PART- 66 AIRCRAFT MAINTENANCE LICENCE APPLICATION FOR INITIAL

ISSUE/VARIATION/RENEWAL
Please complete the form in BLOCK CAPITALS using black or dark blue ink after reading the attached
guidance notes. Fields marked with an asterisk * are mandatory and must be completed in all cases.
PAYMENT METHODS Please complete form SRG 1187.
1. PERSONAL DETAILS

CAA Personal reference/AML number (if known)

*Surname ..................................................................... *Forename(s) ..................................................................................................

*Date of birth (dd/mm/yyyy) ......................................... *Place of birth......................................... *Nationality ...............................

*Permanent address (is this a change of address?) Yes No

........................................................................................................................................................................................................................

............................................................................................................................................................. Postcode ...................................

Address for correspondence (if different from above) ...................................................................................................................................

............................................................................................................................................................. Postcode ...................................

Contact Number ............................................................ E-mail ..............................................................................................................

Name of Current Employer ............................................................................................................................................................................

Contact Number ............................................................ Date Employment Commenced .....................................................................

2. *APPLICATION

Initial AML Amendment of AML Renewal of AML

I wish to apply for initial/amendment/renewal of Part-66 AML as indicated and confirm that the information contained in this form was
correct at the time of application.

A B C

Mechanical

Avionic

Base Maintenance Certifying Technician

3. *SUMMARY OF EXPERIENCE – Not applicable for CATEGORY C or Part-66 renewal applicants - Please refer to Section 7
Dates
Aircraft Engine(s) and/or Description of Work
From To Equipment

Form 19 Issue 6 (SRG 1014)

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 4. *EXAMINATION MODULES COMPLETED

I wish to claim the following credits (if applicable):

........................................................................................................................................................................................................................

Experience credit due Part-147 training

........................................................................................................................................................................................................................

Examination credit due equivalent exam certificates

........................................................................................................................................................................................................................

Please enclose all relevant certificates

5a. REMOVAL OF LIMITATIONS FROM BASIC LICENCE (please refer to guidance notes)
Limitations List Exams Completed

5b. REMOVAL OF LIMITATIONS FROM TYPE(S) (please refer to guidance notes)

Aircraft Type/Series Engine Limitation(s)

6. *DECLARATION

I hereby confirm that:

1. I am not holding any Part-66 AML issued in another Member State;
2. I have not applied for any Part-66 AML in another Member State; and
3. I never had a Part-66 AML issued in another Member State, which was revoked or suspended in any other Member State.
4. I declare that I have attended and passed the relevant training with respect to this application.

Signed ........................................................................... Name ................................................................................................................

Date ..............................................................................

It is an offence to make, with intent to deceive, any false representations 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. A Cancellation Charge may be applied as per
the CAA scheme of charges when an active application request has been cancelled by the CAA or the customer.

7. *RECOMMENDATION (not required for Part-66 renewal)

It is hereby certified that the applicant:

has gained the appropriate experience to meet the requirements of Part-66;
(Cat C only) has been exercising Category B1/B2 privileges for 3 years.

Signature ......................................................................................... Name ..............................................................................................

Position ........................................................................................... Date ................................................................................................

Form 19 Issue 6 (SRG 1014)

UK Version Page 2 of 3
 8. DOCUMENTS, FEES AND SUBMISSION INSTRUCTIONS

1. Original EASA Part-66 aircraft maintenance licence (if existing Part-66 licence holder).

2. Certified true copy of Passport (for Initial Issue).

3. Certified true copies of Exam Certificates (front sheet).

4. Certified true copies of Logbook/Work records.

5. Certified true copy of Company Authorisation for Category ‘C’ issue.

6. Payment Form SRG 1187.

Please refer to the Scheme of Charges for details of fees required. All original documents submitted will be subject to courier charge.
Once your application is completed, your application should be posted along with the required documentation to:
Licensing & Training Standards, Civil Aviation Authority, Aviation House, Gatwick Airport South, West Sussex, RH6 0YR

Notes: Having clear concise supporting data will enable Licensing & Training Standards to issue licences more effectively and
with less risk of errors or rejections. Licensing & Training Standards will not contact you for clarification of details on
applications and therefore it is most important that you have the correct information before applying.
Failure to submit a correctly completed application form and the required documentation will lead to the rejection of your
application and an administration fee being charged.

Form 19 Issue 6 (SRG 1014)

UK Version Page 3 of 3
PART- 66 AIRCRAFT MAINTENANCE LICENCE APPLICATION FOR INITIAL ISSUE/VARIATION

GUIDANCE
General Guidance on how to complete Part-66 Licence Initial Issue/Variation Application Form SRG 1014

In order that Licensing & Training Standards can process your licence application as quickly as possible, it is important that all
sections marked with an asterisk on the application form are completed and the required supporting documentation
submitted.

Please note failure to submit a correctly completed application form and the required documentation will lead to the
rejection of your application and an administration fee being charged.

Section 2 Application
Indicates what type of licence you are applying for.

Section 3 Summary of Experience

This section is required for CAA record purposes and should provide a brief summary of experience applicable to your
application. You will still need to submit detailed maintenance experience records in addition to this information, please refer
to Part-66.A.25 and Part-66.A.30

Section 5a Removal of Limitations from Basic Licence

Application to remove limitations on a basic Category/sub-category must cover all limitations applicable to that Category/
sub-category, as the Part-66 licence is not considered to be a progressive licence.

To remove limitations from a basic licence, where protected rights do not convert to a full Part-66 Category/sub-category
licence, the relevant conversion examinations must be passed and any appropriate experience requirements met.

Section 5b Removal of Limitations from Type(s)

This section should be used if applying for the removal of limitation(s) from type rating(s), and should detail aircraft types by
airframe/engine combination. Please enter the limitation number(s) in the appropriate column. Enter only one airframe/engine
per line.

Section 6 Declaration
By signing the declaration you are confirming that all of the information is correct and true.

Section 7 Recommendation
The referee required to countersign the form must be a Quality Manager or the immediate senior person within the Quality
Department of your current employer, or the organisation where the experience was gained.

Form 19 Issue 6 (SRG 1014) Guidance

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UK Version