the Applicant A P P L I C A N T ' S L I C E N C E N U M B E R : Title First Name Last Name Street Place Postal Country Telephone Fax

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Please fill in the framed fields of the form, sign it and send it together with attachments to: USTRO CONTROL GmbH, viation gency, Department LS/PEL/Licencing, Wagramer Straße 19, 1220 Vienna, ustria 1 Type of pplication I apply for the Revalidation Renewal of the rating for the class/type: according to FLC.740, FCL.740. and ppendix 9. 2 pplicant VFR IR P P L I C N T ' S L I C E N C E N U M B E R : Title First Name Last Name Street Place Postal Country Telephone Fax E-Mail Place Date Signature of pplicant 3 Invoice accepted by / to be sent to the pplicant Company (name/address) the Company Signature 4 Confirmation of the renewal training by the FI/CRI (fill in only in case of renewal) Instructor (The FI/CRI conducting the training confirms fit for prof. check) First name / Last name Licence number Location / Date Signature of instructor 5 Confirmation of the renewal training by the TO (fill in only in case of renewal) From (Date) Until (Date) Head of Training (Name) TO (pproval Number) The Head of Training confirms that the renewal training was performed in compliance with Part-FCL and the approved training manuals and that the applicant possesses all relevant theoretical knowledge and skills for the rating reendorsement. Signature of Head of Training and Seal of TO 1/8

6 Flight experience for the revalidation of the rating (fill in only in case of revalidation) During the period of validity of the rating, the applicant fulfilled at least: 10 route sectors as pilot of the relevant class or type of aeroplane (except SE class ratings) or 1 route sector as pilot of the relevant class or type of aeroplane or, flown with an examiner (except SE class ratings) (this route sector may be flown during the proficiency check) 7 ttachments (Please attach, if not specified differently, copies of the listed documents to the application) In case of revalidation: examiner authorisation, licence and medical certificate of the examiner (only if not an austrian examiner!) In case of renewal: examiner authorisation, licence and medical certificate of the examiner (only if not an austrian examiner!) and the TO certificate (only if not an austrian TO!) 8 Conduct of the proficiency check pplicant First Name Last Name Licence Number Examiner First Name Last Name Examiner Number Seat occupied ircraft Class/Type/Variant Registration FSTD if applicable Class/Type/Variant FSTD-ID FSTD Operator/Location Flight details Date of Test Time on Controls # Landings # pproaches Leg #1 Block-off Departure Destination Block-on Leg #2 (if applicable) Block-off Departure Destination Block-on 9 Proficiency check report Single-Pilot, except for performed in FTD SECTION 1 - DEPRTURE 1.1 Pre-flight including: Documentation Mass and Balance Weather briefing NOTM 1.2 Pre-start checks 1.2.1 External P# P 1.2.2 Internal P M 2/8

P P L I C N T ' S L I C E N C E N U M B E R : Single-Pilot, except for 1.3 Engine starting: Normal Malfunctions performed in FTD P M 1.4 Taxiing P M 1.5 Pre-departure checks: Engine run-up (if applicable) 1.6 Take-off procedure: Normal with Flight Manual flap settings Crosswind (if conditions available) 1.7 Climbing: Vx/Vy Turns onto headings Level off 1.8 TC liaison - Compliance, P M P M P M SECTION 2 - IRWORK (VMC) 2.1 Straight and level flight at various airspeeds including flight at critically low airspeed with and without flaps (including approach to VMC when applicable) P 2.2 Steep turns (360 left and right at 45 bank) 2.3 Stalls and recovery: i) Clean stall ii) pproach to stall in descending turn with bank with approach configuration and power iii) pproach to stall in landing configuration and power iv) pproach to stall, climbing turn with take-off flap and climb power (single-engine aeroplane only) 2.4 Handling using autopilot and flight director (may be conducted in section 3) if applicable P M P M P M 3/8

P P L I C N T ' S L I C E N C E N U M B E R : Single-Pilot, except for performed in FTD 2.5 TC liaison - Compliance, SECTION 3 - EN-ROUTE PROCEDURES VFR (see CONTENTS c) and d)) 3.1 Flight plan, dead reckoning and map reading 3.2 Maintenance of altitude, heading and speed 3.3 Orientation, timing and revision of ETs 3.4 Use of radio navigation aids (if applicable) 3.5 Flight management (flight log, routine checks including fuel, systems and icing) 3.6 TC liaison - Compliance, SECTION 3B - INSTRUMENT FLIGHT 3B.1* Departure-IFR P M 3B.2* En-route IFR P M 3B.3* Holding procedures P M 3B.4* 3D operations to DH/ of 200 feet (60 m) or to higher minima if required by the approach procedure (autopilot may be used to the final approach segment vertical path intercept) P M 3B.5* 2D operations to MDH/ P M 3B.6* Flight exercises including simulated failure of the compass and attitude indicator: rate 1 turns, recoveries from unusual attitudes P M 3B.7* Failure of localizer or glideslope P 4/8

P P L I C N T ' S L I C E N C E N U M B E R : Single-Pilot, except for performed in FTD 3B.8* TC liaison - Compliance, Intentionally left blank SECTION 4 - RRIVL ND LNDINGS 4.1 erodrome arrival procedure P M 4.2 Normal landing P M 4.3 Flapless landing P M 4.4 Crosswind landing (if suitable conditions) 4.5 pproach and landing with idle power from up to 2000 above the runway (single-engine aeroplane only) P P 4.6 Go-around from minimum height P M 4.7 Night go-around and landing (if applicable) P 4.8 TC liaison - Compliance, SECTION 5 - BNORML ND EMERGENCY PROCEDURES (This section may be combined with sections 1 through 4) 5.1 Rejected take-off at a reasonable speed P M 5.2 Simulated engine failure after take-off (single-engine only) 5.3 Simulated forced landing without power (single-engine only) 5.4 Simulated emergencies: i) fire or smoke in flight, ii) systems malfunctions as appropriate 5.5 Engine shutdown and restart (ME skill test only) (at a safe altitude if performed in the aircraft) 5.6 TC liaison - Compliance, P P P P M M 5/8

P P L I C N T ' S L I C E N C E N U M B E R : Single-Pilot, except for SECTION 6 - SIMULTED SYMMETRIC FLIGHT 6.1* (This section may be combined with sections 1 through 5) Simulated engine failure during take-off (at a safe altitude unless carried out in or FNPT II) 6.2* symmetric approach and go-around performed in FTD P X M P M 6.3* symmetric approach and full stop landing P M 6.4 TC liaison - Compliance, RESULTS OF THE TEST SECTIONS P - passed F - failed 1 2 3 4 5 6 REMRKS (if any) 10 Result of the proficiency check PSSED PRTILLY PSSED FILED Manual licence entry was carried out (enclose a copy of the licence) Signature of Examiner Signature of pplicant 6/8

11 Guidelines for the conduct of the proficiency check PSS MRKS In the case of single-pilot, with the exception of for single-pilot, the applicant shall pass all sections of the skill test or proficiency check. If any item in a section is failed, that section is failed. Failure in more than one section will require the applicant to take the entire test or check again. ny applicant failing only one section shall take the failed section again. Failure in any section of the re-test or re- check including those sections that have been passed at a previous attempt will require the applicant to take the entire test or check again. For single-pilot multi-engine, section 6 of the relevant test or check, addressing asymmetric flight, shall be passed. FLIGHT TEST TOLERNCE The applicant shall demonstrate the ability to: a) operate the aeroplane within its limitations; b) complete all manoeuvres with smoothness and accuracy; c) exercise good judgement and airmanship; d) apply aeronautical knowledge; e) maintain control of the aeroplane at all times in such a manner that the successful outcome of a procedure or manoeuvre is always assured; f) understand and apply crew coordination and incapacitation procedures, if applicable; and g) communicate effectively with the other crew members, if applicable. The following limits shall apply, corrected to make allowance for turbulent conditions and the handling qualities and performance of the aeroplane used: Height Tracking Generally ± 100 feet On radio aids ± 5 Starting a go-around at decision height/altitude + 50 feet / - 0 feet For angular deviations half scale deflection, azimuth and glide path (e.g. LPV, ILS, Minimum descent height/mp/altitude + 50 feet / - 0 feet 2D (LNV) and 3D (LNV/VNV) linear lateral deviations 3D linear vertical deviations (e.g. RNP PCH (LNV/VNV) using BaroVNV) Speed Heading all engines operating ± 5 knots all engines operating ± 5 with simulated engine failure +10 knots / - 5 knots with simulated engine failure ± 10 MLS, GLS) Cross-track error/deviation shall normally be limited to ± ½ the RNP value associated with the procedure. Brief deviations from this standard up to a maximum of 1 time the RNP value are allowable. Not more than - 75 feet below the vertical profile at any time, and not more than + 75 feet above the vertical profile at or below 1000 feet above aerodrome level. 7/8

CONTENT OF THE TRINING/SKILL TEST/PROFICIENCY CHECK a) The following symbols mean: P Trained as PIC or Co-pilot and as Pilot Flying (PF) and Pilot Not Flying (PNF) X Flight simulators shall be used for this exercise, if available, otherwise an aeroplane shall be used if appropriate for the manoeuvre or procedure P# The training shall be complemented by supervised aeroplane inspection b) The practical training shall be conducted at least at the training equipment level shown as (P), or may be conducted on any higher level of equipment shown by the arrow The following abbreviations are used to indicate the training equipment used: FTD eroplane Full Flight Simulator Flight Training Device (including FNPT II for ME class rating) c) The starred (*) items of section 3B and, for multi-engine, section 6, shall be flown solely by reference to instruments if revalidation/renewal of an IR is included in the skill test or proficiency check. If the starred (*) items are not flown solely by reference to instruments during the skill test or proficiency check, and when there is no crediting of IR privileges, the class or type rating will be restricted to VFR only. d) Section 3 shall be to revalidate a type or multi-engine class rating, VFR only, where the required experience of 10 route sectors within the previous 12 months has not been. Section 3 is not required of section 3B is. e) Where the letter M appears in the skill test or proficiency check column this will indicate the mandatory exercise or a choice where more than one exercise appears. f) n or an FNPT II shall be used for practical training for type or multi-engine class ratings if they form part of an approved class or type rating course. The following considerations will apply to the approval of the course: i) the qualification of the or FNPT II as set out in the relevant requirements of Part-R and Part-OR; ii) the qualifications of the instructors; iii) the amount of or FNPT II training provided on the course; and iv) the qualifications and previous experience on similar types of the pilot under training. g) When a skill test or proficiency check is performed in multi-pilot operations, the type rating shall be restricted to multi-pilot operations. h) To establish or maintain PBN privileges one approach shall be an RNP PCH. Where an RNP PCH is not practicable, it shall be performed in an appropriately equipped FSTD. 8/8