Form SRG1836 "Part-Cc (Cabin Crew) Report to the UK Civil Aviation Authority" - United Kingdom

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Part-CC (Cabin Crew) Report to the UK Civil Aviation Authority
This form is for requesting the revocation or suspension of a cabin crew attestation issued by an organisation
approved to do so by the UK CAA (as indicated by the prefix GBR on the Attestation Reference Number).
This form can be filled in on screen (preferred method) then printed, signed and submitted as instructed.
Alternatively, please print then complete in BLOCK CAPITALS using black or dark blue ink.
Please read the Guidance Notes before completion of the Part CC (Cabin Crew) report.
CAA use only
1. Details of the Cabin Crew Attestation Holder who is the subject of the report
First Name: ............................................................................................. Surname: .....................................................................................
Address: ........................................................................................................................................................................................................
Town/City: ............................................................................................... Postcode: ....................................................................................
Telephone: ............................................................................................... Mobile Telephone: .......................................................................
Email: ...................................................................................................... Attestation Reference No: GBR - .................................................
2. Description of the Alleged incident(s) that may justify suspension or revocation of the Cabin Crew Attestation (2500
characters).
(If necessary, provide information on separate numbered pages and state here the number of pages attached)
3. Reporters Details
First Name: ............................................................................................. Surname: .....................................................................................
Reporting Organisation: .......................................................................... AOC Number: ..............................................................................
Address: ........................................................................................................................................................................................................
Town/City: ............................................................................................... Postcode: ....................................................................................
Telephone: .............................................................................................. Mobile Telephone: .......................................................................
Email: ......................................................................................................
4. Names and contact details of witnesses:
Witness 1:
Witness 2:
Witness 3:
Witness 4:
What is the provision for the suspension or revocation of the Attestation according to ARA.CC.105 that it is alleged should apply in this
case?
Part ARA.C.105* (a)
(b)
(c)
(d)
*Select all that apply
Please state the applicable regulatory reference that the crew member was allegedly in breach of:...........................................................
Page 1 of 2
Form SRG1836 Issue 1, July 2015
Part-CC (Cabin Crew) Report to the UK Civil Aviation Authority
This form is for requesting the revocation or suspension of a cabin crew attestation issued by an organisation
approved to do so by the UK CAA (as indicated by the prefix GBR on the Attestation Reference Number).
This form can be filled in on screen (preferred method) then printed, signed and submitted as instructed.
Alternatively, please print then complete in BLOCK CAPITALS using black or dark blue ink.
Please read the Guidance Notes before completion of the Part CC (Cabin Crew) report.
CAA use only
1. Details of the Cabin Crew Attestation Holder who is the subject of the report
First Name: ............................................................................................. Surname: .....................................................................................
Address: ........................................................................................................................................................................................................
Town/City: ............................................................................................... Postcode: ....................................................................................
Telephone: ............................................................................................... Mobile Telephone: .......................................................................
Email: ...................................................................................................... Attestation Reference No: GBR - .................................................
2. Description of the Alleged incident(s) that may justify suspension or revocation of the Cabin Crew Attestation (2500
characters).
(If necessary, provide information on separate numbered pages and state here the number of pages attached)
3. Reporters Details
First Name: ............................................................................................. Surname: .....................................................................................
Reporting Organisation: .......................................................................... AOC Number: ..............................................................................
Address: ........................................................................................................................................................................................................
Town/City: ............................................................................................... Postcode: ....................................................................................
Telephone: .............................................................................................. Mobile Telephone: .......................................................................
Email: ......................................................................................................
4. Names and contact details of witnesses:
Witness 1:
Witness 2:
Witness 3:
Witness 4:
What is the provision for the suspension or revocation of the Attestation according to ARA.CC.105 that it is alleged should apply in this
case?
Part ARA.C.105* (a)
(b)
(c)
(d)
*Select all that apply
Please state the applicable regulatory reference that the crew member was allegedly in breach of:...........................................................
Page 1 of 2
Form SRG1836 Issue 1, July 2015
5. Declaration (To be completed by the Reporter on behalf of the organisation)
The information provided above is correct to the best of my knowledge and belief.
I understand that a copy of this document may be given to the person who is the subject of the report.
I understand that I, and those named as witnesses, may be requested to give written statements to the CAA and to appear at a CAA
Review Board in the event of regulatory action being taken and a review hearing being held.
Name:........................................................................
Position in Company: ..................................................................
Signature: ................................................................
Date: ........................................................................
6. Guidance Notes for the completion of Part-CC (Cabin Crew) report to the CAA.
i)
The Part-CC Cabin Crew Report has been created as a means for the holders of Air Operators Certificates and for approved
Cabin Crew training providers to inform the CAA when the organisation believes that suspension or revocation of a Cabin Crew
Attestation should be considered by the CAA.
ii)
Annex VI, Part-ARA, to the Aircrew Regulation sets out the circumstances that may justify suspension or revocation of a Cabin
Crew Attestation as follows:
ARA.CC.105 Suspension or revocation of cabin crew attestations
The competent authority shall take measures in accordance with ARA.GEN.355, including the suspension or revocation of
a cabin crew attestation, at least in the following cases:
a)
non-compliance with Part-CC or with the applicable requirements of Part-ORO and Part-CAT, where a safety issue
has been identified;
b)
obtaining or maintaining the validity of the cabin crew attestation by falsification of submitted documentary evidence;
c)
exercising the privileges of the cabin crew attestation when adversely affected by alcohol or drugs; and
d)
evidence of malpractice or fraudulent use of the cabin crew attestation.
iii)
This report must make clear the reasons why suspension or revocation of the attestation is proposed, including identifying the
non-compliance with Part CC, ORO, CAT if applicable and the provision under ARA.CC.105 that the reporter believes is
applicable.
iv)
Information provided in the report must be factual. e.g. Where and when the incident(s) occurred; who was present; what was
seen/heard and by whom. Witnesses may be asked to provide written statements to the CAA in the course of its
investigations. These may subsequently be disclosed to the attestation holder.
v)
The person who is the subject of the report is entitled to a copy of the report.
vi)
If the CAA decides to revoke or substantively suspend a Cabin Crew Attestation, the holder may request a review under the
procedures of Regulation 6 of the CAA Regulations. This will commonly involve a hearing where the CAA and the appellant
will present their cases. Those who provided reports and statements to the CAA in respect of the case should be prepared to
appear at such a hearing if requested.
vii)
When completed the Part-CC Cabin Crew Report should be signed by the reporter and sent to:
FOCabin.Safety@caa.co.uk
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Form SRG1836 Issue 1, July 2015
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