Pakistan Civil Aviation Authority: (E.g 30/DEC/1977) : (City & Country)
Pakistan Civil Aviation Authority: (E.g 30/DEC/1977) : (City & Country)
Pakistan Civil Aviation Authority: (E.g 30/DEC/1977) : (City & Country)
PCAA FORM 19
AIRWORTHINESS DIRECTORATE
THIS FORM SHALL BE FILLED ON SCREEN THEN PRINTED, SIGNED AND SUBMITTED AS INSTRUCTED
1. APPLICANTS DETAILS: (Do not leave any field blank, otherwise the case will be returned un-actioned)
Name: Email:
Joining date of current employment: Cell Number:
Date of Birth (e.g 30/DEC/1977): Place of Birth (City & Country):
CNIC No: Nationality:
Address:
3. EMPLOYERS DETAILS:
Name: PIAC Date employment commended: N/A
Address: HEAD OFFICE, JIAP, KARACHI.
Organization approval number: PCAA.145.001 Head of Quality: Mr. KHAWAJA NOORUL QADIR
Email Address: khimipk@piac.aero Cell number: 0323-2320390
Previous employer: N/A Date of Joining: N/A Date of Resignation: N/A
Rating: A B1 B2 B3 C
Aeroplane Turbine N/A N/A N/A
Aeroplane Piston N/A N/A N/A
Helicopter Turbine N/A N/A N/A
Helicopter Piston N/A N/A N/A
Avionics N/A N/A N/A N/A
Piston engine non-pressurised
aerplanes of MTOM of 2t & below
N/A N/A N/A N/A
Complex motor-powered
N/A N/A N/A N/A
aircraft
Aircraft other than complex
N/A N/A N/A N/A
motor-powered aircraft
Type endorsements/Rating
endorsement/Limitation
removal (mention briefly):
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5. CREDIT CLAIM: (not required for AML renewal)
I wish to claim the following credits (if applicable):
Experience credit for 147 approved basic training
Organization Name: N/A
Course title:
Course completion date: Certificate number:
Experience credit due equivalent examination certificate
(exam accredited and recognized by PCAA based on examination credit report)
Name of institute: N/A
Credit Report Ref No.
Experience credit due to a skilled worker (Refer ANO.066.A.30)
N/A
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9. DECLARATION:
I wish to apply for initial/amendment/renewal of ANO-066 AML as indicated and confirm that the information contained
in this form was correct at the time of application. I herewith confirm that:
It is hereby certified that the applicant has met the relevant maintenance knowledge and experience requirements of
ANO-066 and it is recommended that PCAA grants or endorses the ANO-066 AML.
Name:_________________________________________________ Signature:________________________________
11. PAYMENT METHOD: (refer latest issue of AWNOT-003 for required fee)
Authorization of fee deduction from advance deposit account granted: Yes / No (or)
Payment may be utilized from attached fee deposit slip of Rs. ________ Slip number/dt: _____________________
12. FOR USE IN AIRWORTHINESS FIELD OFFICE: (to be filled by evaluating officer)
Recommendations: _______________________________________________________________________________
_______________________________________________________________________________________________
13. FOR USE IN HQs AIRWORTHINESS DIRECTORATE: (to be filled by evaluating officer)
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