poseofi nsur ancecl aimsmadei nli
ghtofani nci dent( acci dentori l
lness) .Iacknowl edget hatIam ent i
tledatanyt imet o
withdr awmyconsentf oranyf urt herpr ocessi ngofmyper sonal i
nf ormat ionhel dbyt hecompanyi naccordancewi thmy
ri
ght sundert helaw.Per sonal dat acol lectedaboutmewi llbeadequat e, rel
ev ant ,andl imitedt owhati snecessar yandwi ll
onlybeusedf orthepur posei twasobt ained.Al lper sonal dat aaboutmewi l
l bekeptonl yf orasl ongasi snecessar yand
processedi namannert hatinsur esappr opriatesecur ityagai nstunaut hor isedorunl awf ulpr ocessi ng,accident all
oss,
dest r
uct ion,ordamage, usingappr opr i
at etechni cal oror gani sationmeasur es.Fur t
heri nfor mat ioniscont ainedi nthe
company '
sdat apr otect ionandpr ivacypol i
cieswhi chwi llbemadeav ailabl et omeoncet hecompanyhast hissignedf or m.I
under standt hatt hecompanyi snotpr ev entedf rom di sclosingmyper sonal i
nf or mat i
onwhenr equi r
edoral lowedt odosoby
l
aw.Thi si ncludescasesconcer ningnat i
onal orpubl icsecur ity,commi ssi on, prev entionofcr imi naloffensesorl egal
proceedi ngs.Iher ebyconf ir
mt hatIhav eread, under stoodt heabov eandagr eet ot hecompanypr ocessingofmyper sonal
i
nf ormat i
onf orr easonsout l
i
nedabov e.

Dat
e&Pl
ace:
03 NOV. 2022 ILOILO
Seaf
arerFul
lName&Si
gnat
ure: LAVILLA L, REUBEN JR ARMDA
Dat
e&Pl
ace:

LAVILLA, IMEY LEBUNA 03 NOV. 2022 ILOILO

N.
O.K.Ful
lName&Si
gnat
ure:

         
COMPANYCOLUMN REVI
EWED:
 

ENTERED:

         
Ascannedcopyoft
hesi
gnedf
ormt
obesentt
othecr
ewmanagerv
iaemai
loror
acl
e(asappr
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5/
6
(
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PROCESSI
NGCONSENTRELATI
NGTOAPPLI
CANTPERSONALI
NFORMATI
ONI
NCLUDI
NGPROCESSI
NGOFANYSENSI
TIVEDATA.

I
MPORTANTNOTICE:WEACKNOWLEDGERECEI
PTOFYOURAPPLI CATI
ON,HOWEVER,UNDERREGULATION(EU)2016/
679OFTHE
EUROPEANPARLI
AMENTANDTHECOUNCILOF27APRIL2016,
REPEALI
NGDIRECTI
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,WEREQUI REYOURSI
GNED
CONSENTFORFURTHERPROCESSI
NGOFYOURAPPLI
CATIONANDANYPERSONALI NFORMATI
ONPROVI DEDTOUS.

PLEASEREAD,
SIGNANDSUBMI
TTHELETTERBELOW ALONGWI
THYOURRESUMEORCV.

DearSi
rorMadam,

AsdefinedbyAr ti
cleII
,paragraph1(f)oft
heMar i
ti
meLabourConv enti
on2006,Iher
ebygiv
emyexpli
citconsenttotheMarl
owGr oup
ofCompani es(herebyref
erredtoas“ t
heCompany”)tocol
l
ect,hold,pr
ocess,
stor
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ansf
erandusemypersonalinf
ormati
on,i
ncl
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sensi
ti
v edata,
asr el
evant,requi
red,
andappropr
iat
etomyr equestforemploy
ment.
Incompliancewi t
hanymandat orylegalr
equi
rements,myper sonaldet
ail
smaybeshar edwithShip-owners,I
ssuingAut
hori
ti
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otherthi
rdpar t
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ei sal egi
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matereasonfordoingso.Suchi nf
ormationmayi nclude(butnotl i
mitedto)i
dent
if
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document s,pr
ofessi
onalandtrai
ningquali
fi
cati
ons,seaser
vice,previ
ousexper
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menti nf
ormationsuchasinter
view
andtestresult
s.
Iacknowl
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yt oprovi
deaccurateinf
ormat i
onrelat
ingt omyappli
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hatshoul
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employmentbyt heCompany ,arecordcontaini
ngmyper sonali
nformationr elat
ingtotheperfor
manceofmyempl oymentwillbe
creat
ed.Iunderstandthatunti
ltheCompanyhasr ecei
v edanot if
icati
onofanychangesr elati
ngtomypersonalinf
ormat
ion,the
companyshall
actont hebasi
sthatall
informati
onprovi
dedi scorr
ectlyi
ndueor deranduptodate.
Underdatapr otecti
onlaws,Ial
soacknowledgethatIhaveal egalr
ightt
oviewanypersonali
nfor
mati
ont heCompanymayhav einit
s
possessi
onr elati
ngtome.Wher einf
ormationisincor
rect
,Icanamendsuchi nf
ormat
ionwheresuffi
cientevi
dencecanbeprovided.I
n
fur
theraccordancewi t
hdataprotect
ionl
aws, Ial
soacknowledgemyent i
tl
ementtowit
hdrawconsentatanytimeregar
dingprocessi
ng
ofmyper sonal i
nformati
on.
Al
lpersonaldat
aaboutmewillbekeptonlyforasl
ongasnecessar
yandwi l
lbehandledsecurel
yagainstunaut
hor
izedorunl
awf
ul
pr
ocessing,
acci
dent
all
oss,
destr
uct
ion,ordamageusi
ngappr
opri
atetechni
cal
oror
ganizat
ionalmeasur
es.
Iherebyconfi
rmt hatIhaver
ead,under
stood,andagreetotheprocessi
ngofmyper sonalandsensi
tiv
ei nfor
mat
ionforthereasons
outl
i
nedabov eincludi
ngtheperfor
manceofmySeaf arerEmploy
mentAgr eementandnotwithst
andi
ngt hatmyexpl
ici
tconsentmay
notberequi
redbyv ir
tueofAr
ti
cle6(a)t
o(e)andArti
cles9and10oft heGDPR.

Forf
urt
heri
nfor
mati
onr egar
ding:
 Ourdat apr
otecti
onpolici
esandpr
act
icespl
easer
eadourPr
ivacyPol
i
cyv
isi
tmar
low-
nav
igat
ion.
com/
en/
pri
vacy
-pol
i
cy.
asp
 GDPRenqui riespleaserefert
oGDPR@mar l
owgr
oup.
com

Se
afa
rern
ame
: LAVILLA, REUBEN JR ARMADA

Da
te&Pl
ace
: 03 NOV. 2022 ILOILO

Si
gna
tur
e:

Di
str
ibuti
on:Pl
easesubmitacopyofthi
sfor
m si
gnedandcomplet
edalongwithyourr
esumeorCVt otheappropr
iat
elocalMar l
ow
Manningagencyoryouronl
i
ne‘JobsatSea’
appl
icat
ionv
iaourr
ecrui
tmentpage:marl
ow-nav
igat
ion.
com/en/marl
ow-career
s.asp

6/
6