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Faishah Bin Isahak: Civil Aviation Authority Malaysia

This document is an application form for changing or deleting particulars on a Civil Aviation Authority Malaysia (CAAM) aircraft maintenance license. The applicant is seeking to change their address and has checked the box to indicate this. Section B allows for deletion of particulars but no deletions are requested. The applicant declares that the information provided is true and agrees to notify employers of any license changes. The form provides space for CAAM officials to note the date received, the processing official, and any remarks.

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FAISHAH ISAHAK
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71 views1 page

Faishah Bin Isahak: Civil Aviation Authority Malaysia

This document is an application form for changing or deleting particulars on a Civil Aviation Authority Malaysia (CAAM) aircraft maintenance license. The applicant is seeking to change their address and has checked the box to indicate this. Section B allows for deletion of particulars but no deletions are requested. The applicant declares that the information provided is true and agrees to notify employers of any license changes. The form provides space for CAAM officials to note the date received, the processing official, and any remarks.

Uploaded by

FAISHAH ISAHAK
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CAAM/AW/1801-08

01122020

CIVIL AVIATION AUTHORITY


MALAYSIA

APPLICATION FOR CHANGE/DELETE OF LICENCE PARTICULARS


(Civil Aviation Regulations 2016)

A. Change of Particulars into Licence


Guidance’s for Tick
Type of Changes Current New changes
Licence holder (✓)
For change of
licence holder’s Name:
particulars, a
relevant
evidence or Mykad/Passport
justification from No.:
the holders shall
be attached. NO.112, JALAN SP 2/13, TAMAN NO.J 7582, LORONG 6,
SUBANG PERDANA 2, SEKSYEN
Address:
✓ U3, 40150 SHAHALAM, TAMAN SERI KERAYONG,
SELANGOR 77000, JASIN, MELAKA

Nationality:

B. Deletion of Particulars from Licence


Guidance’s for Tick
Type of Deletion Current New changes
Licence holder (✓ )
For deletion of
licence
holder’s Category/Subcategory:
particulars, a
relevant
evidence or
justification
from the Aircraft Type Rating:
holders shall
be attached.

C. Applicant’s Declaration
In connection with this application, I:

(a) agree to give my authorization to make the changes/deletion indicated on this form.
(b) agree to provide all information required by Civil Aviation Authority of Malaysia (CAAM) for the purpose of
evaluation of the application.
(c) declare and confirm that the information contained in this form is true and correct at the time of application.
(d) understand that any incorrect or false information could disqualify from holding a CAAM Part 66 Aircraft
Maintenance Licence (AML).
(e) agree to personally notify my employer/organization on changes of the licence.

CAAM Official Use Only:


Signature:
Date received:
Name: FAISHAH BIN ISAHAK Process by:

Signature:
Licence No.:
E 2739 Date:
Review by:

Signature:

Date:

Remarks:

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