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.01 APPLICATION FOR EMPLOYMENT RECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE Rank Ch Mate First Name Tahir Last Name Kapisazovic Nationalit y Montenegro Date & Place of Birth: 30 th July 1966. Podgorica Marital Status: Married Present Address: Popovici bb, 85000 Bar, Montenegro Next of Kin: Wife Home phone: +382 30 344 240 Name / Relationship: Dzenana / Wife cell phone: +382 69 594 060 Address: Popovici bb, 85000 Bar - MONTENEGRO Fax: +382 30 344 240 Email: [email protected] Next of kin Cell Phone : +382 69 611 380 Father’s name Seko Mother’s name: Garajfila Nearest Airport: Podgorica Km from Airport: 50 Present Employer: Mediterranean Shipping Company SA Languages: English, Italian Tel + email: +39 081 5321530 [email protected] Medical Certificate issued: Private clinic Expired: 31/12/2012. Previous Employer: - Any visa issued: USA- C1/D Expired: 30/08/2013. Tel + email: Weight(kg) 91 Height(cm) 186 Coverall Size: 62 Shoes Size: 43 Hair: Bro wn Eyes: Brown Position Applied: Master Date of availability: 01 st August 2015 Education: high/secondary school (4 years) , Nautical college (4 years) Last wage (inclusive of leave pay): 6200€ Licence (Certificate of Competency) Licence Country Grade of Licence Number Place & Date Issued Date Expired Montenegro Master 02-1822 Bar, 23/04/2010. 23/04/2015. Panama Master CTB401451 NI Napoli, 20/09/2010. 23/04/2015. Passports – If several passports write them all. Number Place Issued Date Issued Date Expired P94AF0909 PJ Bar 29/05/2008. 29/05/2018. Seaman’s Book - If several seaman’s books write them all (even if expired) Country Place Issued Date Issued Number Date Expired Montenegro Bar 04/03/2011. 85/2011 04/03/2021. Panama Napoli 09/10/2015. CTC134422 07/05/2020. DP Log Book Country Place Issued Date Issued Number Date Expired NA DP Certificates Certificates Place Issued Date Issued Number Date Expired DP Basic (induction) NA DP Advanced NA DP Limited NA DP unlimited NA Application Form Page 1 of 4

CV Tahir Kapisazovic 22-03-2016

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Page 1: CV Tahir Kapisazovic 22-03-2016

.01

APPLICATION FOR EMPLOYMENTRECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

Rank Ch Mate First

Name Tahir Last Name Kapisazovic Nationali

ty MontenegroDate & Place

of Birth: 30th July 1966. Podgorica Marital Status: MarriedPresent

Address:Popovici bb, 85000 Bar, Montenegro Next of Kin: Wife

Home phone: +382 30 344 240 Name / Relationship: Dzenana / Wifecell phone: +382 69 594 060

Address: Popovici bb, 85000 Bar - MONTENEGROFax: +382 30 344 240

Email: [email protected] Next of kin Cell Phone : +382 69 611 380Father’s name Seko Mother’s name: Garajfila

Nearest Airport: Podgorica Km from

Airport: 50 Present Employer: Mediterranean Shipping Company SA

Languages: English, Italian Tel + email: +39 081 [email protected]

Medical Certificate issued: Private clinic Expired: 31/12/2012. Previous

Employer: -

Any visa issued: USA- C1/D Expired: 30/08/2013. Tel + email:Weight(kg

) 91 Height(cm) 186 Coverall Size: 62 Shoes Size: 43 Hair: Bro

wn Eyes: Brown

Position Applied: Master Date of availability: 01st August 2015Education: high/secondary school (4 years) , Nautical college (4 years)

Last wage (inclusive of leave pay): 6200€

Licence (Certificate of Competency)Licence Country Grade of Licence Number Place & Date Issued Date ExpiredMontenegro Master 02-1822 Bar, 23/04/2010. 23/04/2015.Panama Master CTB401451 NI Napoli, 20/09/2010. 23/04/2015.

Passports – If several passports write them all.Number Place Issued Date Issued Date Expired

P94AF0909 PJ Bar 29/05/2008. 29/05/2018.

Seaman’s Book - If several seaman’s books write them all (even if expired)Country Place Issued Date Issued Number Date ExpiredMontenegro Bar 04/03/2011. 85/2011 04/03/2021.Panama Napoli 09/10/2015. CTC134422 07/05/2020.

DP Log BookCountry Place Issued Date Issued Number Date ExpiredNA

DP CertificatesCertificates Place Issued Date Issued Number Date ExpiredDP Basic (induction)

NA

DP Advanced NA

DP Limited NA

DP unlimited NA

Application Form Page 1 of 3

Page 2: CV Tahir Kapisazovic 22-03-2016

.01

APPLICATION FOR EMPLOYMENTRECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

CertificateCertificates STCW Date Issued Place Issued Expiration

date License Number

Yellow Fever certificate 20/01/2009. Piran-Slovenia 20/01/2019. B5447

Helicopter Underwater Escape Training NA

Helicopter Landing Officer NA

MEDICAL (First Aid) VI/4 30/04/2015. Bar 30/04/2020 0404-404-1979/15

MEDICAL (Care) VI/4 30/04/2015. Bar 30/04/2020 0404-404-1980/15

ARPA 06/01/2001. Kotor Unlimited 0038701RAA

GMDSS IV/2 07/05/2015 Kotor 07/05/2020 0405-403-3365/15

Advanced Fire Fighting VI/3 30/04/2015 Bar 30/04/2020 0404-404-1982/15

PSCRB (proficiency in survival craft) VI/2 30/04/2015 Bar 30/04/2020 0404-404-1981/15Basic Safety Training Certificate (or Items from 1 to 4 below MANDATORY) VI/1 30/04/2015 Bar 30/04/2020 0404-404-1978/15

1 - Personal Security and Social Responsibilities -II- -II- -II- -II-

2 - Personal Survival Technique -II- -II- -II- -II-3 - First Aid at sea -II- -II- -II- -II-4 - Fire fighting -II- -II- -II- -II-BOSIET

SSO (Ship Security Officer) VI/5 17/01/2014 Bar 17/01/2019 0404-404-141/14

Dangerous Cargo Handling 30/04/2015 Bar 30/04/2020 0404-404-1983/15

Oil and Chemical Tanker Cargo operations 30/04/2015 Bar 30/04/2020 0404-404-1984/15

Liquefied Gas Tanker Cargo Operation 30/04/2015 Bar 30/04/2020 0404-404-1985/15

ECDIS 16/01/2014. Kotor Unlimited 135/2014Certificate for seafarers with designated security duties 28/01/2014 Bar 28/01/2019 0404-404-452/14

Leadership and team-working skills 22/08/2014 Kotor Unlimited 676/2014

Ship bridge resources management 29/08/2014 Kotor Unlimited 197/2014

Pilot of port Bar 07/06/2008 Bar Unlimited 232/2

Application Form Page 2 of 3

Page 3: CV Tahir Kapisazovic 22-03-2016

.01

APPLICATION FOR EMPLOYMENTRECORD OF PERSONAL INFORMATION AND PAST EXPERIENCE

Previous Sea Experience

Vessel’s Name Flag GRT Vessel Type

Eng Type & KW Company Name Rank Period:

FromPeriod:

To

For Offshore Ships: Type of Job Performed (supply, anchorhandling, towing…), Water Depth, Type of

Rig or Barge Work With, Area of Operation, Charterer-Client

MSC TERESA Panama

153115

Container 14200 TEU

98280 Mediterranean Shipping Company

Ch Mate 29/08/2015 02/02/2016

CONTAINER – W/W

MSC STELLA Panama

73819 Container 6700 TEU

69439 Mediterranean Shipping Company

Ch Mate 08/11/2014 17/04/2015

CONTAINER – W/W

MSC ALEXA Panama

42307 Container 3200 TEU

26350 Mediterranean Shipping Company

Ch Mate 18/03/2014 23/07/2014

CONTAINER – W/W

BOKA BAY Montenegro

260 Tug Boat 1852 Boka Pilot & Tug service

Master 03/02/2014 12/03/2014

TUG BOAT – TUG BOAT SERVICES

BOKA BAY Montenegro

260 Tug Boat 1852 Boka Pilot & Tug service

Ch Mate 10/01/2014 03/02/2014

TUG BOAT- TUG BOAT SERVICES

MSC VITTORIA Panama

89954 Container6200 TEU

68640 Mediterranean Shipping Company

Ch Mate 05/09/13 05/01/2014

CONTAINER – W/W

MSC LUISA Panama

75590 Container6200 TEU

77600 Mediterranean Shipping Company

Ch Mate 07/01/2013 01/06/2013

CONTAINER – W/W

MSC ASYA Panama

107849

Container9200 TEU

69439 Mediterranean Shipping Company

Ch Mate 21/04/2012.

18/09/2012.

CONTAINER – W/W

MSC MARIA ELENA Panama

107849

Container9200 TEU

69439 Mediterranean Shipping Company

Ch Mate 02/08/2011.

10/12/2011.

CONTAINER – W/W

MSC ANS Panama

54304 Container5600 TEU

55890 Mediterranean Shipping Company

Ch Mate 04/09/2010.

23/02/2011.

CONTAINER – W/W

MSC MONICA Panama

37398 Container3400 TEU

33300 Mediterranean Shipping Company

Ch Mate 22/10/2009.

04/04/2010.

CONTAINER – W/W

MSC ANTONIA Panama

22667 Container1900 TEU

16980 Mediterranean Shipping Company

Ch Mate 08/10/2008.

13/04/2009.

CONTAINER – W/W

MSC VERONIQUE Panama

32341 Container1800 TEU

40200 Mediterranean Shipping Company

Ch Mate 17/10/2007.

16/04/2008.

CONTAINER – W/W

MSC STEFANIA Panama

23881 Container1500 TEU

32200 Mediterranean Shipping Company

Ch Mate 08/10/2006.

15/04/2007.

CONTAINER – W/W

ANY ADDITIONNAL INFORMATIONS OR JOB DESCRIPTIONS /EXPERIENCES YOU WANT TO DETAIL IN PARTICULAR. WRITE HERE:Detail the work you have done onboard previous vessels and your previous experience

Application Form Page 3 of 3