AMC1 to Appendix 10 Revalidation and renewal of type ratings, and revalidation and renewal of IRs when combined with the revalidation or renewal of type ratings – EBT practical assessment
ED Decision 2021/002/R
APPLICATION AND REPORT FORM — ADMINISTRATIVE PROCEDURES RELATED TO TYPE RATINGS
(a) Minimum information provided in the form for Appendix 10.
Applicant’s last name(s): |
Applicant’s first name(s): |
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Signature of applicant: |
State of licence issue: |
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Type of licence held: |
Licence number: |
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Type rating: |
FSTD (aircraft type): |
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EBT module 1 |
Session 1……..Name of the instructor: __________________________________________________ Type and number of licence: _________________________________________________________ Location,
date and time: ____________________ FSTD ID
code:__________________________ |
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Session 2……..Name of the instructor:__________________________________________________ Type and number of licence:_________________________________________________________ Location, date and time:____________________ FSTD ID code:_____________________________ |
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Session X…...Name of the instructor:___________________________________________________ Type and number of licence:_________________________________________________________ Location, date and time:____________________ FSTD ID code:_____________________________ |
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Completion of the module:
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_____________________________________________ date / signature (EBT manager) |
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EBT module 2 |
Session 1……..Name of the instructor: __________________________________________________ Type and number of licence: _________________________________________________________ Location,
date and time: ____________________ FSTD ID
code:__________________________ |
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Session 2……..Name of the instructor:__________________________________________________ Type and number of licence:_________________________________________________________ Location, date and time:____________________ FSTD ID code:_____________________________ |
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Session X…...Name of the instructor:___________________________________________________ Type and number of licence:_________________________________________________________ Location, date and time:____________________ FSTD ID code:_____________________________ |
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Completion of the module:
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_____________________________________________ date / signature (EBT manager) |
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(…) |
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EBT module X |
Session 1……..Name of the instructor: __________________________________________________ Type and number of licence: _________________________________________________________ Location,
date and time: ____________________ FSTD ID
code:__________________________ |
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Session 2……..Name of the instructor:__________________________________________________ Type and number of licence:_________________________________________________________ Location, date and time:____________________ FSTD ID code:_____________________________ |
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Session X…...Name of the instructor:___________________________________________________ Type and number of licence:_________________________________________________________ Location, date and time:____________________ FSTD ID code:_____________________________ |
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Completion of the module:
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_____________________________________________ date / signature (EBT manager) |
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C |
____________________________________________ |
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Name(s) in capital letters: Type and number of licence: Examiner certificate number: |
Signature of examiner (EBT manager) _____________________________________________ Date of applicant’s licence endorsement: ___________ |
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Delegation of signature for licence endorsement (instructor) |
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Name: Position in the operator: Date: |
Signature |
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ompletion
of the operator’s EBT programme from____(date) to ____(date)
(b) AOC declaration for revalidation and renewal under the EBT programme for the purpose of AMC1 ARA.GEN.315(a) point (d) and for the purpose of point 1(a) of Appendix 10.
I confirm all of the following:
The EBT manager holds a current type rating examiner certificate in the type rating filled in in Appendix 10 (copy to be attached); |
Y |
The instructor(s) that conducted the training to the applicant has (have) been standardised. |
Y |
The EBT operator has performed a verification of the grading system at least once in the last 3 years. |
Y |
The integrity of the applicant training data is ensured. |
Y |
ES
ES
ES
ES
Signature of the training manager or EBT manager________________________
(c) In order for the EBT manager to delegate their signature in accordance with point 4(c)(2) of Appendix 10 to another person to endorse the licence of the applicant, the following should apply:
(1) the person signing the licence should be nominated,
(2) the person signing the licence should hold or have held an instructor certificate,
(3) the approved procedure for delegation of signature should include procedures to prevent the person who received the delegation from signing the licence when the EBT programme applicable to the validity period has not been completed.
(d) The authority may customise the form above by requesting additional information or changing the order of the elements of the form.