NAVAL MARITIME ACADEMY

INDOS APPLICATION FORM

(To Be Filled In Capital Letters Only)
Personal Details

Application Date : ___________________________________________________________

Category : ___________________________________________________________
Name : ___________________________________________________________
Gender : ___________________________________________________________
Date of Birth : ____________________ Place of Birth : __________________
Birth State : ____________________ Country of Birth : __________________
Nationality : Indian
Identification Mark : ___________________________________________________________
(If not applicable please write NA)
Address Details

Present Address : ___________________________________________________________

___________________________________________________________

______________________________City : ______________________
Pin No : _______________________ State : ______________________
Phone Number : ___________________________________________________________
Permanent Address : ___________________________________________________________
___________________________________________________________

______________________________City : ______________________
Pin No : _______________________ State : ______________________
Phone Number : ___________________________________________________________
Mobile Number : ___________________________________________________________
E-mail ID : ___________________________________________________________
(Please enter only one email id)
Enter additional information/remarks __________________________________________________
____________________________________________________________________________

.. .
(Booking Stamp, Sign & Date) Candidates Signature

Please hand over this form to INDoS Clerk

QSPF-03.1/06 18 Feb 13 Rev 0

 INDOS
1. CANDIDATES CAN APPLY FOR GENERATION OF INDOS NUMBER AT NAMAC.
CANDIDATES, WHO HAVE UNDERGONE COURSES AT NAMAC, ARE ELIGIBLE TO
APPLY FOR INDOS AT NAMAC.

2. CANDIDATE MUST BE IN POSSESSION OF THE FOLLOWING: -

(A) CERTIFICATES OF FOUR BASIC STCW COURSES UNDERGONE AT

NAMAC

(B) ORIGINAL ADDRESS PROOF AND SELF ATTESTED COPY OF ADDRESS

PROOF (SUCH AS PASSPORT / PAN CARD / DRIVING LICENCE /
ELECTRICITY BILL / TELEPHONE BILL / VOTER I CARD OR LETTER FROM
DEFENCE AUTHORITY / GOVT).

3. PROCEDURE FOR APPLICATION OF INDOS NUMBER AT NAMAC IS AS

FOLLOWS:-

(A) CANDIDATE TO FILL UP INDOS APPLICATION FORM AVAILABLE AT

BOOKING OFFICE.

(B) PAY RS 1450/- BEING THE INDOS FEE INCLUDING PROCESSING

CHARGES AND OBTAIN RECEIPT FROM CASHIER.

(C) SUBMIT THE FOLLOWING TO THE INDOS CLERK:-

FILLED APPLICATION TOGETHER WITH PROCESSING FEE RECEIPT.

DOCUMENTS AS GIVEN IN PARA 2

4. AFTER VERIFICATION OF ADDRESS PROOF WITH SELF ATTESTED COPY,

INDOS CLERK WILL RETURN ALL ORIGINAL DOCUMENTS TO THE CANDIDATE,
EXCEPT THE APPLICATION FORM.

5. NAMAC WILL FURTHER PROCESS THIS APPLICATION TO OBTAIN THE INDOS

NUMBER.

6. THIS INDOS NUMBER WILL BE INTIMATED TO THE CANDIDATE ON HIS EMAIL ID.
A PRINTOUT SHOWING INDOS NUMBER DETAILS WILL BE READY AND CAN BE
COLLECTED IF SO DESIRED FROM THE BOOKING OFFICE ON PRODUCTION OF
CASH RECEIPT.