APPLICATION FORM RANK APPLIED FOR CHIEF OFFICER/SKIPPER Date of Availability

As soon as posibleNAME OF APPLICANT

Hajdukovic Milan Citizenship Montenegrin Age: 51

E-mail : milanhaj@gmail.com

E-mail : podgorbar@t-com.me

Home Address

BB. Bjelisi, 85000 Bar- Montenegro

Telephone No.GSM No.

00382 69 552405 Mob.

Date and place of Birth Bar , 19.01.1965

Marital Status Divorced No. of Children : 2 ( two ) dotherNEXT OF KIN Hajdukovic Kristina Relationship : DotherAddress Same as above Tel : 00 382 69 467450 Bjelisi, b.b.

PERSONAL DOCUMENTS Number Place Issued Date Issued Valid TillSeaman’s Discharge Book 1834 Bar 27.10.2014 27.10.2024Passport B83LZ7017 Bar 28.05.2013 28.05.2026USA visa ( if any )Other Visas

NAT. LICENCE Capacity Number Place/Date Is.

Valid till

Certificate / EndorsmentSTCW-2/II

Master from 500 to 3000 BT No. 0404-403-6198/16

Montenegro14.10.2016

14.11.2018

FLAG ENDORSEMENTS Number Place Issued Date Issued Class / GradeMontenegro Same as above Bar- Montenegro 14/10/2016 Master Licence from 500

to 3000 BT

St.Vincent and the Grenadines Officer in charge of a Navigational watch (II/1)

D/G130221162951/

G

Geneva-21/02/2013

Ch.Mate21.02.2018

CERTIFICATES HELD Number Place Issued Date IssuedBasic safety A-VI/1 0404-404-6542/15 Bar 21.12.2015PSCRB VI/2 0404-404-6543/15 Bar 21.12.2015Med. First Aid VI/4 0404-404-6544/15 Bar 21.12.2015Medical Care VI/4 0404-404-6545/15 Bar 21.12.2015Adv. F.F. VI/3 0404-404-6546/15 Bar 21.12.2015GOC IV/4 Radar-04-5223/2 Kotor 23.10.2015ROC R.874/2015 RAA Kotor 23.10.2015Dang. Cargo B-V/4,V/5 0404-404-6222/15 Bar 30.11.2015Marine Environmental awareness

2774 Bar 12.10.2016

Platform Supplay Vessel PCV 10/149 MA/D00283 Marrseille-France 21.10.2010 Dynamic Position Simulator Course

No. DP 0478 Split -Croatia 24.02.2011

Dynamic Position B/Induction Course

No. DP 0444 Split- Croatia 25.10.2010

Helicopter Underwater Eskape Training Course

HUET- 020/2011 Sibenik-Croatia 08.03.2011

DPO LOG BOOK No.0478 Split -Croatia 24.02.2011SSO No.0405-404-9075/15 Kotor 06.11.2015SECURITY Awarnes IMETA/COP/5711 Singapure 29.11.2013LNG FAMILIARISATION Miaheel Staufeldt Soyo- Angola 02.05.2012Familiarization Train. A-VI/1

O4 - 978 Bar 10.03.2011

GMDSS 0405-403-8950/15 Kotor 29.10.2015ECDIS No.810/2015 Bar 27.10.2015Managament &Tim Work on board

No.803/2015 Bar 26.10.2015

Bridge Resources Menagment

No.808/2015 Bar 31.10.2015

English Language Test/Marlin’s Test

No.59EE8A210D74BE8B Kotor 27.10.2015

Security Awareness Certifficate

No.0405-404-9261/15 Kotor 09.11.2015

Certifies on Completed Training- SSO

No.04-5223/2 Kotor 28.10.2015

Medical Fitness Certificate

No. 2152 Bar 30.12.2015

HEALTH CERTIFICATE Intnl. / Flag Date Issued Validity Drug & Alcohol TestBar - Montenegro Montenegro-Kotor 27.10.2015 27.10.2017 Montenegro-Kotor

Medical Fitness Report Montenegro-Bar 30.12.2015 31.12.2017 Montenegro-Bar

ADDITIONAL EDUCATION COURSE OF GERMAN SHIPPING LAW- MSG MARINE SERVE-HAMBURG,/12.05.2010ADDITIONAL TRAINING PAUSE- TRAINING COURSE(WEST AFRICA) ON 28th April 2007

LANGUAGE V. Good Good Satisfactory PoorEnglish Yes

Spanish-Portugese Yes

SEA SERVICE FOR LAST 7 YEARS OR MORE SHIPS

Vessel’s Name Period at sea months days

Signed on Signed off Position Type of Vesl.

BRT Type of ME

Seabulk Raven 02/07 02.03.2007 06.05.2007 2nd mate AHTS 1608 Man 7760 SB Raven 02/01 04.07.2007 03.09.2007 2nd Mate AHTS 1608 Man 7760 SB Raven 03/10 07.11.2007 15.02.2008 2nd/Ch.M AHTS 1608 Man 7760 SB Raven 02/00 23.04.2008 23.06.2008 2nd Mate AHTS 1608 Man 7760 SB Raven 02/00 27.08.2008 27.10.2008 2nd Mate AHTS 1608 Man 7760 Seacor Express 02/10 17.12.2008 26.02.2009 2nd Mate AHTS-DP1 1777 Man 5280 Seacor Express 03/09 21.08.2009 30.11.2009 Ch.Mate AHTS-DP1 1777 Man 5280

Bourbon Artabaze00/24 15.07.2010 09.08.2010 Ch.Mate AHTS-

DP2 2343 Motor 2x4000k

Bourbon Liberty 115 02/00 16.08.2010 18.10.2010 Ch.Mate

PSV/DP2-ASD

1517 D.Elect. 2582

Bourbon Liberty 115 01/26 05.12.2010 29.01.2011 Ch.Mate PSV/DP2-ASD

1517 D.Elect. 2582

Bourbon Liberty 115 02/04 25.03.2011 29.05.2011 Ch.Mate PSV/DP2-ASD

1517 D.Elect. 2582

Warlock 02/02 13.09.2011 13.11.2011 Ch.Mate AHT-ASD 609 Man 5300Svitzer Soyo 02/15 11.04.2012 26.06.2012 Ch.Mate TUG/ ASD 601 Nigata 2x2200 Svitzer Soyo 03/15 07.09.2012 18.12.2012 Ch.Mate TUG/ ASD 601 Nigata 2x2200 Svitzert Soyo 03/03 09.02.2013 10.05.2013 Ch.Mate TUG/ ASD 601 Nigata 2x2200 Svitzer Soyo 01/21 25.07.2013 14.09.2013 Ch.Mate TUG/ ASD 601 Nigata 2x2200 Svitzer Soyo 02/04 19.12.2013 19.02.2014 Ch.Mate TUG/ ASD 601 Nigata 2x2200

I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE TO THE BEST OF MY ABILITY AND THAT NO CERTIFICATE OF COMPETENCE OR LICENCE ISSUED TO ME HAS EVER BEEN REVOKED OR SUSPENDED.I UNDERSTAND THAT PREVIOUS EMPLOYERS MAY BE ASKED FOR INFORMATION CONCERNING MY EMPLOYMENT RECORD WITH THEM AND I HEREBY RELEASE FROM LIABILITY OR DAMAGE THOSE INDIVIDUALS OR COMPANIES WHO PROVIDE SUCH INFORMATION.

Place and date : Bar-Montenegro ,17.10.2016

Signed : Hajdukovic Milan