Form Aw-200 - Application For The Issue Of A Certificate Of Airworthiness Page 2
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1
2
3Form AW-200
Issue 3
12/2015
7
FLIGHT MANUAL REF. NO
(See Note 6)
*Form AW-235 shall be completed and submitted along with this application
8
EXPORT C OF A (See Note 7)
Issuing Authority:
Type Certification Reference :
9
OWNER/APPLICANT
Name and address of aircraft
DETAILS
owner/applicant (in full)
Telephone No:
E-mail address:
10
TECHNICALCOORDINATOR
Contact name:
OR POST HOLDER (As
Position Held:
described in OTAR 39.51)
Telephone No:
Fax No:
E-mail address:
11
MINIMUM EQUIPMENT LIST
BDCA MEL Approval Reference (If applicable):
(See Note 8)
12
LOCATION OF AIRCRAFT
FOR BDCA INSPECTION
Facility name:
Address:
Contact name:
Telephone No:
Fax No:
E-mail address:
13
WEIGHT AND BALANCE
Last Weighing Date:
Copy of Weight and Balance Report attached?
Yes
No
14
TECHNICAL LOG (See Note 9)
Yes
No
Sample attached?
15
AIRCRAFT DAMAGE
Damage Chart included in aircraft records (as per
Yes
No
CHART (See Note 10)
requirement in OTAR 39.73(c)(10)?
16
MANUFACTURER'S DATA
Digital pictures of the airframe manufacturer's data plate should be included with
PLATE
this application.
DECLARATION (See Note 11)
I hereby declare that to the best of my knowledge the particulars entered on this application are accurate in every
respect.
Name:
Signature:
____________________________________
Position:
Date:
Organisation:
Page 2 of 3
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