Advance Information Form
-
Upload
syarli-wellman -
Category
Documents
-
view
226 -
download
0
description
Transcript of Advance Information Form
![Page 1: Advance Information Form](https://reader036.fdocuments.in/reader036/viewer/2022082403/55cf8c9c5503462b138e3e1b/html5/thumbnails/1.jpg)
S/N FULL NAME PARENTAGE NATIONALITY OCCUPATION PRESENT ADDRESS PERMANENT ADDRESS
1 KAZUHIRO ARAI UMEKICHI ARAI JAPAN ENGINEER NO NO NO
2 LABORIE FRANCAISE NO NO NO
3 WAHYUDI SETIYAWAN SETIYAWAN INDONESIA MD TECHNICIAN NO NO NO
4 PACKIRISAMY BASKAR V PACKIRISAMY INDIAN N/A NO NO NO
5 BULIK ANAK GRINANG GRINANG MALAYSIA CTO NO NO NO
6 MEDCALF BRITISH CITIZEN NO NO NO
DATE & PLACE OF BIRTH
PASSPORT DETAILS ( NO/Issued at/Valid
upto)
VISA DETAILS(No/Ty
pe of Visa/Validity)
PLACE & PURPOSE OF VISIT
DETAILS OF LAST VISIT TO
INDIA
DETAILS LAST VISIT
OF RESTRICTE
D AREAS IN INDIA
WHETHER PERMISSIO
N REJECTED EARLIER,
IF SO, DETAILS THEREOF
24 MAY 1952KANAGAWA
JAPAN
M/S. SWIBER OFFSHORE INDIA (PVT.) LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
8-16 SETO, KANAZAWA-KU, YOKOHAMA
KANAGAWA-KEN 236-0431 JAPAN
TK4191589MINISTRY OF
FOREIGN AFFAIRSJAPAN
04 APR 201104 APR 2021
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD TO JOIN SWIBER
VESSEL /BARGE
LABORIE PATRICK, MICHEL
09 AUG 1974LAGNY SUR MARNE
FRANCEMAINTENANCE
SUPERVISOR
M/S. SWIBER OFFSHORE INDIA (PVT.) LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
PRIMA REGENCY, PLENTONG 5 K20
BERMERICOURT FRANCE
12CV05846KUALA LUMPUR - AMBASSADE DE
FRANCE EN MALAISIE17 AUG 201229 JUN 2019
UNDER PROCESS
BASSIEN FIELDS / BASSIEN &
SATELLITE FIELD (B&S)
TO JOIN SWIBER VESSELS/ BARGES
19 FEB 1984BANYUWANGI
INDONESIA
M/S. SWIBER OFFSHORE INDIA (PVT.) LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
TAMAN VALENCIA BLOK A NO. 28 BATAM
INDONESIA
S 425446BATAM
INDONESIA13 OCT 200813 OCT 2013
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD TO JOIN SWIBER
VESSEL /BARGE
11 MAY 1972PONMALAI TN
INDIAOPERATIONS
MANAGERAPT BLK 469 CHOA CHU KANG AVENUE 3#05-97
SINGAPORE 680469
NO 14 7TH CROSS GANDHI SALAI KAILASH NAGAR KATTUR POST TRICHY TAMILNADU
620019 INDIA
Z1826126SINGAPORE20 FEB 200919 FEB 2019
MUMBAI HIGH OFFSHORE FIELD TO JOIN SWIBER
VESSEL /BARGE
12 JUL 1977SARAWAKMALAYSIA
M/S. SWIBER OFFSHORE INDIA (PVT.) LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
P.O BOX 4281, RUMAH ACHAN, SUNGAI AMANG, 96800 KAPIT SARAWAK,
MALAYSIA
K24323766SIBU
MALAYSIA14 JUN 201114 DEC 2016
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD TO JOIN SWIBER
VESSEL /BARGE
MEDCALF DAVID MICHAEL
31 MAY 1947GUILDFORD
UKSENIOR DIVE TECHNICIAN
M/S. SWIBER OFFSHORE INDIA (PVT.) LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
DULVERTUN, HOLLY CLOSE, HEADLEY DOWN, BORDON, LUANTS GU35 8JN, SOMERSET, SOUTH
WEST ENGLAND, UK.
511044611IPSUK
01 OCT 201201 APR 2023
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD TO JOIN SWIBER
VESSEL /BARGE
![Page 2: Advance Information Form](https://reader036.fdocuments.in/reader036/viewer/2022082403/55cf8c9c5503462b138e3e1b/html5/thumbnails/2.jpg)
S/N FULL NAME PARENTAGE NATIONALITY OCCUPATION PRESENT ADDRESS PERMANENT ADDRESS DATE & PLACE OF
BIRTH
PASSPORT DETAILS ( NO/Issued at/Valid
upto)
VISA DETAILS(No/Ty
pe of Visa/Validity)
PLACE & PURPOSE OF VISIT
DETAILS OF LAST VISIT TO
INDIA
DETAILS LAST VISIT
OF RESTRICTE
D AREAS IN INDIA
WHETHER PERMISSIO
N REJECTED EARLIER,
IF SO, DETAILS THEREOF
7 HERMAWAN INDONESIA NO NO NOOKY KRISNA HERMAWAN
19 OCT 1970UJUNG PANDANG
INDONESIASECOND CAPTAIN
M/S. SWIBER OFFSHORE INDIA (PVT.) LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
JL WARAKAS II GG7 NO. 3RTO 13/002, WARAKAS
KAKARTA, UTARA
A 2445140BATAM
INDONESIA10 APR 201210 APR 2017
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD TO JOIN SWIBER
VESSEL /BARGE
![Page 3: Advance Information Form](https://reader036.fdocuments.in/reader036/viewer/2022082403/55cf8c9c5503462b138e3e1b/html5/thumbnails/3.jpg)
ADVANCE INFORMATION LIST OF EXPATRIATES TO BE ENGAGED BY :
M/S. SWIBER OFFSHORE CONSTRUCTION PTE LTD./M/S.PUNJ LLOYD LTED
S/N BLOOD GROUP FATHER'S NAME OCCUPATION
1
2
NAME OF THE APPLICANT (s)
PLACE & DATE OF BIRTH
NATIONALITY(PRESENT / & PAST)
PERMANENT ADDRESS (RESIDENCE)
PRESENT ADDRESS(OFFICIAL)
PASSPORT DETAILS ( NO/Issued at/Valid upto)
VISA DETAILS(No/Ty
pe of Visa/Validity)
PLACE & PURPOSE OF VISIT
DETAILS OF LAST VISIT TO
INDIA
M/S. SWIBER OFFSHORE CONSTRUCTION PTE LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD /TO JOIN SWIBER
VESSELS/ BARGES
M/S. SWIBER OFFSHORE CONSTRUCTION PTE LTD.
502-B WING, DELPHI, HIRANANDANI GARDENS,
POWAI, MUMBAI -76.
UNDER PROCESS
MUMBAI HIGH OFFSHORE FIELD /TO JOIN SWIBER
VESSELS/ BARGES
![Page 4: Advance Information Form](https://reader036.fdocuments.in/reader036/viewer/2022082403/55cf8c9c5503462b138e3e1b/html5/thumbnails/4.jpg)
ADVANCE INFORMATION LIST OF EXPATRIATES TO BE ENGAGED BY :
M/S. SWIBER OFFSHORE CONSTRUCTION PTE LTD./M/S.PUNJ LLOYD LTED
DIARY NO & DATE OF
FORWARDING DETAILS TO IB
DETAILS OF NO & DATE OF
CLEARANCE RECEIVED FROM IB