Download - CIVIL AVIATION AUTHORITY MALAYSIA
CAAM/AW/1101-01 10042020
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CIVIL AVIATION AUTHORITY MALAYSIA PIHAK BERKUASA PENERBANGAN AWAM
MALAYSIA
APPLICATION FOR AIRCRAFT MAINTENANCE LICENCE (AML) (CAAM PART 66)
(Civil Aviation Regulations 2016)
1. APPLICATION FOR:(Please tick (√) on relevant box) ISSUANCE RENEWAL VARIATION
2. APPLICANTS DETAILSName:
NRIC / Passport No:
Date of Birth:
Address:
Nationality:
Contact No:
Email:
3. AML DETAILS (if applicable)
AML No:
AML valid until :
4. EMPLOYER DETAILS
Name of current employer
AMO/MTO/CAMO Approval reference
Contact Person
Contact Number
Date of Employment
5. CATEGORY OF AML(Please tick (√) on relevant box)
A B1 B2 C
Aeroplanes Turbine
Aeroplanes Piston
Helicopters Turbine
Helicopters Piston
Avionics
Large Aircraft
Aircraft other than large
CAAM/AW/1101-01 10042020
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6. SCOPE OF APPLICATION(For variation of application only, please tick (√) on relevant box)
6.1 Type/Task Rating Endorsement
6.2 Removal of Limitation 6.3 Additional Category/ Subcategory
7. TYPE/ TASK RATING ENDORSEMENT(List full airframe/engine combination)
Aircraft Type/ Task Rating Type/ Task Training Provider
8. REMOVAL OF LIMITATION
Limitations to be removed 8.1 Basic AML
8.2 Aircraft Type
9. SUMMARY OF MAINTENANCE EXPERIENCE(S)Period (Years of involvement)
Aircraft (Type and Reg. Mark)
Description of Experience (Details of experience should include the category of such experience i.e. A, B1, B2 or C)
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10. DOCUMENTS SUBMITTED (as applicable)
Document Documents reference
10.1 Original CAAM Part 66 AML (for existing AML Holder) 10.2 Certified true copy of Approved CAAM Part 147
Certificate of Recognition 10.3 Certified true copy of Examination Report/ Examination
Certificates and Assessment Report
10.4 Aircraft Maintenance Experience Logbook
10.5 Supporting Letter from Employer/ Approved CAAM Part 147
10.6 Certified true copy of Company Authorisation (for Category C issue)
10.7 3 Passport size photos (for issuance application only)
10.8
Others; please specify
11. APPLICANT’S DECLARATION
I wish to apply for issuance/ renewal / variation of CAAM Part 66 AML as indicated and confirm that the information contained in this form was correct at the time of application.
I hereby confirm that the following evidence that I have submitted for the purpose of the issuance and variation of CAAM Part 66 AML are true and valid, and I am conversant with the applicable current regulations and requirements.
i) Evidence of competency in theoretical knowledge and/ or, the English language proficiency as applicable.ii) Evidence of competency in practical skills certified by a validator.iii) Evidence of OJT in aircraft maintenance and practical assessments certified by Practical Assessor.
I also understand that any incorrect information could disqualify me from holding a CAAM Part 66 AML
Signature: Date:
False Representation Statement
It is an offence under Regulation 164 of the Civil Aviation Regulation 2016 to make any false representation for the purpose of himself, herself or any other person the grant, issue, renewal or variation of any such authorization, direction, certificate, licence, approval, permission, permit, exemption or other documents issued or required by this regulation.
12. RECOMMENDATION
It is certified that the applicant has met the relevant maintenance knowledge and experience requirements of Notice 1101 and all the supporting documents submitted has been verified and reviewed, and it is hereby recommended that the Authority issue / renew / vary the CAAM Part 66 AML.
Signature: Name:
Date: Position & Company Stamp:
Photocopy of NRIC/Passport (for issuance application only)
10.9
CAAM/AW/1101-01 10042020
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13. FOR CAAM USE ONLY
Amount Received Receipt No.
Date of Payment Signature and date
Remarks:
Signature: Name:
Date: Position:
INSTRUCTION
The following information will facilitate us in completing your application, failure to supply such information may result in your application being delayed while we endeavor to contact you.
Field 1,2,3 and 4 To be completed in all cases Field 5 Indicates what type of AML you are applying for. Please tick appropriate box for category of
AML applied. Field 6 Only applicable for applicant who wishes to apply for variation of AML. Field 6.1 For applicant who wishes to apply for type/ task endorsement please list the individual aircraft
type/ task rating by airframe/ engine combination in Field 7 Field 6.2 For applicant who wishes to remove AML limitation please specify which limitation number you
wish to remove in Field 8. It is recommended that applicant remove all the limitation that correspond to the category of the AML.
Field 6.3 For applicant who wishes to apply for additional of AML category. Field 7 Please list the individual aircraft type/ task rating by airframe/ engine combination and training
provider (i.e OEM/ CAAM Approved MTO/ CAAM Approved Training) Field 8 For Basic AML Limitation removal please specify limitation number to be removed in Block 8.1
For Aircraft Type Limitation removal please specify limitation number to be removed in Block 8.2
Field 9 Please specify a brief summary of maintenance experience relevant to the application. Cross referencing of maintenance experience to logbook/ work records submitted is unacceptable.
Field 10 Please attached appropriate documents relevant to the application being made. The applicant may include additional supporting documents if necessary.
Field 11 By signing the declaration, you are conforming that all the information is correct and true and you are declaring to comply with Regulation 164 of Civil Aviation Regulation 2016. CAAM will not accept application form not signed by the applicant.
Field 12 To be completed by MTO/ AMO/CAMO preferably Quality Assurance Personnel.