APPLICATION FOR CLASS OR TYPE RATING (A) (H)

1 CA 26 JUNE 2018 Page 1 of 3 Section/division: Personnel Licensing, Aviation Personnel Standards Form Number: CA Telephone number: 011-545-1000 Fax Number: 011-545-1459 Physical address: Ikhaya Lokundiza, 16 Treur Close, Waterfall Park, Bekker Street, Midrand, Gauteng Postal address: Private Bag X73, Halfway House 1685 Website: DETAILS OF BANK ACCOUNT FOR PAYMENT OF PRESCRIBED FEE Bank: Standard Bank of SA Ltd Branch: Brooklyn, Pretoria Branch Code: 011245 Account Number: 013007971 COMPULSORY CLIENT PAYMENT CODE (to be completed on deposit slip) Service/transaction Over the counter payments EFT, Internet, Wire, Electronic payments APPLICATION for CLASS , Warbird or Type RATING APPLICATION FOR CLASS OR TYPE RATING (A) (H) Aeroplane RATING CLASS Type SEP SETP MEP SP MP Helicopter RATING Type SEP SETP MEP SP MP TRAINED PILOT DETAILS Surname Initials Gender Male Female Nationality RSA ID/Passport Licence number Telephone number Cell phone number Email address SIGNATURE OF PILOT TRAINED NAME IN BLOCK LETTERS DATE TRAINING DETAILS Place Date of flight test Name of ATO ATO number Trained as Pilot Restrictions (If any)

2 Co-pilot Third pilot Other Pilot Instructor Duration of training Simulator Aircraft day Aircraft night Duration of skill test Simulator Aircraft day Aircraft night Stamp showing Name of training organisation and CAA ATO number AIRCRAFT / SIMULATOR DETAILS A/C designator A/C registration MCM kg FSTD type FSTD registration CA 26 JUNE 2018 Page 2 of 3 INSTRUCTOR DETAILS Name in block letters RSA ID/Passport Licence Number Telephone number Cell phone number Email address I confirm that I conducted the training in compliance with the South African Regulations SACAR and the following Technical Standards (tick the applicable block): SA-CATS Technical Standards for CLASS and Type ratings APPENDIX Syllabus of theoretical knowledge instruction for CLASS /type ratings for single-engine and multi-engine aeroplanes (Single pilot) APPENDIX Syllabus for Theoretical Training for High Performance Aircraft (HPA) APPENDIX Requirements for ATPL/type RATING /training/skill test and proficiency check on multi-pilot aeroplanes APPENDIX Contents of the CLASS /type RATING /training/skill test and proficiency check on single-engine and multi-engine single-pilot aeroplanes APPENDIX Practical Training Syllabus for Single Engine Aircraft APPENDIX High Performance Aeroplane (HPA) Practical Training Syllabus APPENDIX Practical Training Syllabus for Multi Engine Aeroplanes APPENDIX Practical Training Syllabus for Multi-Pilot (Aeroplane)

3 Type RATING APPENDIX Practical Flying Training Syllabus for Warbird Type RATING SIGNATURE OF INSTRUCTOR NAME IN BLOCK LETTERS DATE TESTING OFFICER DETAILS Name in block letters RSA ID/Passport Licence Number Telephone number Cell phone number Email address I, the undersigned, confirm that I conducted the skill test in compliance with the South African Regulations SACAR and the following Technical Standards (tick the applicable block): SACATS Technical Standards for CLASS and Type ratings APPENDIX Guidance for the Conducting of Skill Test and Proficiency Check for Aeroplane CLASS /Type ratings and ATPL APPENDIX Requirements for ATPL/type RATING /training/skill test and proficiency check on multi-pilot aeroplanes APPENDIX Contents of the CLASS /type RATING /training/skill test and proficiency check on single-engine and multi-engine single-pilot aeroplanes SIGNATURE OF TESTING OFFICER NAME IN BLOCK LETTERS DATE CA 26 JUNE 2018 Page 3 of 3 TEMPORARY CERTIFICATE OF COMPETENCY FOR TYPE ratings (A) AND (H) I, the undersigned, certify that I have endorsed the logbook of applicant in respect of the RATING on type and authorise him or her to fly this aircraft for a period of 30 days within the Republic of South Africa without the appropriate licence endorsement.

4 SIGNATURE OF TESTING OFFICER NAME IN BLOCK LETTERS DATE