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SFF-001-Seafarers Application Form Fillable

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22 views4 pages

SFF-001-Seafarers Application Form Fillable

Uploaded by

hz9sx6f7ts
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Receipt No:

3) Permanent Address of Applicant: 4) Address to which Certificate should be


forwarded:

30) Function: 31) Level:

32) Limitations:

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33) Title of Certificate

a) b) c) d)

38) Functions:

39) Level

40) Capacity

41) Limitations

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I hereby affirm that all information provided by me in this application and its supporting documents and proofs are true and correct to
the best of my knowledge and belief; further, that no certificate issued to me heretofore by any Government has ever been revoked or
suspended and
I acknowledge receipt of the Maritime legislation of Belize relevant to my function onboard and confirm that I have read, understood
and undertake to comply with same at all times.
By affixing my true signature to this consent form, I confirm that pursuant to the provision of Article 7 of the General Data Protection
Regulation 2016, as amended, the International Merchant Marine Registry of Belize (IMMARBE) established under section 3 (1) of the
Merchant Ships (Registration) Act, 2010 herein identified as the data controller, may process my personal data for the purposes of
processing of my seafarer’s documentation with intent to produce an:
- (OE, CRA, EST, CRAT, MT, SB). (Tick options available)
This consent is also considered as the consent to transfer my personal data in an encrypted electronic format in an established secure
medium to be processed through a data processor – an affiliated company of IMMARBE acting in its legal capacity as Deputy Registrar
established under section 6 (1) of the Merchant ships (Registration) Act, 2010; found within the European Union, or make such data
available to such companies under the terms and conditions set out by the Personal Data Protection contract in accordance with
paragraph 12 of the EU Directive on standard contractual clauses for the transfer of personal data to processors established in third
countries (2010/87/EU).
The consent is provided for the unlimited period until it is revoked. The personal data may be modified or supplemented, and the consent
to processing thereof may be revoked by sending an e-mail to: seafarersmanager@immarbe.com. In such a case, the provided personal
data will be updated, blocked or deleted.

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