GM1 ARA.GEN.360 Change of competent authority

• ED Decision 2020/005/R found in: Aircrew (1178/2011) Part-FCL Part-MED Part-CC Part-ARA Part-ORA Part-DTO (Aug 2023)

GM1 ARA.GEN.360 Change of competent authority ED Decision 2020/005/R APPLICATION FORM FOR CHANGE OF COMPETENT AUTHORITY In this form, ‘current competent authority’ means the ‘transferring competent authority’ of [ARA.GEN.360](#_DxCrossRefBm1199963957), and ‘future competent authority’ means the ‘receiving competent authority’ of [ARA.GEN.360](#_DxCrossRefBm1199963957). <table border="1" cellpadding="0" cellspacing="0" width="604"><tr><td colspan="4" width="604"><p align="center">APPLICATION FORM FOR CHANGE OF COMPETENT AUTHORITY</p></td></tr><tr><td rowspan="4" valign="top" width="121"><p>Applicant details:</p></td><td colspan="2" valign="top" width="242"><p>Full name</p><p>(Last and first names)</p></td><td valign="top" width="241"><p><i>LAST NAME 1, LAST NAME 2, etc.</i></p><p><i>First name 1, First name 2, etc.</i></p></td></tr><tr><td colspan="2" valign="top" width="242"><p>Title of licence(s)/certificate(s) (including restriction(s)) and corresponding licence(s)/certificate(s) number(s)<a href="#_ftn24">[24]</a></p></td><td valign="top" width="241"><p><i>e.g. PPL(A) — UN country code.FCL.xxx</i></p><p><i>e.g. SPL — UN country code.FCL.xxx</i></p></td></tr><tr><td colspan="2" valign="top" width="242"><p>Current competent authority</p></td><td valign="top" width="241"><p><i>Country and authority</i></p></td></tr><tr><td colspan="2" valign="top" width="242"><p>Future competent authority</p></td><td valign="top" width="241"><p><i>Country and authority</i></p></td></tr><tr><td colspan="4" width="604"><p>I, ________________________ (last name, first name) hereby apply for a change of competent authority from my current competent authority to the future competent authority. To that end, I consent to a transfer of medical records, including the transfer of medical records and associated exchange of information between the current and future competent authorities. I apply for transfer of all my licences issued in accordance with Regulations (EU) No 1178/2011, (EU) 2018/395, and (EU) 2018/1976 within the different categories.</p></td></tr><tr><td colspan="4" valign="top" width="604"><p>I will immediately surrender my current licences/certificates and medical certificate to the future competent authority upon receiving the ‘new’ licences/certificates and medical certificate.</p><p>I understand that the current competent authority remains my competent authority until I have received the new licences/certificates and medical certificate, as applicable, issued by the future competent authority.</p><p>I hereby declare that I have not submitted any other request to another competent authority than the future competent authority as indicated above.</p><p>I have fully reviewed the [<i>please insert reference to the current competent authority’s relevant information material</i>] and have submitted all the necessary paperwork for my application to be considered.</p><p>I declare that the information provided on this application form is true, complete, and correct.</p><p>Any incorrect information on this form or non-compliance with the essential requirements of Annex IV to the Basic Regulation or with the requirements of Regulations (EU) No 1178/2011, (EU) 2018/395, and (EU) 2018/1976 could disqualify the applicant from having his records transferred from the current to the future competent authority.</p></td></tr><tr><td colspan="2" width="313"><p>Signature:</p></td><td colspan="2" width="290"><p>Date:</p></td></tr><tr height="0"></tr></table> --- [[24]](#_ftnref24) Indicate all licences and certificates currently held. Indicate only the related certificate(s) if you do not hold a valid licence anymore (e.g. SFI(A)). GM1 ARA.GEN.360 Change of competent authority ED Decision 2020/005/R APPLICATION FORM FOR CHANGE OF COMPETENT AUTHORITY In this form, ‘current competent authority’ means the ‘transferring competent authority’ of [ARA.GEN.360](#_DxCrossRefBm894736102), and ‘future competent authority’ means the ‘receiving competent authority’ of [ARA.GEN.360](#_DxCrossRefBm894736102). <table border="1" cellpadding="0" cellspacing="0" width="604"> <tr> <td colspan="4" width="604"> <p align="center">APPLICATION FORM FOR CHANGE OF COMPETENT AUTHORITY</p> </td> </tr> <tr> <td rowspan="4" valign="top" width="121"> <p>Applicant details:</p> </td> <td colspan="2" valign="top" width="242"> <p>Full name</p> <p>(Last and first names)</p> </td> <td valign="top" width="241"> <p><i>LAST NAME 1, LAST NAME 2, etc.</i></p> <p><i>First name 1, First name 2, etc.</i></p> </td> </tr> <tr> <td colspan="2" valign="top" width="242"> <p>Title of licence(s)/certificate(s) (including restriction(s)) and corresponding licence(s)/certificate(s) number(s)<a href="#_ftn27">[27]</a></p> </td> <td valign="top" width="241"> <p><i>e.g. PPL(A) — UN country code.FCL.xxx</i></p> <p><i>e.g. SPL — UN country code.FCL.xxx</i></p> </td> </tr> <tr> <td colspan="2" valign="top" width="242"> <p>Current competent authority</p> </td> <td valign="top" width="241"> <p><i>Country and authority</i></p> </td> </tr> <tr> <td colspan="2" valign="top" width="242"> <p>Future competent authority</p> </td> <td valign="top" width="241"> <p><i>Country and authority</i></p> </td> </tr> <tr> <td colspan="4" width="604"> <p>I, ________________________ (last name, first name) hereby apply for a change of competent authority from my current competent authority to the future competent authority. To that end, I consent to a transfer of medical records, including the transfer of medical records and associated exchange of information between the current and future competent authorities. I apply for transfer of all my licences issued in accordance with Regulations (EU) No 1178/2011, (EU) 2018/395, and (EU) 2018/1976 within the different categories.</p> </td> </tr> <tr> <td colspan="4" valign="top" width="604"> <p>I will immediately surrender my current licences/certificates and medical certificate to the future competent authority upon receiving the ‘new’ licences/certificates and medical certificate.</p> <p>I understand that the current competent authority remains my competent authority until I have received the new licences/certificates and medical certificate, as applicable, issued by the future competent authority.</p> <p>I hereby declare that I have not submitted any other request to another competent authority than the future competent authority as indicated above.</p> <p>I have fully reviewed the [<i>please insert reference to the current competent authority’s relevant information material</i>] and have submitted all the necessary paperwork for my application to be considered.</p> <p>I declare that the information provided on this application form is true, complete, and correct.</p> <p>Any incorrect information on this form or non-compliance with the essential requirements of Annex IV to the Basic Regulation or with the requirements of Regulations (EU) No 1178/2011, (EU) 2018/395, and (EU) 2018/1976 could disqualify the applicant from having his records transferred from the current to the future competent authority.</p> </td> </tr> <tr> <td colspan="2" width="313"> <p>Signature:</p> </td> <td colspan="2" width="290"> <p>Date:</p> </td> </tr> <tr height="0"> </tr> </table> --- [[27]](#_ftnref27)    Indicate all licences and certificates currently held. Indicate only the related certificate(s) if you do not hold a valid licence anymore (e.g. SFI(A)). ##### GM1 ARA.GEN.360 Change of competent authority *ED Decision 2020/005/R* **APPLICATION FORM FOR CHANGE OF COMPETENT AUTHORITY** In this form, ‘current competent authority’ means the ‘transferring competent authority’ of [ARA.GEN.360](#_DxCrossRefBm1743303768), and ‘future competent authority’ means the ‘receiving competent authority’ of [ARA.GEN.360](#_DxCrossRefBm1743303768). <table cellpadding="7" cellspacing="0"> <col/> <col/> <col/> <col/> <tr> <td colspan="4"><p align="center"> <b>APPLICATION FORM FOR CHANGE OF COMPETENT AUTHORITY</b></p> </td> </tr> <tr valign="top"> <td rowspan="4"><p align="left"> Applicant details:</p> </td> <td colspan="2"><p align="left"> Full name</p> <p align="left">(Last and first names)</p> </td> <td><p align="left"> <i>LAST NAME 1, LAST NAME 2, etc.</i></p> <p align="left"><i>First name 1, First name 2, etc.</i></p> </td> </tr> <tr valign="top"> <td colspan="2"><p align="left"> Title of licence(s)/certificate(s) (including restriction(s)) and corresponding licence(s)/certificate(s) number(s)<a href="#_ftn30" name="_ftnref30">[30]</a></p> </td> <td><p align="left"> <i>e.g. PPL(A) — UN country code.FCL.xxx</i></p> <p align="left"><i>e.g. SPL — UN country code.FCL.xxx</i></p> </td> </tr> <tr valign="top"> <td colspan="2"><p align="left"> Current competent authority</p> </td> <td><p align="left"> <i>Country and authority</i></p> </td> </tr> <tr valign="top"> <td colspan="2"><p align="left"> Future competent authority</p> </td> <td><p align="left"> <i>Country and authority</i></p> </td> </tr> <tr> <td colspan="4"><p align="left"> I, ________________________ (last name, first name) hereby apply for a change of competent authority from my current competent authority to the future competent authority. To that end, I consent to a transfer of medical records, including the transfer of medical records and associated exchange of information between the current and future competent authorities. I apply for transfer of all my licences issued in accordance with Regulations (EU) No 1178/2011, (EU) 2018/395, and (EU) 2018/1976 within the different categories.</p> </td> </tr> <tr> <td colspan="4" valign="top"><p align="left"> I will immediately surrender my current licences/certificates and medical certificate to the future competent authority upon receiving the ‘new’ licences/certificates and medical certificate.</p> <p align="left"> I understand that the current competent authority remains my competent authority until I have received the new licences/certificates and medical certificate, as applicable, issued by the future competent authority.</p> <p align="left"> I hereby declare that I have not submitted any other request to another competent authority than the future competent authority as indicated above.</p> <p align="left"> I have fully reviewed the [<i>please insert reference to the current competent authority’s relevant information material</i>] and have submitted all the necessary paperwork for my application to be considered.</p> <p align="left"> I declare that the information provided on this application form is true, complete, and correct.</p> <p align="left">Any incorrect information on this form or non-compliance with the essential requirements of Annex IV to the Basic Regulation or with the requirements of Regulations (EU) No 1178/2011, (EU) 2018/395, and (EU) 2018/1976 could disqualify the applicant from having his records transferred from the current to the future competent authority.</p> </td> </tr> <tr> <td colspan="2"><p align="left"> Signature:</p> </td> <td colspan="2"><p align="left"> Date:</p> </td> </tr> </table> --- [[30]](#_ftnref30) Indicate all licences and certificates currently held. Indicate only the related certificate(s) if you do not hold a valid licence anymore (e.g. SFI(A)).