Flight Operations Standards Department

General Aviation & Training Section

Air Transport Pilot License (A) - Issuance Application Form

CARC Form 28 - 04 -4009 Effective Date: December 2018 Page 1 of 3

A. FOR APPLICANT USE ONLY 1. Personal Details.

Applicant name

Address

Mobile Number

Date & place of birth Nationality

I hereby declare that the information given in this form is true, correct completed. Applicant’s signature:

2. Application Details.

3. JCAR Flight Crew License Held Details.

License type & number License expiry date

Airplane type Type rating expiry date

Total flying Hrs Total flying Hrs on MPA

4. JCAR Medical Certificate Held Details.

Class Expiry date AME name Limitations

5. Air Transport Pilot License (A) Issuance Requirements.

No. JCAR-FCL 1 Requirements

f Pre-requisite flight experience

●Shall have (1500) hours flight time, up to (100) hours of flight time may have been completed in FS and FNPT of which a maximum of (25) hours may have been completed in FNPT

Hrs

MPA. At least 500 Hrs MPA experience on JCAR CS 25/23 airplanes Hours

PIC:

At least 500 Hrs PICUS, or Hours

At least 250 Hrs PIC ,or Hours

At least (250) hours made up by at least (70) hours as pilot-in-command and the necessary additional flight time as pilot-in- command under supervision.

Hours

Cross –Country.

At least 200 Hrs, of which Hours

At least 100 Hrs PIC or PICUS Hours

Instrument time

At least 75 Hrs of instrument time of which Hours

Not more than 30 Hrs instrument ground time Hours

Night flight time. At least 100 Hrs as PIC or co-pilot Hours

g *Pass ATPL (A) Skill Test on (MPA) in accordance with Appendix 2 to JCAR FCL 1.240 & 1.295

Passed

* The ATPL (A) skill test may serve at the same time as a skill test for the issue of the license and a proficiency check for the

revalidation of the type rating for the airplane used in the test and may be combined with the skill test for the issue of a multi-pilot type rating.

I am applying for air transport pilot license (A) - issuance on ( )

a Shall be at least 21 years of age Date of birth

b Hold JCAR FCL Commercial pilot license (CPL) Multi pilot license (MPL) Valid until

c Hold valid type rating multi pilot airplane Valid until

d Hold valid JCAR ATPL (A) Theoretical knowledge examination Valid until

e Hold valid JCAR medical class 1certficate Valid until

Flight Operations Standards Department

General Aviation & Training Section

Air Transport Pilot License (A) - Issuance Application Form

CARC Form 28 - 04 -4009 Effective Date: December 2018 Page 2 of 3

6. * Training Post Holder Recommendation.

I hereby certify that, the applicant meets JCARs requirements for ATPL issuance on ( ), and I have checked the

applicant license, log book, medical and training records, I am satisfied that the information contained in this application is correct

Name Date

AOC/TRTO Name Signature

B. FOR CARC USE ONLY

1. CARC Assessment.

f Shall have (1500) hours flight time, up to (100) hours of flight time may have been completed in FS and

FNPT of which a maximum of (25) hours may have been completed in FNPT

MPA. At least 500 Hrs MPA experience on JCAR CS 25/23 airplanes

PIC:

Cross –Country. At least 200 Hrs, of which at least 100 Hrs PIC or PICUS

Instrument time. At least 75 Hrs of instrument time of which maximum 30 Hrs instrument ground time

Night flight time. At least 100 Hrs as PIC or co-pilot

g Check applicant has passed ATPL (A) Skill Test on (MPA) in accordance with Appendix 2 to JCAR FCL

1.240 & 1.295

Flight Operations Inspector Name: Date: Signature:

2. CARC Recommendation.

Flight Operation Inspector Name: Date: Signature:

At least 500 Hrs PICUS, or

At least 250 Hrs PIC ,or

At least (250) hours made up by at least (70) hours as pilot-in-command and the

necessary additional flight time as pilot-in- command under supervision.

Assessment results Satisfactory Unsatisfactory

Remarks

ATPL issuance Approved Not approved

ATPL privileges Commercial Air Transport in Multi-Pilot airplanes on Pilot in Command Co-pilot

License details ATPL

License expiry date

JCAR English language Level 4 5 6

English expiry date

JCAR medical class Class 1

Medical expiry date

Airplane type

Type rating expiry date

Remarks

No Events YES NO

a Check applicant is at least 21 years of age

b Check applicant JCAR FCL Commercial pilot license (CPL) Multi pilot license (MPL)

c Check applicant Hold type rating multi pilot airplane validity d Check applicant JCAR ATPL (A) Theoretical knowledge examination validity

e Check applicant JCAR medical class 1certficate validity

Flight Operations Standards Department

General Aviation & Training Section

Air Transport Pilot License (A) - Issuance Application Form

CARC Form 28 - 04 -4009 Effective Date: December 2018 Page 3 of 3

C. SUPPORTING DOCUMENTS.

Cover letter from the TRTO/AOC for air transport pilot license (MPA) issuance (if required)

This application form

Copy of JCAR Flight Crew License (CPL/MPL)

Copy of FCL attachment - valid type rating

Copy of valid JCAR medical class 1 certificate

Certified copy of related log book pages

Copy of valid JCAR ATPL theoretical knowledge examination pass certificate

Copy of MCC training certificate(If Required)

Copy of air transport pilot license (MPA) skill test report .