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Appendix II — EASA Form 4

ED Decision 2015/029/R



[COMPETENT AUTHORITY]



Details of Management Personnel required to be accepted as specified in Part-………………


1. Name:


2. Position:




3. Qualifications relevant to the item (2) position:




4. Work experience relevant to the item (2) position:












Signature: ................................................................. Date: ..............................................................


On completion, please send this form under confidential cover to the competent authority.



Competent authority use only

Name and signature of authorised competent authority staff member accepting this person:



Signature: ................................................................ Date: ..............................................................



Name: ...................................................................... Office: .............................................................




EASA Form 4