AMC 21 B 520 b Application

AMC 21.B.520(b) Application for a permit to fly

CAA ORS9 Decision No. 1

The CAA must receive an application for permit to fly in a form and manner established by that authority, e.g. on the CAA Form 21 (see below) completed by the applicant.

Application for Part 21 Permit to Fly
1. Applicant:	[Name of applicant]
2. Aircraft nationality and identification marks:
3. Aircraft owner:
4. Aircraft manufacturer/type	5. Serial number
6. Purpose of flight [Use terminology of 21.A.701(a) and add any additional information for accurate description of the purpose, e.g. place, itinerary, duration…] [For an application due to a change of purpose (ref. 21.A.713): reference to initial request and description of new purpose]
7. Expected target date(s) for the flight(s) and duration
8. Aircraft configuration as relevant for the permit to fly 8.1 The above aircraft for which a permit to fly is requested is defined in [add reference to the document(s) identifying the configuration of the aircraft. Same as required in AMC 21.A.263(c)(6) or AMC 21.A.709(b) application approval form 18A or 18B, box 6] 8.2 The aircraft is in the following situation related to its maintenance schedule: [Describe status]
9. Approval of flight conditions [if not available at the time of application, indicate reference of request for approval] [Reference to: 1. CAA approval, if flight conditions are approved by CAA; or 2. DOA approval form (see AMC 21.A.263(c)(6)), if approved under DOA privilege; or 3. CAA approval.
10. Date:	11. Name and signature: [Authorised signatory]

Application for Part 21 Permit to Fly

1. Applicant:

[Name of applicant]

2. Aircraft nationality and identification marks:

3. Aircraft owner:

4. Aircraft manufacturer/type

5. Serial number

6. Purpose of flight

[Use terminology of 21.A.701(a) and add any additional information for accurate description of the purpose, e.g. place, itinerary, duration…] [For an application due to a change of purpose (ref. 21.A.713): reference to initial request and description of new purpose]

7. Expected target date(s) for the flight(s) and duration

8. Aircraft configuration as relevant for the permit to fly

8.1 The above aircraft for which a permit to fly is requested is defined in [add reference to the document(s) identifying the configuration of the aircraft. Same as required in AMC 21.A.263(c)(6) or AMC 21.A.709(b) application approval form 18A or 18B, box 6]

8.2 The aircraft is in the following situation related to its maintenance schedule:

[Describe status]

9. Approval of flight conditions [if not available at the time of application, indicate reference of request for approval]

[Reference to:

1. CAA approval, if flight conditions are approved by CAA; or

2. DOA approval form (see AMC 21.A.263(c)(6)), if approved under DOA privilege; or

3. CAA approval.

10. Date:

11. Name and signature:

[Authorised signatory]

CAA Form 21