Form ASC6000 "Application to Become a Regulated Supplier" - United Kingdom

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APPLICATION TO BECOME A REGULATED SUPPLIER
You should fill in this form if you wish to be included on the List of Regulated Suppliers because you supply
items intended to be taken on board an aircraft for use, consumption or purchase by passengers or crew
during the flight.
Please print clearly in black ink
Please tick the relevant boxes
Yes
No
Have you applied for listing before?
New Application
Relisting
Additional Site
Update of Details
Other Changes
This application will be considered in respect of and if appropriate, granted to, the Company Name as registered under
the Company Number provided on this form.
Part A Company Name
Registered Company Name (in full): ..............................................................................................................................................................
Trading as (if different): ………………………………………………..……………………………..……………………….................................
Type of Business: ………………………………………………..……………………………..………………………..........................................
Registered Company Number: ......................................................................................................................................................................
Registered Office Address: ............................................................................................................................................................................
...............................................................................................................
Postcode: .........................................................................
Telephone: ............................................................................................
Fax: . . ................................................................................
Part B. Security Manager contact details
Please give details of the individual in your company who will officially accept any written or verbal communication from the CAA
acting as the Appropriate Agent.
Title: ................. Forename: ...................................... Surname: ................................................................................................................
Position in Company: …………………………………………………………………………..…..………..………..…………............................
Official Address: ..........................................................................................................................................................................................
Postcode: ...............................................................................................
Telephone: .................................................................................... Mobile: ...................................................................................................
E-mail: ........................................................................................... Fax: .........................................................................................................
Form ASC6000 Issue05, Dec 2020
Page 1 of 3
APPLICATION TO BECOME A REGULATED SUPPLIER
You should fill in this form if you wish to be included on the List of Regulated Suppliers because you supply
items intended to be taken on board an aircraft for use, consumption or purchase by passengers or crew
during the flight.
Please print clearly in black ink
Please tick the relevant boxes
Yes
No
Have you applied for listing before?
New Application
Relisting
Additional Site
Update of Details
Other Changes
This application will be considered in respect of and if appropriate, granted to, the Company Name as registered under
the Company Number provided on this form.
Part A Company Name
Registered Company Name (in full): ..............................................................................................................................................................
Trading as (if different): ………………………………………………..……………………………..……………………….................................
Type of Business: ………………………………………………..……………………………..………………………..........................................
Registered Company Number: ......................................................................................................................................................................
Registered Office Address: ............................................................................................................................................................................
...............................................................................................................
Postcode: .........................................................................
Telephone: ............................................................................................
Fax: . . ................................................................................
Part B. Security Manager contact details
Please give details of the individual in your company who will officially accept any written or verbal communication from the CAA
acting as the Appropriate Agent.
Title: ................. Forename: ...................................... Surname: ................................................................................................................
Position in Company: …………………………………………………………………………..…..………..………..…………............................
Official Address: ..........................................................................................................................................................................................
Postcode: ...............................................................................................
Telephone: .................................................................................... Mobile: ...................................................................................................
E-mail: ........................................................................................... Fax: .........................................................................................................
Form ASC6000 Issue05, Dec 2020
Page 1 of 3
Part C. Site Security Representative
Please complete Part C for every site to be listed and/or approved. Please ensure that the details you provide are those that
you would like to see on the UK Database on Supply Chain Security.
Name of Person responsible for site security:
Title: ................. Forename: ...................................... Surname: ...... ........................................................................................................
Site Address where Inflight Supplies are located:.......................................................................................................................................
............................................................................................................................... ....................................................................................
Postcode: ............................................................................
Telephone: ................................................................................. Fax: .................................................................................... ..................
E-mail: ........................................................................................ Mobile Telephone: ............................................................. ..................
Regulated Number (if assigned): GB/RS/ ………………………………………………………………..…………….……………..................
VAT Number : ……………………………………………………
Reminder EACH site you wish to be listed MUST be on a separate Part C
Form ASC6000 Issue05, Dec 2020
Page 2 of 3
Part D
Now please read the declaration and then sign and date below
ATTACHMENT 8-A
DECLARATION OF COMMITMENTS
REGULATED SUPPLIER OF IN-FLIGHT SUPPLIES
In accordance with Regulation (EC) No 300/2008 of the European Parliament and of the Council (
) and
1
its implementing acts, I declare that,
- to the best of my knowledge, the information contained in the company's security programme is true and accurate,
- the practices and procedures set out in this security programme will be implemented and maintained at all sites covered by the programme,
- this security programme will be adjusted and adapted to comply with all future relevant changes to Union legislation, unless
........................................................................................................... informs the CAA (as agent of the appropriate authority) that it no longer
wishes to deliver in-flight supplies directly to aircraft (and thus no longer wishes to trade as a regulated supplier),
...........................................................................................................will inform the CAA (as agent of the appropriate authority) in writing of:
(a) minor changes to its security programme, such as company name, person responsible for security or contact details, promptly but at least
within 10 working days; and
(b) major planned changes, such as new screening procedures, major building works which might affect its compliance with relevant Union
legislation or change of site/address, at least 15 working days prior to their commencement/the planned change,
- in order to ensure compliance with relevant Union legislation, ........................................................................................................... will
cooperate fully with all inspections, as required, and provide access to all documents, as requested by inspectors,
- .......................................................................................................... will inform the CAA (as agent of the appropriate authority) of any serious
security breaches and of any suspicious circumstances which may be relevant to in-flight supplies, in particular any attempt to conceal prohibited
articles in supplies,
- .......................................................................................................... will ensure that all relevant staff receive training in accordance with Chapter
11 of the Annex to Implementing Regulation (EU) 2015/1998 and are aware of their security responsibilities under the company's security
programme; and
- ...........................................................................................................will inform the CAA (as agent of the appropriate authority) if:
(a) it ceases trading;
(b) it no longer delivers in-flight supplies directly to aircraft; or
(c) it can no longer meet the requirements of the relevant Union legislation.
I shall accept full responsibility for this declaration.
Signed:
……………………..……………………..……………………..……………………..……………………..
ity
(The signatory must hold a senior position in the company or business which carries responsibility for secur
Name: ………..……………………..…………………………..……………………..……………………..…................................
Position in company or business. ……………………..…………………………………………………………………...
Date: .................................................
Please return the completed application form together with the following information:
details of previous applications for listing To:
Aviation Security Compliance
Cargo and In-Flight Supplies Business Support
Civil Aviation Authority, 5th Floor, 11 Westferry Circus, London, E14 4HD
On receipt you will be contacted to progress your application and provided information to support the completion of your
security programme.
Regulation (EC) No 300/2008 of the European Parliament and of the Council of 11 March 2008 on common rules in the field of
([1])
civil aviation security and repealing Regulation (EC) No 2320/2002 (OJ L 97, 9.4.2008, p. 72).
Form ASC6000 Issue05, Dec 2020
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