Rohi Global Services Pvt. LTD
Rohi Global Services Pvt. LTD
Rohi Global Services Pvt. LTD
DECLARATION BY SEAFARER
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ROHI GLOBAL SERVICES PVT. LTD. QUALITY SYSTEM MANUAL.
MS/ MV:
Name : Rank: ECN:
Details of Nominee to receive compensation in case of fatality:
Last Name * First Name * Middle Name Relationship * Gender *
Date of Birth * Place of Birth Nationality * Tel.: (+country code, area code, Mob No.: (+country code –
Tel No.) No.)
Family Data
Date of Birth Date Place Valid
Relation* Gen* First Name * Last Name * Passport No.
* Issued Issued until
Spouse M/F
Child M/F
Child M/F
Child M/F
Child M/F
Address of spouse if different from seafarers address* :
Tel.: (+country code, area code, Mob No.: (+country code cell
Tel No.) No.) E-Mail: Alt contact No.
Branch *:
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