SYSTEMAR Ltd.E-mail: crew@systemar.com.ua

http://systemar.com.ua

F1.1 APPL ICAT ION F OR EMPLO YMENTPlease type or use block letters. Please complete in the English Language.

1. POSITION APPLIED FOR CHIEF OFFICER2. FAMILY NAME (as in Seaman’s Book) KRAVTSOV3. FIRST NAME (as in Seaman’s Book) SERGEY4. DATE OF BIRTH

(DD.MM.YYYY) 07.02.1961 5. PLACE OF BIRTH USSR ,Krasnodar reg.6. COMPLETE ADDRESS (Only in English). Please indicate an ALTERNATIVE TELEPHONE NUMBER or a NUMBER OF YOUR NEIGHBOURS if the direct line is not available.

+7918 117 26 81 RUSSIA,ANAPA,ASTRAKHANSKAYstr.,22,fl.2 +7918 1172681            7.MARITAL STATUS (Please mark which is relevant).

Married Single Divorced Widow/Widower 8.CITIZENSHIP RUSSIAN9. NEXT OF KIN (Please advise compulsory the following information).

a) Relationship WIFE d) Place of Residence (Please state "THE SAME" if coincides with your permanent address stated above)

b) Family Name KRAVTSOVA THE SAMEc) First Name ELENA +7918 4410650      10. OTHER PERSONAL DATAa) Height 178 b) Weight 73 c) Boots Size 42 d) Overall Size 50

e) Color of Eyes BLUE f) Color of Hair LIGHT BROWN11. MARITIME EDUCATION

Educational institution Specialty Place Period of StudiesFrom To

Courses School College Academy TECH.-NAVIGATOR NOVOROSSIYSK 1979 198512. CERTIFICATES OF COMPETENCY

Grade / Class/STCW Code Number Date of Issue(DD.MM.YY)

Date of Expire(DD.MM.YY) Country

Certificate of Competence: CHIEF MATE 2010201130 26.03.08 08.12.15 RUSSIA

Endorsement: OIL,CHEM. MANAGEMENT 2010222081 01.03.10 19.02.15 RUSSIA

Basic Safety Course (VI/1) 283768 08.12.10 08.12.15 RUSSIA

Advanced Fire Fighting (VI/3) 175351 25.07.12 25.07.17 RUSSIA

Medical First Aid (VI/4-1) Medical Care (VI/4-2) 152442 04.08.12 04.08.17 RUSSIASurvival Craft and Rescue boats (VI/2-1) 234572 10.12.10 10.12.15 RUSSIA

Proficiency in Fast Rescue Boats (VI/2-2) 234572 10.12.10 10.12.15 RUSSIA

Tankerman Oil Familiarization Advanced 108913 27.02.10 27.02.15 RUSSIA

Tankerman Chemical Familiarization Advanced 134944 19.02.10 19.02.15 RUSSIA

Tankerman Gas Familiarization Advanced Radar Observation & Plotting Simulator Course 0139961 17.12.10 17.12.15 RUSSIAAutomatic Radar Plotting Aids (ARPA) 0139961 17.12.10 17.12.15 RUSSIAGMDSS General Operator 2012303061 20.07.12 20.07.17 RUSSIABridge Team & Resource Management 0137140 28.08.11 28.08.16 RUSSIAManeuvering & Ship Handling UMA11825 23.12.10 23.12.15 UKRAINEWelder Electro Gas TIG ECDIS 0130065 13.07.12 13.07.17 RUSSIASSO (Ship Security Officer) 030187 10.06.09 10.06.14 RUSSIA

Please turn over and complete the reverse side.

13. PASPORTS AND VISAS (Please OBLIGATORY advise the complete details of your passports) 14. MEDICAL CERTIFICATE AND VACCINATIONSType Country Serial Number Date of Issue

(DD.MM.YY)Date of Expire

(DD.MM.YY) Date of Issue (DD.MM.YY)

Date of Expire(DD.MM.YY)

National Passport RUSSIA 03 06 208639 21.04.06      Medical Certificate Tourist / Travel Passport RUSSIA 64#1640857 12.03.10 12.03.15 Drug & Alco Test Certificate Seaman's Book / Seaman’s Passport RUSSIA RUS 0057629 25.07.11 25.07.16 Yellow Fever Vaccination 01.11.12 Other Seaman’s Book MARSH.ISL. MH 0136397 07.05.08 06.05.13 15. TESTSOther Seaman’s Book MARLINS test result 83 % date 04.06.09US Visa C1/D MOSCOW 13.07.07 13.07.09 CES 4.1 test result 72 % date 23.12.08

16. PREVIOUS SEA SERVICE (Please submit the complete information about your service at sea during last five years)Owners or Managers Vessel's name Type of vessel Flag GRT Kwt Type of Engine Rank Sign-on

(DD.MM.YY)Sign-off

(DD.MM.YY)TREFIN TANKERS TREFIN ADAM CHEM.TANKER MALTA 5300 MAK CH.OFF. 16.10.11 10.04.12TREFIN TANKERS TREFIN ADAM CHEM.TANKER MALTA 5300 MAK CH.OFF. 26.12.10 25.05.11V.SHIPS GERMANY KING DARWIN PROD.TANKER MHL 75000 MAN B&W CH.OFF. 12.07.09 30.11.09SEA STAR HOLY VICTORIA PROD.TANKER PAN 75000 MAN B&W CH.OFF. 10.02.09 16.05.09CAPITAL AMOR TANKER MALTA 30000 MAN B&W CH.OFF. 07.05.08 05.09.08CAPITAL ARCTIC BREEZE PROD.TANKER MALTA 51000 MAN B&W CH.OFF. 20.09.07 24.01.08NOVOSHIP GR. NESTERENKO TANKER MALTA 30000 MAN B&W CH.OFF. 15.09.06 16.03.07ENTERPRISES ENERGY PRIDE PROD.TANKER IOM 51000 MAN B&W CH.OFF. 16.11.05 27.02.06NOVOSHIP MCT ALIOTH CHEM.TANKER LIB 19500 MAN B&W CH.OFF. 01.04.05 15.08.05NOVOSHIP MCT ALIOTH CHEM.TANKER LIB 19500 MAN B&W CH.OFF. 07.07.04 14.12.04NOVOSHIP ALIOTH CHEM.TANKER LIB 19500 MAN B&W CH.OFF. 10.11.03 11.04.04 DECLARATION: I do hereby declare that all the above statements are complete and correct to the best of my knowledge. I do understand that this application form contains information vital for my further employment, however, its presenting gives me no guarantee for such unless proper requirement available. I do also understand that the below assessments of my qualifications and knowledge will affect my ability to be employed via LAPA Ltd.

DATE OF APPLICATION: 19.11.12 SIGNATURE:      WHILE SUBMITTING YOUR APPLICATION

Please attach: Evoluation (appraisal forms), if any.

Your application will not be accepted unless it complies with all the above requirements.THANK YOU! DO NOT WRITE ON THE SPACE BELOW!

Test in English passed (date): Score: Authorized

signature:Professional Competence Test passed (date): Score: Authorized

signature:This application form is property of LAPA Limited Company. No copies of this form will be accepted by the company. All rights for duplication and distribution are reserved. "LAPA" is the registered trademark of LAPA Limited Company. Form F1.1., research by VMO 2007.