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Fill the Seafarer's Details
New Seafarer Registration form
Full Name
*
C.D.C. No.
*
INDOS NO
Registration No.
Father's Name
*
Identification Or Other Distinguishing Marks
*
Date Of Birth
*
Religion
*
Hindu
Muslim
Christian
Sikh
Buddhist
Jain
Other Religion
Marital Status
*
Married
Single
Divorced
Widowed
Separated
Permanent Address
*
Seafarer's Email
*
Mobile Number
*
*
I declare that I have not previously been a member of Seamen's Provident Fund and I hereby nominate the person (s) mentioned below to receive the amount standing to my credit in the Fund in the event of my death before that amount has become payable or having become payable has not been paid and direct that the said amount shell be distributed among the said person (s) in the manner shown below against his/her/their name(s)
Enter Nominee Details (Atleast one is mandatory)
*
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Nominee #1
Nominee Full Name:
Nominee Full Address:
Copy Addr
Nominee's Relationship:
Father
Mother
Brother
Sister
Wife
Son
Daughter
Other
Share Payable(%):
Email:
Whether Minor or Major:
Minor
Major
Age of Minor:
Guardian Full Name:
Guardian Full Address:
Yes
No
*Certified that I have no family as defined in paragraph 2(e) of the Seamen's Provident fund Scheme, 1966 and should I acquire a family hereafter, the above nomination should be deemed as cancelled
Yes
No
*Certified that my father/mother is dependent upon me.
Upload CDC Book(Upload the pages having personal particulars and address details)
(In PDF Format Only)
Upload self attested photocopy of Aadhar Card Or Passport Or Driving License
(In PDF Format Only)
*
I hereby declare that the information given in this application is true and correct to the best of my knowledge and belief.
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