Application for the issue of a FIE (A) issued under the Commission Regulation (EU) No 1178/2011 of 3 November 2011 as amended Civil Aviation Directorate Transport Malta, Luqa Airport, Luqa LQA 3290 Malta. Tel:+356 2555 2365 Fax:+356 2123 9278 [email protected] www.transport.gov.mt WARNING TO ALL APPLICANTS – Any false statement, misrepresentation or concealment of material fact on this form or any document presented in support of this application may be grounds for criminal prosecution. INFORMATION PROTECTED – Transport Malta Civil Aviation Directorate collects and processes information to carry out its functions under the Civil Aviation Act. All data is collected and processed in accordance to the Data Protection Act 2001, the Civil Aviation Act, the Air Navigation Order, the Regulation (EC) No.216/2008, Commission Regulation (EU) No. 1178/2011 as amended, other subsidiary legislation and the Privacy Policy of Transport Malta, a copy of which is available on demand and also on Transport Malta website: http://www.transport.gov.mt/. Send completed form to: Transport Malta - CAD, Personnel Licensing Section, Gate 1 Luqa Airport, Luqa LQA 3290. Malta Application Form for the issue of a FIE (A) Licence Type /No: FIRST ISSUE To be completed by applicant Last and First Name: ________________________________________________________________________________ Date of Birth dd/mm/yyyy: _______________________________________ Nationality:____________________________ Address: __________________________________________________________________________________________ email: ____________________________________________________________________________________________ Telephone Number (Home): _________________________________ (Mobile) _________________________________ □ID card or □ Passport No.:______________________________ Country of issue:______________________________ FIE (A) requested on the following type: __________________________________________________________ Application to Conduct assessments of competence for the issue, revalidation and renewal for, □ FI(A) FI(A) certificate number _____________________________valid until: ________________________. (Copy required) □CRI (A) CRI(A) certificate number _____________________________valid until: ________________________. (Copy required) □IRI(A) IRI(A) certificate number _____________________________valid until: ________________________. (Copy required) □TRI(A) on single pilot aeroplanes TRI(A) certificate number _____________________________valid until: ________________________. (Copy required) Flight time as pilot on Aeroplanes or TMGs: _______________________________hours (2000 hrs minimum) Flight time instructing applicants for an instructor certificate: ____________________hours (100 hrs minimum) Examiner standardisation course completed on Date:________________________________(Copy of certificate required) Examiner Assessment of competence passed on Date :________________________________with (Name of Inspector / Senior Examiner): _________________________________________ (attach form TM/CAD 0141) Were any of your licence/s, rating/s, certificate/s suspended, limited or revoked or were you otherwise sanctioned for non-compliance with the Basic Regulation and its Implementing Rules during the last 3 years? □ NO □ YES Date: __________________ Form TM/CAD/0168 Signature of Applicant: ____________________________________________ Transport Malta is the Authority for Transport in Malta set up by ACT XV of 2009 Page 1 of 2 Application for the issue of a FIE (A) issued under the Commission Regulation (EU) No 1178/2011 of 3 November 2011 as amended Civil Aviation Directorate Transport Malta, Luqa Airport, Luqa LQA 3290 Malta. Tel:+356 2555 2365 Fax:+356 2123 9278 [email protected] www.transport.gov.mt Office Use Only Submission Instructions Documents required: 1. A copy of the Certificate for the Examiners Standardisation Course. 2. Log Book 3. Copy of Licence held. 4. Copy of FI(A) / CRI(A) / IRI(A) / TRI(A) on single pilot aeroplanes Instructor Certificate/s, as applicable 5. Certification from ATO showing Flight Time instructing Applicants for an Instructor certificate 6. Copy of Medical certificate 7. Assessment of Competence Form TM/CAD/0141 8. Copy of your Criminal Record (not older than 3 months) It is important to send all the documents to avoid a delay in the issue of the rating. Fee: The applicable fee in the Malta Air Navigation Order / Scheme of Charges on the Transport Malta website has to be submitted with the application. Queries: If you need additional information send an email to [email protected] Attention: Personnel Licensing Section, Transport Malta Civil Aviation Directorate - giving your contact telephone number. Send completed form to: Transport Malta-CAD, Personnel Licensing Section, Gate 1 Luqa Airport, Luqa LQA 3290 Malta Form TM/CAD/0168 Transport Malta is the Authority for Transport in Malta set up by ACT XV of 2009 Page 2 of 2
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