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Union of India - Section
Section 19 in The Merchant Shipping (Recruitment and Placement of Seafarers) Rules, 2016
19. Appeal.
| 1. | Name of the recruitment and placement service | |
| 2. | Report for the period | From _________To _________ |
| 3. | Name of the seafarer | |
| 4. | Indian National Database of seafarer (INDOS) number | |
| 5. | Continuous Discharge Certificate (CDC) Number | |
| 6. | Rank | |
| 7. | Name of the vessel | |
| 8. | Flag of the vessel | |
| 9. | Date of commencement of contract | |
| 10. | Date of sign off | |
| 11. | Date of completion of contract/arriving in India | |
| 12. | Remarks, if any. |
| 1. | Name of seafarer | |
| 2. | Sex | |
| 3. | Age | |
| 4. | Date of Birth | |
| 5. | Continuous Discharge Certificate (CDC) Number | |
| 6. | Certificate of Competency (CoC) details, where applicable | |
| 7. | Next-of-kin details | |
| (a) Name | ||
| (b) Relationship | ||
| (c) Address, Tel.No. andE-mail/Fax | ||
| 8. | Nature of accident / incident including damages /casualtiessuffered(use additional sheet if required) | |
| 9. | Details of ship involved in marine casualty / incident | |
| (a) Name of Ship and InternationalMaritime Organization (IMO )Number. | ||
| (b) Tonnage | ||
| (c) Location of ship | ||
| (d) Flag | ||
| (e) Coastal state(s) involved | ||
| (f) Name of Protection andIndemnity(P&I) Club | ||
| (g) Name of Captain | ||
| (h) Details of owners | ||
| 10. | Details of recruitment and placement service in India | |
| (a) Name | ||
| (b) Address, Tel.No. and Email /Fax address | ||
| (c) Licence No. | ||
| 11. | Details of Assistance given to the seafarer | |
| 12. | Insurance Coverage of the seafarer |
| Place: | Name and Designation of Authorised Signatory |
| Date: | Signature and Seal |
| 1. | Name | |
| 2. | Status[person/company/institution/agency or otherorganisation]. | |
| 3. | Date of incorporation. | |
| 4. | Name, designation and address of the authorised signatories. | |
| 5. | Telephone Number. | |
| 6. | Fax Number. | |
| 7. | Website and e-mail id. | |
| 8. | (a) Registered office address | |
| (b) Address of all branches | ||
| 9. | Whether the office is owned/leased/hired. | |
| 10. | Residential address of the authorised signatories. | |
| 11. | Name and address of all the Bankers. | |
| 12. | Permanent Account Number along with a copy of the previousyears income-tax returns. | |
| 13. | Details of business during the last five years(enclose profitand loss account and balance sheet). | |
| 14. | Experience, if any, in recruitment of seafarer, number ofyears. | |
| 15. | Whether any authorised signatory has been associated with anyrecruiting agency in the past, if so, give details. | |
| 16. | If previously in the business of recruitment of seafarerstotal number of seafarers deployed year wise, country-wise andcategory-wise during the last five years. | |
| 17. | Whether there are any complaints pending in respect ofseafarers recruited, if so, details thereof. | |
| 18. | Whether there i s any criminal or civil case pending in anycourt. If so, details thereof | |
| 19. | Whether any authorised signatory has been convicted. If so,details thereof. | |
| 20. | Total number of agreements or contracts with employer withdetails thereof. | |
| 21. | Number of seafarers proposed to be recruited. | |
| 22. | Other Shipping related activities carried out, if any. |
| 1. | Name | |
| 2. | Status [person/company/institution/agency or otherorganisation] | |
| 3. | Licence number and date of issue | |
| 4. | Validity period of licence | |
| 5. | Total number of seafarers employed during the period oflicence - category wise Pending complaints of seafarers recruitedand if so, details thereof. | |
| 6. | Whether there is any criminal or civil case pending in anycourt. If so, details thereof. | |
| 7. | Whether any authorised signatory has been convicted. If so,details thereof. | |
| 8. | Details of change of registered office / branch | |
| 9. | Total number of agreement / contracts signed with employers.Please give the details Flag-wise and ownership-wise. |