CAA Form 18 (SRG1779) Appendix 4 "Brazilian Maintenance Organisation (Mo) Application for Initial/Continuation of a Maintenance Approval in Accordance With the Mou Between Anac and the Caa" - United Kingdom

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Appendix 4: Application form
(CAA Form
SRG1779)
Brazilian Maintenance Organisation (MO) application for initial/
continuation of a Maintenance Approval in accordance with the MoU
between ANAC and the CAA.
Applicant
1. RBAC 145 MO name: ............................................................................ RBAC 145 certificate number: .....................
2. Address of MO: ...........................................................................................................................................................
3. Address for correspondence: ........................................................................................................................................
(if different from above):
4. Tel: ..................................................................................... Fax: ...................................................................................
Main Contact E-mail: .....................................................................................................................................................
Application type
5. Please select the type of application and complete section 6 of the Form.
(in case of continuation and or change) CAA Part 145 approval number: UK.145.______
a. Initial
b. Continuation
c. Change
Application
6. I wish to apply on behalf of this Brazilian MO for approval to perform maintenance on UK products in
accordance with the MoU concluded between the UK and ANAC.
I understand that a maintenance approval granted under the terms and conditions of the MoU between the CAA
and ANAC is subject to the fees described in the CAA's Scheme of Charges. Failure to pay the required fee may
result in the invalidity of an initial application or in the revocation of an existing approval.
I further understand that no technical investigation in relation to an initial application to a maintenance approval will
be carried out until payment of applicable fees has been made.
Signature of the Accountable Manager: ........................................................................
Print name in block letters: .................................................................................... Date: ...................................
Note: This application form will be addressed to the ANAC Airworthiness Regional Office in charge of the
AMO surveillance, together with documents supporting the application, and in particular the CAA
supplement to the Maintenance Organisation Manual.
For ANAC Inspector: Please process this application in accordance with ANAC internal procedures.
Form SRG1779 Issue02, July 2021 (CAA Form 18)
Page 1 of 2
Appendix 4: Application form
(CAA Form
SRG1779)
Brazilian Maintenance Organisation (MO) application for initial/
continuation of a Maintenance Approval in accordance with the MoU
between ANAC and the CAA.
Applicant
1. RBAC 145 MO name: ............................................................................ RBAC 145 certificate number: .....................
2. Address of MO: ...........................................................................................................................................................
3. Address for correspondence: ........................................................................................................................................
(if different from above):
4. Tel: ..................................................................................... Fax: ...................................................................................
Main Contact E-mail: .....................................................................................................................................................
Application type
5. Please select the type of application and complete section 6 of the Form.
(in case of continuation and or change) CAA Part 145 approval number: UK.145.______
a. Initial
b. Continuation
c. Change
Application
6. I wish to apply on behalf of this Brazilian MO for approval to perform maintenance on UK products in
accordance with the MoU concluded between the UK and ANAC.
I understand that a maintenance approval granted under the terms and conditions of the MoU between the CAA
and ANAC is subject to the fees described in the CAA's Scheme of Charges. Failure to pay the required fee may
result in the invalidity of an initial application or in the revocation of an existing approval.
I further understand that no technical investigation in relation to an initial application to a maintenance approval will
be carried out until payment of applicable fees has been made.
Signature of the Accountable Manager: ........................................................................
Print name in block letters: .................................................................................... Date: ...................................
Note: This application form will be addressed to the ANAC Airworthiness Regional Office in charge of the
AMO surveillance, together with documents supporting the application, and in particular the CAA
supplement to the Maintenance Organisation Manual.
For ANAC Inspector: Please process this application in accordance with ANAC internal procedures.
Form SRG1779 Issue02, July 2021 (CAA Form 18)
Page 1 of 2
Appendix 4: Application form
(CAA Form
SRG1779)
Brazilian Maintenance Organisation (MO) application for initial/
continuation of a Maintenance Approval in accordance with the MoU
between ANAC and the CAA.
For CAA
Initial Application
7. The CAA hereby confirms that ANAC MO# ..........................., has paid the fees in relation to the above described
application, and therefore authorises the granting by ANAC of the Part 145 approval.
CAA No: UK.145.................
to perform maintenance on UK products once it has been satisfied compliance of the MO to applicable regulatory
requirements.
Please forward this acknowledgement to:
ANAC
Email:
foreign145@anac.gov.br
and
gcvc@anac.gov.br
To be filled in by the CAA in case of non-compliance
8. The CAA informs ANAC that the applicant has failed to demonstrate compliance with the fees and charges and
that the application/continuation of the CAA approval is rendered invalid.
(This information is to be forwarded to the ANAC at the above mentioned address)
Print Name in block letters: .....................................................................................
Date: .........................................
Notes on Fees and Charges
1. For information regarding the current fees and charges please refer to the CAA Scheme of Charges which can be
found on the CAA website
www.caa.co.uk/ors5.
2. Upon receipt of an application SRG1777 for initial approval, the CAA will send an invoice containing details related
to payment methods.
3. For continuation of a CAA approval, the CAA will invoice the applicant on an annual basis.
Form SRG1779 Issue02, July 2021 (CAA Form 18)
Page 2 of 2
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