Limited Company Complete Section 2. a) Individual (Sole Traders) Complete Section 2. c)

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1 Application to Change or Cancel Registration for Training for a Private Pilot Licence in Conjunction with Appendix 2 to JAR-FCL and /or Appendix 2 to JAR-FCL Please print this form and then complete in BLOCK CAPITALS using black or dark blue ink. Then, sign and submit as instructed. Unique Corporate No. (to be completed by CAA) Please read attached Guidance Note on page 10 before completing this form. 1. APPLICANT TYPE Limited Liability Partnership Complete Section 2. a) Public Educational Complete Section 2. b) Establishment University/College Limited Company Complete Section 2. a) Individual (Sole Traders) Complete Section 2. c) Charity Complete Section 2. b) Partnership Complete Section 2. c) Ministry of Defence Complete Section 2. b) Private Clubs Nominated Representative to Trust Complete Section 2. b) Complete Section 2. c) 2. APPLICANT DETAILS (The Applicant is the person responsible for payment of CAA charges) a) A Company Registered Company Name (in full):... Registered Company Number:... Country of Company Registration:... Registered Office Address: Postcode:... Telephone:... Fax: Trading Name: (if applicable)... Trading Address (primary site): Postcode:... Website address:... Authorised Representative of Company This application is to be signed by either a Director or Company Secretary or a person authorised by the board to act on behalf of the Company, and who is thereby deemed to be the Accountable Manager. Title:... Forename:... Surname:... Position in Company:... Telephone No: If you are a not a Director or Company Secretary and have been authorised to sign the application form on behalf of the Company, proof of that authority must be provided with the completed application form. This application will be considered in respect of and, if appropriate, granted to, the Company Name as registered under the Company Number provided on this form. Page 1 of 10

2 or b) An Unincorporated Association or other body Name of Unincorporated Association or other body:... Address: Postcode:... Telephone:... Fax: Mobile Telephone:... Website address:... Authorised Representative This application is to be signed by a person authorised by the body named above to act on behalf of it, and who is thereby deemed to be the Accountable Manager. Title:... Forename:... Surname:... Position:... Charity Number (if applicable):... or c) Individual (including sole traders and partnerships) Title:... Forename:... Surname:... Address: Postcode:... Telephone:... Fax: Mobile Telephone:... Trading Name: (if applicable)... Website address:... A photocopy of your valid Passport or valid photocard Driving Licence must accompany your application as proof of identification. Failure to supply proof of identification may result in a delay to the application processing time. In the case of a partnership, please complete details of all partners. Continued on a separate sheet (if applicable) 3. TRAINING ORGANISATION CAA REFERENCE NUMBER (on Current Certificate of Registration) This is your current reference with the UK CAA OCP CANCELLATION (please complete this section only if you wish to cancel your registration, otherwise move to Section 5) Please cancel my registration as a facility to conduct training for the Private Pilot Licence at (name of Base) Name (block capitals):... Post (Accountable Manager/Managing Director (please specify)):... Signature:... Date:... Please ensure the current Certificate of Registration and examination papers, if previously issued, are returned with this form. DO NOT COMPLETE THE REST OF THE FORM IF YOU ARE CANCELLING YOUR REGISTERED FACILITY Page 2 of 10

3 5. APPLICATION (complete only if you wish to amend your basic registration details) From 17th September 2012, with the introduction of EASA Aircrew Regulation Part-ORA and Part-FCL, it is not possible to change the scope of a Registered Facility in respect of addition of further PPL courses. Any organisations wishing to change the scope of the Registered Facility must apply for approval as an ATO under EASA Aircrew Regulation Part-ORA, using form SRG2116. Application for: (see notes below and tick the relevant application) Change of Legal Entity name (copy of Companies House certificate to be enclosed) Change of Trading Name of Organisation Change of Custodian of Examination Papers Addition or Variation to FSTD used Addition of or deletion of Base Changes to Instructors and Aircraft should be notified by submission of page 9 of this form only. (All instructional staff must be nominated and the CAA must be informed whenever staff changes occur.) Where the change is to the organisation, please note that registration is not transferable from one legal entity to another. For variation of a registration (other than staff or aircraft see above) complete Sections 2, 3, 5, 11 plus the sections in which variations are required. All other sections can be struck through and marked No change. Any other changes, such as addition of a further course, require the organisation to apply for formal approval as an Approved Training Organisation (please see form SRG 2116 if this is required). 6a. ACCOMMODATION / FACILITIES (please complete only where a site is added or deleted) Address:... (i) Deletion of Base Postcode:... Airport code:... (ii) Addition of Base Address: Postcode:... 6b.ACCOMMODATION (please complete in respect of Accommodation detailed at Section 6a.(ii)) Location and description of briefing and flight planning facilities at new base (state number of rooms and approximate sizes): Sole Use Shared Owned Leased (long term) Rented (short term) Other (please specify)... Shared facilities are acceptable as long as formal arrangements are in place to guarantee access when required. A copy of the agreement in respect of shared premises should be forwarded with this application. Page 3 of 10

4 7. TRAINING AERODROME/S (in respect of premises detailed in Section 6a.(ii)) * delete if not applicable Base Aerodrome Name... ICAO Designator... * I have read and understood Amendment 1/2010 to Article 208A of the Air Navigation Order 2009 and CAP 793 as this is an unlicensed airfield. The aerodrome must meet the requirements of paragraph 6 of Appendix 1 to JAR-FCL or paragraph 5 of Appendix 1 to JAR-FCL as appropriate. You are also STRONGLY RECOMMENDED to ensure that amendment 1/2010 to article 208A is read and understood by all Instructors and that you are in compliance with CAP 793 if the aerodrome in unlicensed. If non-uk aerodrome then give brief details of ATC services, fire services, navigation aids, runway length. Base Aerodrome Owner/Operator Certificate * delete if not applicable I have no objection to the organisation named in Section 2 carrying out training for the issue of a Private Pilot Licence from... (Aerodrome Name) * I have read and understood Amendment 1/2010 to Article 208A of the Air Navigation Order 2009 and CAP 793 as this is an unlicensed airfield. Signature... Date... Name (block capitals)... Organisation... Position... 8a. FSTD USED FOR PPL INSTRUMENT TRAINING (if applicable) 1. FSTD are not specifically approved for use during courses of instruction for the PPL. However, any FSTD that has been qualified and approved for a similar, appropriate purpose (such as CPL, IR, equivalent type rating) may be used. 2. BITD may only be used for training for the PPL(A). FSTD Type FSTD Number (FNPTI, FNPTIII) Name of RF, ATO, FTO or TRTO holding FSTD Qualification 8b.If the RF, ATO, FTO or TRTO is not the organisation named in Section 2, then the following declaration must be completed by the FSTD Qualification holder. I certify that the organisation named in Section 2 has permission to use the FSTDs listed above for the purposes of PPL training. Signature:... Date:... Position:... RF/ATO/FTO/TRTO Name: CUSTODIAN OF JAR-FCL GROUND EXAMINATION PAPERS (if applicable) JAR-FCL Examination papers are supplied directly to Registered Facilities. In order to hold these papers the Registered Facility must have a nominated Custodian of Examination Papers (CEP) who is an authorised Ground Examiner (GR). I nominate the person below as the CEP for the Registered Facility named in Section 2. Nominated CEP:... CAA Examiner No.:... Accountable Manager Signature:... Date:... For completion by CEP nominee I accept full responsibility for all examination papers issued by the Authority on behalf of this organisation as detailed in Standards Document 11. CEP Signature:... Date:... Page 4 of 10

5 10. SUPPLEMENTARY BASE INFORMATION (tick and complete only if a further base is required to that in Section 6a.(ii)) Address:... Further/Subsequent Addition of Base Postcode:... Additional base aerodromes * delete if not applicable Base Aerodrome Name... ICAO Designator... * I have read and understood Amendment 1/2010 to Article 208A of the Air Navigation Order 2009 and CAP 793 as this is an unlicensed airfield. The aerodrome must meet the requirements of paragraph 6 of Appendix 1 to JAR-FCL or paragraph 5 of Appendix 1 to JAR-FCL as appropriate. You are also STRONGLY RECOMMENDED to ensure compliance with CAP 793 if the aerodrome in unlicensed. If non-uk aerodrome then give brief details of ATC services, fire services, navigation aids, runway length. Base Aerodrome Owner/Operator Certificate * delete if not applicable I have no objection to the organisation named in Section 2 carrying out training for the issue of a PPL from... (Aerodrome Name) * I have read and understood Amendment 1/2010 to Article 208A of the Air Navigation Order 2009 and CAP 793 as this is an unlicensed airfield. Signature... Date... Name (block capitals)... Organisation... Position... Additional Base Accommodation Location and description of briefing and flight planning facilities (state number of rooms and approximate sizes) Sole Use Shared Owned Leased (long term) Rented (short term) Other (please specify) 11. ACCOUNTABLE MANAGER'S DECLARATION I declare that the information provided on this form is correct and that all of the named persons are in compliance with JAR-FCL. I wish to vary my registration to conduct training for the JAR PPL. I will notify the Authority of all changes to the information provided in a timely manner and understand that, if I do not do so, my registration will no longer be valid. I understand that the information provided will be used for the purpose of publication in Standards Document 30. Signature:... Date:... Name (block capitals):... Position:... FALSE REPRESENTATION STATEMENT It is an offence under Article 231 of the Air Navigation Order 2009 to make, with intent to deceive, any false representation for the purpose of procuring the grant, issue, renewal or variation of any certificate, licence, approval, permission or other document. This offence is punishable on summary conviction by a fine up to 5000, and on conviction on indictment with an unlimited fine or up to two years imprisonment or both. Page 5 of 10

6 12. SUBMISSION INSTRUCTIONS Applications including supporting documents can be submitted by post, by fax or by in pdf format, to the address below: Licensing and Training Standards - Approvals CAA, Aviation House, GE Gatwick Airport South West Sussex RH6 0YR Fax no: ltsapprovals@caa.co.uk For an individual applicant, please provide proof of ID (suitably certified copy of Passport or Driving Licence - see Guidance Note 1). If you are not a Director or Company Secretary and have been authorised to sign the application form on behalf of the Company, please enclose proof of that authority. Checklist for submission: SRG2188 Copy of Companies House Certificate (where legal name of company has changed) Amendment fee (where fee is to be paid by debit/credit card, please submit application by post or fax) Copy of Shared Premises Agreement (if applicable) The amendment fee is relevant only where the Legal Entity name has changed or where there is a change of base to the Certificate of Registration, see paragraph 6.4 of CAA Scheme of Charges (Personnel Licensing) at ors5. CAA USE ONLY Applicant s name... Date of application... Department:... Contact Name:... Job No:... Folio No:... CAA Account Number: Nominal Code:... Cost Centre:... Date received:... If payment is received by cheque, attach a copy to this application form. The sum of... has been received by:... Date:... Amount paid by: Cheque Cash Card Electronic Transfer* * Receipt of Electronic Transfer to be verified by Treasury. Cheque drawn against account of:... Bank Account No:... Sort Code:... Is this part of a Company payment? Yes No If Yes - Total amount paid:... Amount to be deducted from NATS account:... Enclosures:... FedEx paid Yes/No Loaded by:... Signed/Despatched:... Legal Entity Details Company Date of incorporation of Company:... If declaration is signed on behalf of a Company: is declaration signed by a Director or Company Secretary?... if not, then does signatory have authority to sign?... Page 6 of 10

7 13. PAYMENT DETAILS a) Payment type (please tick your chosen method of payment). Visa Mastercard Debit Card Cheque/Banker s Draft Electronic Transfer Cash (max. 200) We do not accept American Express, Diners Club or JCB cards. Please do not send cash by post. b) Bank Details (for payment by Cheque/Banker s Draft) Cheques or Postal Orders should be made payable to 'Civil Aviation Authority'. Please write the CAA Application Form No. on the reverse of your cheque. Please note that any refund applicable will be paid directly to the bank account stated below by BACS transfer. Name in which Bank Account held:... Account Number:... Sort Code:... If overseas: IBAN Number:... Swift Code:... c) CAA Bank Account Details (if paying by Electronic Transfer) National Westminster Bank plc Bloomsbury Parr s Branch Account Name: Civil Aviation Authority PO Box 158 Account Number: High Holborn Sort Code: London Swift Code: NWBK GB 2L WC1V 7BX IBAN: GB90 NWBK Please supply the following information: Amount:... BACS/CHAPS Reference*:... * When making an electronic transfer please instruct your bankers to quote the CAA Application Form number followed by the application date in the description field (i.e. SRG 2188ddmmyyyy). Payer:... Date of Transfer:... d) Card Details (for payment by Credit/Debit Card) Card number: Expiry date: / Security Code (last 3 digits on signature strip on reverse of card) Debit cards only: / Start date: Amount:... Issue No: (if applicable) Name (as written on card):... (BLOCK CAPS) Full postal address of card holder: Postcode:... Card holder s signature:... Please tick box if paying with Company Card Company Name:... This information is provided at the applicant s risk and will be used by the CAA for this payment only and will not be used for any other purpose. Page 7 of 10

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9 SRG 2188 Issue 03 Page 9 of 10 APPENDIX 1: APPLICATION TO CHANGE AIRCRAFT OR INSTRUCTIONAL STAFFING DETAILS AT A REGISTERED FACILITY Registered Facility Name: (as per current CAA certificate of registration) OCP No.: Base Name: 1. INSTRUCTIONAL STAFF (Please complete fields and tick all that apply. Those FIs who will supervise FI(R) or AFIS must be specifically nominated.) Last Name First name Licence Number (specify State of issue if non-uk) Base/Site Full/Part time (indicate (FT or PT) Chief Flight Instructor Ground Instructor Flight Instructor Tick as appropriate 2. TRAINING AIRCRAFT (Please indicate those equipped with ADF and / or VOR and those with AI or TC; at least one nominated aircraft must be fully equipped) Training in aeroplanes greater than 2730kg MTWA or helicopters greater than 3175kg MTWA must take place at licensed aerodromes. Type Reg. ADF/VOR AI/TC Type Reg. ADF/VOR AI/TC Type Reg. ADF/VOR AI/TC 3. ACCOUNTABLE MANAGER'S DECLARATION I declare that the information provided on this form is correct and that all of the named persons are in compliance with JAR-FCL. I wish to vary my registration to conduct training for the JAR PPL. I will notify the Authority of all changes to the information provided in a timely manner and understand that, if I do not do so, my registration will no longer be valid. Signature:... Date:... Name (block capitals):... Position: Accountable Manager/Managing Director (please specify)... FALSE REPRESENTATION STATEMENT It is an offence under Article 231 of the Air Navigation Order 2009 to make, with intent to deceive, any false representation for the purpose of procuring the grant, issue, renewal or variation of any certificate, licence, approval, permission or other document. This offence is punishable on summary conviction by a fine up to 5000, and on conviction on indictment with an unlimited fine or up to two years imprisonment or both. Assistant Flying Instructor Flight Instructor (Restricted) Synthetic Training Instructor (STI) AFI/FI(R) Supervisor (Y/N)

10 General Guidance The following documents are currently available and should be used for guidance. CAA Standards Documents can be downloaded, free of charge, at Standards Document 11 Standards Document 30 CAP 793 JAR-FCL 1 JAR-FCL 2 Criteria for Registration of a Flying Training Organisation offering UK PPL Training within a JAA State UK CAA Registered Training Facilities: Private Pilots Licence Aeroplanes, Helicopters and Seaplanes Safe Operating Practices at Unlicensed Aerodromes Flight Crew Licensing (Aeroplane) Subparts A, B and C Flight Crew Licensing (Helicopter) Subparts A, B and C The CAA will endeavour to publish a list of names and addresses of all Registered Training Facilities annually in Standards Document 30. Section 2: Registered Company Name and Number: this is the legal name and reference number of the company as registered with Companies House or as detailed on the Company Certificate of Incorporation. Trading Name and Address: Where the company uses a name other than the above for trading / instructional purposes, this name should be annotated accordingly and the main base for training should also be detailed. Authorised Representative of the Company: The Accountable Manager of the company may wish to delegate responsibility for the completion of application forms to another Director of the company or to the designated Head of Training. Details of the nominee should be completed and relevant correspondence verifying this agreement should be forwarded from the Accountable Manager. Page 10 of 10