PAKISTAN

CIVIL AVIATION AUTHORITY

CAAF-127-AWRG-3.0
APPLICATION FOR ISSUANCE OF CERTIFICATE OF
AIRWORTHINESS
AIRWORTHINESS DIRECTORATE
THIS FORM SHALL BE FILLED ON SCREEN THEN PRINTED, SIGNED AND SUBMITTED AS INSTRUCTED

1. APPLICANT’S DETAILS ( OWNER / OPERATOR / AUTHORISED DESIGNEE): (tick appropriate)

Name: M/S AIR EAGLE PVT LTD Nationality: PAKISTANI CNIC/ Passport No. N/A

Phone: 051-5405146 Email: INFO@AIREAGLE.PK

Contact Details:
Address: AIR EAGLE HEAD OFFICE, NEAR RFC, BBIAP, RAWALPINDI, PAKISTAN

2. AIRCRAFT DETAILS:

Certificate of Airworthiness in respect of E __

AP- __ G __
A (if already allotted)

Type Certificate (TC) issued by PCAA

This Aircraft has
Type Acceptance Certificate (TAC) issued by PCAA
HARBIN HAFEI AVIATION CHINA
Aircraft Manufacturer Manufacturer Country No. of Seats 18
INDUSTRY CO LTD
Aircraft Type & Model HARBIN Y12IV MSN 015 Year of Manufacture 2006
Type Acceptance Certification
Type Certificate number A00006WI Certificate number Standards FAR 23 & CCAR 23

Power-driven airplane Rotorcraft UAV

Airframe Type
Manned free balloon Airship Unpowered Aircraft
Fitted for landing on Land Water Amphibious

Maximum Takeoff Mass 5670 Kg Maximum Landing Mass

(in Kgs) (in Kgs) 5400 Kg

3. POWERPLANT DETAILS:

Engine Manufacturer PRATT AND WHITNEY CANADA No. of Engines 02

Engine Category Piston Turboprop Turbofan Turbo-shaft

Engine Type / Model PT6A-27

4. PROPELLER DETAILS: (if any)

Propeller Manufacturer HARTZELL No. of Blades 03 Model HC-B3TN-3B/T10173B-3

Fixed Pitch Variable Pitch Constant Speed

Propeller Type
Full-feathering Ground Adjustable Pitch Other (specify)

5. OPERATION CATEGORY: (attach copy of AOC and Ops Specs, if already issued)

Tick the appropriate category for which Certificate of Regular Public Transport Charter
Airworthiness is sought: Aerial Work Private

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6. CHECKLIST FOR APPLICATION: (attached as appropriate)
Attached
Airplane Flight Manual (AFM)/ Maintenance Manuals (AMM, SRM WDM etc.) (may be in soft copy)
Latest weight and balance report
Authority letter in case of authorized designee (mandatory, otherwise the case will be rejected)

7. MANDATORY DECLARATIONS:

1. I hereby certify that all statements in this application are true and correct in every particular and that I have read
and understood all provisions of the Civil Aviation Rules 1994.

2. I authorize PCAA to deduct required fee from, my advance account of Category-A /OR receipt attached.

Signature: ___________________ Date: ______________ Official stamp: _____________________

8. FOR USE IN HQs AIRWORTHINESS DIRECTORATE: (to be filled by evaluating officer)

Reference Minute: Recommended Not-Recommended

I have also updated aircraft information sheet in Airworthiness Management System (AMS) for this aircraft.

Signature: ___________________ Date: ______________ Official stamp: _____________________

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