Form SRG2133 "Confirmation of Military Experience for Military Accreditation Scheme (Mas) Credits in Accordance With Article 10 of Commission Regulation (Eu) 1178/2011" - United Kingdom

Form SRG2133 is a United Kingdom Civil Aviation Authority form also known as the "Confirmation Of Military Experience For Military Accreditation Scheme (mas) Credits In Accordance With Article 10 Of Commission Regulation (eu) 1178/2011". The latest edition of the form was released in August 1, 2016 and is available for digital filing.

Download an up-to-date Form SRG2133 in PDF-format down below or look it up on the United Kingdom Civil Aviation Authority Forms website.

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Download Form SRG2133 "Confirmation of Military Experience for Military Accreditation Scheme (Mas) Credits in Accordance With Article 10 of Commission Regulation (Eu) 1178/2011" - United Kingdom

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Confirmation of Military Experience for Military Accreditation Scheme
(MAS) Credits in Accordance with Article 10 of Commission Regulation
(EU) 1178/2011
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 No. (to be completed by CAA)
Please read attached Guidance Notes before completing this form.
FALSE REPRESENTATION STATEMENT
It is an offence under Article 256 of the Air Navigation Order 2016 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. This offence is punishable on summary conviction by a fine up to £5000, and on
conviction on indictment with an unlimited fine or up to two years imprisonment or both.
1. APPLICANT DETAILS
To be completed by the Applicant
CAA Personal reference number (if known):
Title: .............
Forename(s): ...................................................
Surname: ..................................................................
Date of birth (dd/mm/yyyy): .....................
Nationality: ..........................................................
Town of birth: .................................................................
Country of birth: ..................................................................
Permanent Address: ..........................................................................................................................................................
.........................................................................................................................
Postcode: ...........................................
Telephone: .........................................................
Alternative telephone Number: .......................................................
E-mail: ............................................................................
Fax Number: .......................................................................
A certified copy of your valid Passport, EEA/EU National Identity Card or Full EU Photographic Driving Licence (see
Guidance Note 1) must accompany your application as proof of identification.
2. ADDRESS FOR CORRESPONDENCE (if different from above)
To be completed by the Applicant
Postal Address: .................................................................................................................................................................
...........................................................................................................................................................................................
.........................................................................................................................
Postcode: ...........................................
3. SERVICE DETAILS
To be completed by the Applicant
Branch RN
Army
RAF
Service No.: ..............................................................................................
(for serving and former serving members of HM Armed Forces)
Currently serving Yes
No
if no, date of leaving UK Armed Forces: ...........................................................
Form SRG 2133 Issue 03 August 2016
Page 1 of 2
Confirmation of Military Experience for Military Accreditation Scheme
(MAS) Credits in Accordance with Article 10 of Commission Regulation
(EU) 1178/2011
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 No. (to be completed by CAA)
Please read attached Guidance Notes before completing this form.
FALSE REPRESENTATION STATEMENT
It is an offence under Article 256 of the Air Navigation Order 2016 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. This offence is punishable on summary conviction by a fine up to £5000, and on
conviction on indictment with an unlimited fine or up to two years imprisonment or both.
1. APPLICANT DETAILS
To be completed by the Applicant
CAA Personal reference number (if known):
Title: .............
Forename(s): ...................................................
Surname: ..................................................................
Date of birth (dd/mm/yyyy): .....................
Nationality: ..........................................................
Town of birth: .................................................................
Country of birth: ..................................................................
Permanent Address: ..........................................................................................................................................................
.........................................................................................................................
Postcode: ...........................................
Telephone: .........................................................
Alternative telephone Number: .......................................................
E-mail: ............................................................................
Fax Number: .......................................................................
A certified copy of your valid Passport, EEA/EU National Identity Card or Full EU Photographic Driving Licence (see
Guidance Note 1) must accompany your application as proof of identification.
2. ADDRESS FOR CORRESPONDENCE (if different from above)
To be completed by the Applicant
Postal Address: .................................................................................................................................................................
...........................................................................................................................................................................................
.........................................................................................................................
Postcode: ...........................................
3. SERVICE DETAILS
To be completed by the Applicant
Branch RN
Army
RAF
Service No.: ..............................................................................................
(for serving and former serving members of HM Armed Forces)
Currently serving Yes
No
if no, date of leaving UK Armed Forces: ...........................................................
Form SRG 2133 Issue 03 August 2016
Page 1 of 2
4. CURRENT TRAINING LEVEL(S)
To be completed by the Applicant
I have completed training to the following level:
Elementary Flying Training Graduate (EFTG)
Date of Confirmation Sortie: ..............................
Single Engine Rotary Training Graduate (SERP)
Date of Confirmation Sortie: ..............................
QMP - Basic Fast Jet Training Graduate
Date of Confirmation Sortie: ..............................
QMP - Multi Engine Pilot Training Graduate
Date of Confirmation Sortie: ..............................
QMP - Single Engine Rotary Training Graduate
Date of Confirmation Sortie: ..............................
QMP - Multi Engine Rotary Training Graduate
Date of Confirmation Sortie: ..............................
Operational Category to Operate Military Multi-Pilot Aircraft
Date of Confirmation Sortie: ..............................
(Multi-pilot aircraft utilised must conform to the definition in Commission Regulation No 1178/2011)
Qualified Flying Instructor (single-engine piston
other
)
Date of Confirmation Sortie: ..............................
Qualified Helicopter Instructor (single-engine
other
)
Date of Confirmation Sortie: ..............................
I currently hold
have held
Military Restricted
Unrestricted
Green Instrument Rating
date of latest confirmation sortie: ..........................
for fixed wing
helicopter
5. DETAILS OF EXPERIENCE
To be completed by the Applicant
Aeroplanes
Helicopters
Single Engine
Multi Engine
Day
Night
Day
Night
Day
Night
Single Engine Piston
Multi Engine Piston
Flight Time as Pilot
(do not add taxi time to military
Multi Pilot Aircraft
logbook times)
Turbine/Turbo Prop.
Total
6. DECLARATION OF APPLICANT (see Guidance Notes)
To be completed by the Applicant
I declare that the information provided on this form is correct.
Signature: ..........................................................................................................................
Date: ..................................
PLEASE REFER TO FALSE REPRESENTATION STATEMENT ON PAGE 1
7. DECLARATION OF COMMANDING OFFICER / FLIGHT COMMANDER / ATO HEAD OF TRAINING
I hereby confirm that the information provided by the applicant regarding Military experience is correct.
Unit/Regt/Sqn/Flt/ATO details: ............................................................................................................................................
ATO approval number (If an ATO): ......................................................................................................................................
UNIT OR ATO STAMP
Name of Commanding Officer / Flight Commander (Lt Cdr/Maj/Sqn Ldr or
above) / ATO Head of Training
(Block capitals):..........................................................................................
Rank/Position:............................................................................................
Signature: ..........................................................................................................................
Date: ................................
PLEASE REFER TO FALSE REPRESENTATION STATEMENT ON PAGE 1
Form SRG 2133 Issue 03 August 2016
Page 2 of 2
Confirmation of Military Experience for Military Accreditation Scheme (MAS)
Credits in Accordance with Article 10 of Commission Regulation (EU) 1178/2011 –
GUIDANCE NOTES
The qualifying criteria and credits available under the Military Accreditation Scheme (MAS) are set out in CAP 804, Section 4,
Part O.
This form must be completed to confirm the applicant's entitlement for Credits accepted under the terms of the MAS for
persons who are or have been serving members of the UK Armed Forces. Credits are granted under the terms of the EASA
Credit Report, in accordance with Article 10 of the EASA Aircrew Regulation (Commission Regulation (EU) 1178/2011), as
submitted by 22 (Trg) Group RAF , and as agreed with the CAA in consultation with the Agency. The credits derived from this
report are published in CAP 804.
An applicant claiming credits under the MAS must include this form in support of their application to the CAA for the grant
of any licence, rating, certificate or when applying to take theoretical knowledge examinations based on their military training.
Where the application for the licence, rating or certificate will include training carried out at an Approved Training
Organisation, a copy of this form must also be retained as part of the Training Records for that individual at the ATO making
the recommendation for licence/rating/certificate issue.
The applicant must submit certified copies of their Personal Flying Log pages and clearly identify their qualifications and flight
experience that is relevant to their application for military credits.
The declaration at Section 7 must be completed by the applicant's Commanding Officer or the Head of Training of the ATO
where the additional training was completed.
Where an applicant for the licence, rating or certificate is not required under the terms of the MAS to complete training at
an ATO prior to undertaking the Skill Test, the Declaration of Commanding Officer (Section 7) is acceptable as a
Recommendation for test as required by FCL.030.
Guidance for the completion of this application form
1) Section 1 - Applicant Details.
• All applicants are to complete the section.
•
Ensure that the applicant's full name is given.
•
The CAA Personal Reference number, if applicable, will be found on any licence or medical certificate that has been issued to the
applicant.
2) Section 3 - Service Details.
• Applicants are to give details of their military service and service number.
3) Section 4, Military training level
• Applicants shall give details of the training completed in military service. The credits applicable according to the military level
achieved are set out in CAP 804, Section 4, Part O. For QMP credits, applicants must provide documentary evidence that they
obtained the appropriate level of training (and were issued with their wings, if applicable), for the MAS credits requested.
4) Section 5, Flying experience in Military aircraft.
• This section is to be completed by the applicant. Please refer to CAP 804, Section 4, Part O for the multi pilot aircraft types eligible
for which credit may be given.
5) Section 6, Applicant's Declaration.
• This section is to be completed by the applicant.
6) Section 7 . Declaration of Commanding Officer, Flight Commander or ATO Head of Training.
• This Section shall be completed by an officer at the level of Staff Officer 2 (Lt Cdr/Maj/Sqn Ldr) or above, who must be at least one
rank senior to the individual whose eligibility is being confirmed. Alternatively, the CAA will accept the signature of the Head of
Training of an ATO who has reviewed the applicant's military records and confirms their compliance with the eligibility criteria
published in CAP 804.
Form SRG 2133 Issue 03 August 2016 Guidance Notes
Page i of i
United Kingdom Civil Aviation Authority United Kingdom Federal Legal Forms United Kingdom Legal Forms

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