005-application-for-aircraft-special-flight-permit

gaca_gov_sa · form · processed · 1 chunks

document_type=form entity=format:application/pdf entity=language:ar language=en taxonomy_l1=transport taxonomy_l2=aviation taxonomy_l3=aircraft_certification validity=valid validity_confidence=0.6

GACA
الطبيه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
APPLICATION FOR AIRCRAFT SPECIAL FLIGHT PERMIT
<table><tr><td colspan="6">OWNER/OPERATOR INFORMATION</td></tr><tr><td colspan="3">Name Of Owner/Operator</td><td colspan="3">Address Of Owner/Operator</td></tr><tr><td colspan="3"></td><td colspan="3"></td></tr><tr><td colspan="3">Email</td><td colspan="3">Telephone No.</td></tr><tr><td colspan="3"></td><td colspan="3"></td></tr><tr><td colspan="6">DESCRIPTION OF AIRCRAFT</td></tr><tr><td colspan="3">Make</td><td colspan="3">Model</td></tr><tr><td colspan="3"></td><td colspan="3"></td></tr><tr><td colspan="3">Manufacturer&#x27;s Serial No.</td><td colspan="3">Registration Mark</td></tr><tr><td colspan="6"></td></tr><tr><td></td><td colspan="5">Ferry Flight For Repair, Alteration, Maintenance or Storage</td></tr><tr><td></td><td colspan="2">Delivery Or Exporting</td><td colspan="3">Customer Demonstration Flights</td></tr><tr><td></td><td colspan="2">Production Flight Testing</td><td colspan="3">Operation In Excess of Maximum Certified Take Off Mass</td></tr><tr><td></td><td colspan="2">Evacuation From Area of Impeding Dander</td><td colspan="3">Other (Specify):</td></tr><tr><td colspan="6">DESCRIPTION OF THE FLGHT</td></tr><tr><td>From</td><td></td><td>To</td><td></td><td>Duration</td><td>Dep. Date</td></tr><tr><td colspan="6">Via</td></tr><tr><td colspan="6"></td></tr><tr><td colspan="6">CREW REQUIRED TO OPERATE THE FLIGHT</td></tr><tr><td colspan="6">Pilot ☐ SIC ☐ Flight Engineer ☐ Other (Specify):</td></tr><tr><td colspan="6">The Aircraft Does Not Meet Applicable Airworthiness Requirements as Follows</td></tr><tr><td colspan="6"></td></tr><tr><td colspan="6">The Following Restrictions Are Considered Necessary for Safe Operation</td></tr><tr><td colspan="6"></td></tr><tr><td colspan="6">CERTIFICATION: I hereby certify that I am the registered owner (or his authorized agent) of the aircraft described above; and that the aircraft has been inspected and is safe for the flight described.</td></tr><tr><td>Name of Applicant</td><td>Title</td><td colspan="2">Signature</td><td colspan="2">Date Applied</td></tr><tr><td></td><td></td><td colspan="2"></td><td colspan="2"></td></tr></table>
GACA-AVSES-AIR-F005
Rev: 6, Date: 20 Apr 25
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