Diirectorate General of Shipping EAC Branch

2" MATE (F.G.) CHECK LIST GENERIC FOR ALL :

NAME OF MERCANTILE MARINE DEPARTMENT

Following nil origirAdocuments 1s required for scrutiny, assessment and booking for Secohd Mate (C) grade.
•0r1g1nfil / copy of es c), document must be arranged In the following sequence.

Name of the Candidate:

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INDOS Nu.:
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1,Sr. No
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: i:Signa lure or verifying DA

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 • Data of Birth:
Required Documents

Form — 29 Original on line OR / Printout of on line

Form — 29 Duplicate to be sited on lint or / Printout for duplicate
Proof of payment
Copy Midical Certificate ( As per MS notice 1 of2015 )
Copy SlIzlit Test Certificate ( As per MS notice 1 of 2015 ) -
Original College Attendance Certificate (2" Mat: Function course) Not applicable to 3
4 ears B.Sc!NSINT/DE (Marine)) Candidates
Copy of INDOS
Copy of Mark sheet X11 ( PCM) — Minimum 50% marks in English
Dc 'me certificate only for D.Sc NS / MS /NT or DE Marine candidates
or 1 Year DGS approved Pre-sea Deck Cadet Course
Cot :DLP I SSTP (18 Months onboard trainin_•rom-arn certificate
Full updated DOS Seafarer's profile print out to be returned after verification
SEATII41E I

b. Copy Of Indian Passport 1" and last page only

nal '
tl. Copy of Watch-keeping Certificates with CTR13
v. Copy 6
f. Co. o:Steering Certificates with CTRB
.•
Original of PSSR. completed and updated
Original of PST course + Up gradation

Original of FPFF + Up gradation

final EFA Course valid within 5 years

3.10CIIMENTS TO DE VERIFIED PRIOR ORALS

I) Original Radar Observer and ARPA Simulator (ROC-ARPA)
Original PSC-RB with us gradation ••
• Original Advanced Fire Fichting (AFF)2010 or + Refresher
Original Medical First Aid (MFA) valid within 5 veers
• 5) V Origin:if Global Maritime Distress and Safety System (GMDSS)
Original of-ECDIS Model 1.27 DGS approved
Ori Plital of SSO or STSDSD if not done earlier
) Si finals Ex5raination answer sheei-(For Function I Oral Eligibility only)
'Siganhore of Candidate • "Signsture

,•
'-tiignaliirr of verifying DA
W1)11:-75=tet-01-2NIFG-GEN 0 i ST JAN 2015
 -

Ye-s/N of Rethark
— NA

III.TIREMENT AS PER EXAMINATION RULES 2014 !ABLE II

a. Verification sea service as-on Indian CDC (All relevant sea time Pages)
ort 1" and last page only
c. Original RPSL Co. Sea-time Letters & Form 111A online update (For Foreign Flag -

g Certificates with CTR13

CTRL;- Duly filled in, completed and signed by Master & CTO
ates with CTRB •
Required Documents Cert.: Number Name of Institute
eted and updated

• Date
Cert. Number Name of Institute
of the-Verifying Clerk Date

Signature of the Approving Authority Dote

- REV 00
 BELOVED@MMDEXAM
Directorate General of Shipping EAC Branch
2" MATE (F.G.) CHECK LIST GENERIC FOR ALL : PDF

NAME OF MERCANTILE MARINE DEPARTMENT MMD KOLKATA

Following all original documents is required for scrutiny, assessment and booking for Secohd Mate (FG) grade.
•0riginal/ copy of each document must be arranged In the following sequence.
Name of the Candidate: PRAVEEN GUPTA

INDOS No.: 18NL0350 • Data of Birth: 16- APR - 1998

ASSESSMENT
CHECKLIST
section A
sr. no. Required documents yes/no/NA remark

1 1.FORM 29

Form — 29 Original on line OR / Printout of on line YES

2 2.FORM 29

Form — 29 Duplicate to be sited on lint or / Printout for duplicate YES

3 3.PROOF OF
PAYMENT

Proof of payment YES

4. COPY OF
4 MEDICAL CERTIFIC

Copyof Medical Certificate ( As per MS notice 1 of2015 ) YES

5.COPY OF SIGHT
5 TEST CERTIFICATE

Copy of Sight Test Certificate ( As per MS notice 1 of 2015 ) YES

6
NO
Original College Attendance Certificate (2" Mat: Function course) Not applicable to
4 ears B.Sc!NSINT/DE (Marine)) Candidates

7 7. COPY OF INDOS

Copy of INDOS YES

8 COPY OF
MARKSHEET XII

Copy of Mark sheet X11 ( PCM) — Minimum 50% marks in English YES

9 9.DEGREE
CERTIFICATE
Degree certificate only for D.Sc NS / MS /NT or DE Marine candidates YES

10
copy of 1 Year DGS approved Pre-sea Deck Cadet Course NO
 BELOVED@MMDEXAM
11
copy of DLP/ SSTP (18 Months onboard trainin_ NO

12 12.PROFILE

Full updated DGS Seafarer's profile print out to be returned after verification YES

13
SEATIME TIREMENT AS PER EXAMINATION RULES 2014 TABLE II

13.a

a. Verification sea service as-on Indian CDC (All relevant sea time Pages) YES

13.b

b. Copy Of Indian Passport 1" and last page only YES

13.c FORM III

c. Original RPSL Co. Sea-time Letters & Form 111A online update (For Foreign Flag YES

Bridge Port
ER

d. Copy of Watch-keeping Certificates with CTRB YES

13.e

e.copy of CTRB;- Duly filled in, completed and signed by Master & CTO YES

13.f

f. Copy of Steering Certificates with CTRB YES

DOCUMENTS TO BE SHOWN AND TAKEN AWAY- PLEASE FIL IN THE CERTIFICATES NO AS
APPLICABLE OR WRITTEN NA
Sr. no. Required documents cert. number name of institute
1 Original of PSSR. completed and updated 7915 T.S.CHANAKYA
2 Original of PST course + Up gradation 7915 T.S.CHANAKYA
3 Original of FPFF + Up gradation 7915 T.S.CHANAKYA
4 Original EFA Course valid within 5 years 7915 T.S.CHANAKYA

signature of verifying DA Date

DOCUMENTS TO DE VERIFIED PRIOR ORALS cert. number name of institute

1 Original Radar Observer and ARPA Simulator (ROC-ARPA)

2 Original PSC-RB with us gradation
3 • Original Advanced Fire Fichting (AFF)2010 or + Refresher
4 Original Medical First Aid (MFA) valid within 5 veers
5 Origin:if Global Maritime Distress and Safety System (GMDSS)
6 Original of-ECDIS Model 1.27 DGS approved
7 Ori Plital of SSO or STSDSD if not done earlier
8 Si finals Ex5raination answer sheei-(For Function I Oral Eligibility only)

Signature of Candidate

,•
'-tiignaliirr of verifying DA Signature of the Approving Authority