APPLICATION FOR INITIAL/AMENDMENT/RENEWAL OF PART-66 AIRCRAFT MAINTENANCE LICENCE (AML)

EASA FORM 19

APPLICANT’S DETAILS:

Name: ………………………………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

Tel: ……………………………………………………………………….. E-mail: …………………………………………………………………….

Nationality: …………………………………………………………... Date and Place of Birth: ………………………………………….

PART-66 AML DETAILS (if applicable):

Licence No: …………………………………………………………………. Date of Issue: …………………………………………………….

EMPLOYER’S DETAILS:

Name: ………………………………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………………………………………….

Maintenance Organisation Approval Reference: ………………………………………………………………………………………

Tel: …………………………………………………………………………….. Fax: ……………………………………………………………………

APPLICATION FOR: (Tick relevant boxes)

Initial AML 

Amendment of AML 

Renewal of AML  

(Sub)categories

Aeroplane Turbine

Aeroplane Piston

Helicopter Turbine

Helicopter Piston

A

B1

B2

B2L

B3

C

L (see below)

Avionics

 See system ratings below

Piston engine non-pressurised aeroplanes of MTOM of 2t and below

Complex motor-powered aircraft

Aircraft other than complex motor-powered aircraft

System ratings for B2L licence:

1.  autoflight

2.  instruments

3.  com/nav

4.  surveillance

5.  airframe systems

L-licence subcategories:

L1C: Composite sailplanes

L1: Sailplanes

L2C: Composite powered sailplanes and composite ELA1 aeroplanes

L2: Powered sailplanes and ELA1 aeroplanes

L3H: Hot-air balloons

L3G: Gas balloons

L4H: Gas balloons

L4H: Hot-air airships

L4G: ELA2 gas airships

L5: Gas airship other than ELA2

Type endorsements/Rating endorsement/Limitation removal (if applicable): …………………………………………………………………………………………………………………………………………………………………….

I wish to apply for initial/amendment of/renewal of Part-66 AML, as indicated, and confirm that the information contained in this form was correct at the time of application.

I herewith confirm that:

1.          I am not holding any Part-66 AML issued in another Member State;

2.          I have not applied for any Part-66 AML in another Member State; and

3.          I never had a Part-66 AML issued in another Member State which was revoked or suspended in any other Member State.

I also understand that any incorrect information could disqualify me from holding a Part-66 AML.

Signed: …………………………………………………………………. Name: ……………………………………………………………………….

Date: ………………………………………………………………………………………………………………………………………………………….

I wish to claim the following credits (if applicable):

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

Experience credits for Part-147 training

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

Examination credits for equivalent exam certificates       

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

Please enclose all relevant certificates

Recommendation (if applicable): It is hereby certified that the applicant has met the relevant Part-66 maintenance knowledge and experience requirements and it is recommended that the competent authority grants or endorses the Part-66 AML.

Signed: ..............................................................  Name: ..................................................................................

Position: ...........................................................   Date: ....................................................................................