14 DAYS NOTICE OF READINESS TO RESUME SHIPBOARD SERVICE

( 14 Hari Notis Sedia Berkhidmat Diatas Kapal )

Date: 07/01/2011

(To be tendered by e-mail: nor2sail@miscbhd.com, or Courier/Pos Laju or by hand. Pls retain proof of submission or postage ).
(Hantar notis melalui e-mail: nor2sail@miscbhd.com atau Pos Laju atau hantar sendiri. Sila simpan bukti penghantaran atau kiriman pos laju).
ADDRESS / Alamat (if sending via Courier/Pos Laju )
FLEET PERSONNEL DEPARTMENT (ATTN : NOR/LOGISTICS), LEVEL 18 MENARA DAYABUMI,JLN SULTAN HISHAMUDDIN, 50050 KUALA LUMPUR,MALAYSIA

NAME /CREW NO: HASNOL HAIRANI BIN HASSAN RANK/LAST VESSEL : CATERING OFFICER
(Nama/No Pekerja) (Jawatan/Kapal Terakhir)

DATE SIGN OFF : 15/11/2010 DATE LEAVE EXPIRE: 25/02/2011

(Tarikh Sign Off) (Cuti Tamat)

LATEST ADDRESS: NO.25 DAT.PENGKALAN BARAT 6, CONTACT NO/EMAIL: H:05 216582 H/P:019 3549686
(Alamat Terkini TAMAN TEMARA 31650 IPOH , (No Tel/Alamat email) hasnolhairanih@yahoo.com
PERAK.

I declare that I am ready IN ALL RESPECTS to join ship within 2 weeks of my leave expiry date.
(Saya mengaku dan bersedia untuk menaiki kapal dalam masa 2 minggu sebelum cuti saya tamat)

I declare that all my travel documents/seaman card/discharge book and all relevant and required certificates for shipboard service
are valid and in order.
(Saya mengaku bahawa dokumen perjalanan/ Kad Pelaut/ Buku Pelaut and dokumen berkaitan serta yang diperlukan di atas kapal
adalah sah dan mengikut peraturan)

A DOCUMENTS AND CERTIFICATES – APPLICABLE TO ALL TICK

YES NO N/A
 √
1 International Passport (required validity > one year) *(Expiry date: )    
Medical Fitness Certificate /Category A (> 50 yrs every year) & (18-50 yrs every 2 yrs)  √
2 (validity > one year) *(Expiry date: )    
Seaman Identification Card ( New microchip format for Msians )  √
3 *(Expiry date: )    
 √
4 Discharge Book    
 √
5 Vaccination Book (For Yellow Fever – Validity 5 years) *(Expiry date: )    
Basic Safety Training (For all ranks) Comprises 4 Training Certs ( Personal Survival Techniques / Personal  √
6 Safety & Social Responsibilities / Basis First Aid / Basic Fire Fighting )    

B1/C1 CERTIFICATE OF COMPETENCY (COC) FOR OFFICERS YES NO N/A

 √
1 Certificate of Competency (Min validity of COC > 6 months) *(Expiry date: )    
 √
2 Certificate of Recognition (for Expatriate & M’sian holding foreign COC) *(Expiry date: )    
√

3 Dangerous Cargo Endorsement (Min. validity >6months) :-

√

*Oil *(Expiry date: )      

 √
*Chemical *(Expiry date: )    
*Gas *(Expiry date: )      
Remarks ( if any ) :

FPD/FMO/NOR/OCT/2009
 C2 MODULAR/SPECIALIZED COURSES (WHERE APPLICABLE) FOR DECK OFFRS /ENGRS YES NO N/A

 √
1 Advance Fire Fighting ( For all ranks except CTOF , A/O and E/O )  
 √
2 Shipboard Management ( Master, C/O, C/E and 2/E )  
 √
3 Medical Care (Master, C/O, C/E and 2/E )  
√
4 GMDSS ( for all officers except CTOF, A/O & E/O ) *(Expiry date: )
General Operator Certificate (GOC) for all Deck Officers except CTOF/AO&EO √
5 *( Expiry date: )
√
6 ARPA Bridging ( for all deck officers except CTOF. A/O & E/O )
√
7 Tanker Familiarization: Combined Oil /Chem/Gas ( For all Deck Offrs and Engrs )- Tankers Only
√
8 Advanced Oil Tanker Training ( For all ranks except CTOF, A/O & E/O )
√
9 Advanced Chemical Tanker Training ( For all ranks except CTOF, A/O & E/O )
√
10 Advanced Liquefied Gas Tanker Training ( For all ranks except CTOF, A/O & E/O )
√
11 GMDSS Refresher ( For all ranks except CTOF, A/O & E/O )
√
12 Bridge Resources Management ( For all ranks except CTOF, A/O & E/O )
√
13 Shipboard Safety Officer (C/O MUST have – Others Optional )
√
14 Ship Security Officer (SSO-ISPS) - (Master, C/Off, C/E & 2/E)
√
15 Ship Handling Simulator (Master & C/Off)
√
16 Tripod Incident Investigation Course (Master, C/Off, C/E & 2/E)
√
17 Risk Assessment (Master, C/Off, C/E & 2/E)
√
18 Electronic Chart Display (ECDIS) – ( For all Deck Officers )

D1 CERTIFICATES FOR RATINGS YES NO N/A

√
1 Rating Watch Keeping Certificate (For Deck Rating and Eng Rating)  
√
2 Dangerous Cargo Endorsement (Min. validity >6months)  
√
*Oil *(Expiry date: )  
√
*Chemical *(Expiry date: )  
*Gas *(Expiry √
date: )  

D2 MODULAR/SPECIALIZED COURSES (WHERE APPLICABLE) FOR RATING YES NO N/A

 √
1 Tanker Familiarization – Combined (For Deck and Eng Rating)    
I understand that if I wrongfully declare any of the above information OR if any of my required documents / certicates are found to be invalid/expired OR if I tender
this notice less than 2 weeks before my leave expiry date or after my leave expiry date , this NOR shall be deemed as NOT VALID . Further, if I refuse or fail to take
up shipboard assignment when called upon after giving this NOR within the 2 week period from my leave expiry date or thereafter , I shall be deemed to be placed
on “Forced Unpaid Leave Status” upon expiry of my leave . In such case , I am required to re-tender a new NOR within 30 days thereafter failing which my service
with the Company may be ceased after that 30 day grace period.

(Saya memahami jika maklumat yang diberikan diatas adalah tidak benar atau jika saya menghantar NOR ini kurang daripada 2 minggu sebelum cuti tamat, NOR
ini akan jadi TIDAK SAH. Jika saya tidak setuju atau pun gagal untuk menerima tugasan dalam masa 2 minggu sebelum cuti tamat setelah NOR telah diberi
status saya akan jadi “Forced Unpaid Leave “ dan saya terpaksa menghantar semula NOR baru dalam tempoh 30 hari. Jika syarat ini tidak di patuhi,
perkhidmatan saya di MISC boleh di tamatkan selapas tempoh 30 hari itu .

FPD/FMO/NOR/OCT/2009
 Signature: ………………………………………….
(Not required if submission by e-mail/ Tandatangan
tidak perlu jika hantar melalui e-mail)

FPD/FMO/NOR/OCT/2009