Form SRG1013B "Application for Approval to Conduct on the Job Training (Ojt) Within a Foreign Organisation Approval (In Accordance With the Requirements of Part-66 Appendix Iii)" - United Kingdom

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Application for Approval to Conduct On the Job Training (OJT)
within a Foreign Organisation Approval
(In Accordance with the Requirements of Part-66 Appendix III)
Please complete this form online (preferred method) then print, sign and submit as instructed.
Alternatively, print, then complete in BLOCK CAPITALS using black or dark blue ink.
Unique Corporate No. (to be completed by CAA)
Please read the Guidance Notes before completing the technical sections of this form.
1. APPLICANT TYPE
Public Limited Company
Complete Section 2. a)
Public Educational
Complete Section 2. b)
Establishment University/College
Complete Section 2. a)
Limited Company
Complete Section 2. b)
Charity
Individual (Sole Traders)
Complete Section 2. c)
Complete Section 2. b)
Ministry of Defence
Partnership
Complete Section 2. c)
Complete Section 2. b)
Trust
Private Clubs
Nominated Representative to
Complete Section 2. c)
2. APPLICANT DETAILS (The Applicant is the person responsible for payment of CAA charges)
a) A Company
Registered Company Name (in full): ..................................................................................................................................
Registered Company Number: ..........................................................................................................................................
Country of Company Registration: ................................................
Registered Office Address: ...............................................................................................................................................
........................................................................................
Postcode: ...............................
Telephone: ......................................................................
Fax: .....................................................................................
E-mail: ...............................................................................................................................................................................
Trading Name: (if applicable) .............................................................................................................................................
Trading Address (primary site): ..........................................................................................................................................
........................................................................................
Postcode: ...............................
Website address: ..............................................................................................................................................................
Authorised Representative of Company
This application is to be signed by either a Director or Company Secretary or a person authorised by the board to act on
behalf of the Company, and who is thereby deemed to be the Accountable Manager.
Title: ................
Forename: ......................................................
Surname: .............................................................
Position in Company: .........................................................................................................................................................
Telephone No: ......................................
E-mail: .............................................................................................................
If you are a not a Director or Company Secretary and have been authorised to sign the application form on behalf of the
Company, proof of that authority must be provided with the completed application form.
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.
Form SRG 1013B Issue 01
Page 1 of 7
Application for Approval to Conduct On the Job Training (OJT)
within a Foreign Organisation Approval
(In Accordance with the Requirements of Part-66 Appendix III)
Please complete this form online (preferred method) then print, sign and submit as instructed.
Alternatively, print, then complete in BLOCK CAPITALS using black or dark blue ink.
Unique Corporate No. (to be completed by CAA)
Please read the Guidance Notes before completing the technical sections of this form.
1. APPLICANT TYPE
Public Limited Company
Complete Section 2. a)
Public Educational
Complete Section 2. b)
Establishment University/College
Complete Section 2. a)
Limited Company
Complete Section 2. b)
Charity
Individual (Sole Traders)
Complete Section 2. c)
Complete Section 2. b)
Ministry of Defence
Partnership
Complete Section 2. c)
Complete Section 2. b)
Trust
Private Clubs
Nominated Representative to
Complete Section 2. c)
2. APPLICANT DETAILS (The Applicant is the person responsible for payment of CAA charges)
a) A Company
Registered Company Name (in full): ..................................................................................................................................
Registered Company Number: ..........................................................................................................................................
Country of Company Registration: ................................................
Registered Office Address: ...............................................................................................................................................
........................................................................................
Postcode: ...............................
Telephone: ......................................................................
Fax: .....................................................................................
E-mail: ...............................................................................................................................................................................
Trading Name: (if applicable) .............................................................................................................................................
Trading Address (primary site): ..........................................................................................................................................
........................................................................................
Postcode: ...............................
Website address: ..............................................................................................................................................................
Authorised Representative of Company
This application is to be signed by either a Director or Company Secretary or a person authorised by the board to act on
behalf of the Company, and who is thereby deemed to be the Accountable Manager.
Title: ................
Forename: ......................................................
Surname: .............................................................
Position in Company: .........................................................................................................................................................
Telephone No: ......................................
E-mail: .............................................................................................................
If you are a not a Director or Company Secretary and have been authorised to sign the application form on behalf of the
Company, proof of that authority must be provided with the completed application form.
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.
Form SRG 1013B Issue 01
Page 1 of 7
or b)
An Unincorporated Association or other body
Name of Unincorporated Association or other body: ........................................................................................................
Address: ............................................................................................................................................................................
........................................................................................
Postcode: ..............................
Telephone: ......................................................................
Fax: ......................................................................................
E-mail: .............................................................................
Mobile Telephone: ...............................................................
Website address: ...............................................................................................................................................................
Authorised Representative
This application is to be signed by either a Director or Company Secretary or a person authorised by the board to act on
behalf of the Company, and who is thereby deemed to be the Accountable Manager.
Title: .................
Forename: .......................................................
Surname: .............................................................
Position: .............................................................................................................................................................................
Charity Number (if applicable): .............................................................
or c)
Individual (including sole traders and partnerships)
Title: ................
Forename: ......................................................
Surname: .............................................................
Address: ............................................................................................................................................................................
.........................................................................................
Postcode: .............................
Telephone: ......................................................................
Fax: ......................................................................................
E-mail: .............................................................................
Mobile Telephone: ...............................................................
Trading Name: (if applicable) ..............................................................................................................................................
Website address: ...............................................................................................................................................................
A photocopy of your valid Passport / National Identity Card or valid photocard Driving Licence must accompany
your application as proof of identification. Failure to supply proof of identification may result in a delay to the
application processing time.
In the case of a partnership, please complete details of all partners. Continued on a separate sheet
3. APPLICATION
EASA.145 .............................................................................
Maintenance Organisation CAA Reference Number:
• 145 Organisation Number required for Practical Training applications.
Proposed Date Training to commence: ..................................
NB: Applications must be made a minimum of 6 weeks in advance.
4. APPLICATION FOR TRAINING & ASSESSMENTS (please complete all appropriate details, tick as applicable)
Type / Task
Rating
Airframe
Engine
B1
B2
Form SRG 1013B Issue 01
Page 2 of 7
5. ACCOMMODATION (please complete the address in respect of the application above)
1. Main Training Site Address (if not the address detailed in Part 1)
............................................................................................................................................................................................
Postcode:................................................................ Country: ..............................................................................................
Telephone Number: ................................................
2. Training Site Address
............................................................................................................................................................................................
Postcode:................................................................
Country:.........................................................................................
Telephone Number: ................................................
• All training sites should be audited for suitability in advance of any training by the applicant organisation, and the audit
reports are to be made available at the time of any CAA audit or forwarded for review when requested by the
nominated surveyor.
6a. MANAGEMENT STRUCTURE
Position/Post
Name
Licence Number
Accountable Manager
Maintenance Manager
Quality Manager
• Please complete in full for all applications.
6b. APPROVED ASSESSOR
Position/Post
Name
Licence Number / Approval
Number
Assessor /
Assessor /
Assessor /
• Please complete in full for all applications.
7. FEES
The fee(s) required as calculated in accordance with the CAA Personnel Licensing Scheme of Charges (published in
www.caa.co.uk/ors5
CAA Official record Series 5)
to be paid on application are enclosed herewith.
NB. This application will not be processed until the applicable fees have been received.
Total fees included are: £ .....................................
IMPORTANT NOTES:
• Additional Charges: Where the cost of the CAA investigations exceeds the application charge payable, the applicant
shall pay additional charges to recover those excess costs incurred by the CAA in accordance with the Scheme of
Charges.
• Overseas Visits: If a member or employee of the CAA is required to travel overseas in respect of this application you
are advised to read the CAA Scheme of Charges to which this application relates and the section entitled 'additional
charge where functions are performed abroad'. All expenses incurred in pursuance of this application by virtue of
travelling overseas will be payable by the applicant on demand.
• Withdrawal / Cancellation of Approval: In the event that this application is withdrawn by the applicant, a
cancellation charge may be levied. The cancellation charge reflects the work carried out by the CAA on behalf of the
applicant up to the point of cancellation. Please see the CAA Refunds Policy at
www.caa.co.uk/refunds
for more
information. Where sufficient funds remain from the original application fee, this charge will be deducted from any
refund made in respect of the application following cancellation.
Form SRG 1013B Issue 01
Page 3 of 7
8. FINANCIAL DECLARATION
• I hereby declare that to the best of my knowledge the particulars entered on this application are accurate.
• I enclose the charges payable on application as noted in Section 7 of this application form.
• I agree to pay any additional charges which may become payable in respect of this application under the Scheme of
Charges.
Name of Applicant: ............................................................................................................................................................
2 a), 2 b) or 2 c)
(as shown in
)
Signature of Applicant
2 c)
: ................................................................................................................................
(named in
)
or Signature of Accountable Manager
2 a) or 2 b)
: .................................................................................................
(named in
)
Date: ........................................
FALSE REPRESENTATION STATEMENT
It is an offence to make, with intent to deceive, any false representation for the purpose of procuring the grant, issue,
renewal or variation of any certificate, licence, approval, permission or other document. Persons doing so render
themselves liable, on summary conviction, to a fine not exceeding the statutory maximum (currently £5000, or in
Northern Ireland £2000) and on conviction on indictment to an unlimited fine or imprisonment for a term not exceeding
two years or both.
9. SUBMISSION INSTRUCTIONS
When you have completed this Form, please send it, with attachments as listed below, to:
Applications & Approvals
CAA, Aviation House
Gatwick Airport South
West Sussex
RH6 0YR
• For an individual applicant, please provide proof of ID (suitably certified copy of Passport or Driving Licence - see
Guidance Note 1).
• If you are not a Director or Company Secretary and have been authorised to sign the application form on behalf of the
Company, please enclose proof of that authority.
• NB. No applications will be progressed until all the relevant items on the checklist have been submitted.
Checklist for submission (All applicants): Please tick or complete, as requested, those items being enclosed.
Fee
Completed SRG
Copy of Internal Audit
Certified true copy of approved OJT Logbook
Certified true copy of the Compliance Report
Nomination of Practical Assessors (and copy of authorisation)
Photocopy of PHOTO ID
(Passport or Photocard Driving Licence for Individuals/Sole Traders)
Page 4 of 7
Form SRG 1013B Issue 01
Guidance Note 1
Section 2: Applicant Details
• Registered Company Name and Number: this is the legal name and reference number of the company as registered
with Companies House or as detailed on the Company Certificate of Incorporation.
• Trading Name and Address: Where the company uses a name other than the above for trading / instructional
purposes, this name should be annotated accordingly and the main base for training should also be detailed.
• Authorised Representative of the Company: The Accountable Manager of the company may wish to delegate
responsibility for the completion of application forms to another Director of the company or to the designated Head of
Training. Details of the nominee should be completed and relevant correspondence verifying this agreement should
be forwarded from the Accountable Manager.
• Please refer to the relevant Standards Document, for appropriate information/guidance, available via
www.caa.co.uk/fclstandards
CAA USE ONLY
Applicant’s name .................................................................... Date of application ......................
Department: ...................................................................
Contact Name: ....................................................................
Job No: ............................................ Folio No: .............
CAA Account Number: .........................................................
Nominal Code: ............................
Cost Centre: ..................................
Date received. .........................................
If payment is received by cheque, attach a copy to this application form.
The sum of £ .............................. has been received by: ................................................
Date: ..................................
Amount paid by:
Cheque
Cash
Card
Electronic Transfer*
£ .................................
£ .........................
£ ..............................
£ ...................................
* Receipt of Electronic Transfer to be verified by Treasury.
Cheque drawn against account of: ....................................................................................................................................
Bank Account No: ...........................................................
Sort Code: ..............................
Is this part of a Company payment?
Yes
No
If Yes - Total amount paid:£ ......................................
Amount to be deducted from NATS account: £ ........................
Enclosures: .................................................
FedEx paid Yes/No Loaded by: .............. Signed/Despatched: ...............
Legal Entity Details
Company – Date of incorporation of Company: ...................
If declaration is signed on behalf of a Company:
is declaration signed by a Director or Company Secretary? .......................
if not, then does signatory have authority to sign? .....................................
Individual – Identification Document Details e.g. Passport/Driving Licence.
Type of identification: ......................................................
Signature on ID checked against Form Signature:
.
Appropriately certified:
Page 5 of 7
Form SRG 1013B Issue 01