FATA FATA FATA FATA FATA

Registration Temp Id: P-T2018/2020 P-T2018/2020

APPLICATION FOR ALLOTMENT OF COMPUTER NUMBER FOR APPEARING DGCA INDIA CA-9
IN FLIGHT CREW LICENCE EXAMINATION (FATA Comp. No.)

GOVERNMENT OF INDIA
DIRECTORATE GENERAL OF CIVIL AVIATION
CENTRAL EXAMINATION ORGANISATION

FOR OFFICE USE ONLY SIGN OF OFFICER

P-

1. PERSONAL DETAILS

1.1. Name LUIS AUGUSTO ALDANA

1.2. Gender MALE

1.3. Date of Birth 04-10-1987

1.4. Mother's Name SONIA CAMPOS

1.5. Fathers Name LUIS EDUARDO ALDANA ESTRADA

1.6. Email ID aldanacamposluis@gmail.com

1.7. Nationality Guatemalan

1.8. Mobile Number XXXXXX0701

2. Details of Sponsoring Organisation

Address of the Name of the Name Email ID Mobile Number

Organistaion Organisation

ALLIANCE AIR AASL IGI AIRPORT GEETHA AJMANI 9810077767 AASLOPS.ADMIN@A

LUFTHANSA IRINDIA.IN
HANGER BUILDING
ALLIANCE BAWAH

3. Details of FATA Licence

Date of Issue FATA Authorisation Number Date of Expiry

19-11-2018 410-2018 18-02-2019

4. Details of Valid Licence

License Number Date of Issue Issuing Authority & Date of Expiry

Country

3162 31-01-2014 30-12-2019 DGAC GUATEMALA

5. Visa details

Visa No. Issue Date Expiry Date Place of Issue

2502447 12-09-2018 11-09-2019 INIDIA EMBASSY

Online Submission Date & Time : 11/12/2018 & 16:20:23 Page No. 1
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Registration Temp Id: P-T2018/2020 P-T2018/2020

6. Passport Details

Passport No. Issue Date Expiry Date Place of Issue

192963414 07-09-2018 06-09-2023 DIRECTOR DE

MIGRACION DE
GUATEMALA

7. Address

Correspondence Address Permanent Address

the ashok hotel channakyapuri new delhi km.19.5 car san jose pinla res. lo de valdez C29 MzD13
channakyapuri- new delhi Delhi PIN-110021 India san jose pinula-Guatemala- Guatemala Guatenala PIN-
01052 Guatemala

8. Documents Uploaded and to be enclosed

S.No. Doc.No. Document Name Tick Mark DGCA Remark

1 - Applicant Photograph

2 - Applicant Signature

3 - Date of Birth Proof

4 - Copy of Proof of Permanent Address

5 - Copy of Passport

6 - Visa Documents

7 - PILOT License

8 - FATA Authorisation Certificate

9. Declaration

I hereby certify that the above particulars/enteries made by me are true and correct in every respect to
❏ the best of my knowledge and belief and that nothing has been concealed or withheld by me. I
understand that if any of my particulars/enteries are found false or incorrect at any time, my
candidature will stand rejected and further action can be taken against me by DGCA as per the Rules.
Further, I have read the requirement for issue/ extension of Pilot Licence/Rating, as laid down in
Aircraft Rules / CARs amended from time to time.

I declare that I have read and understood the above declaration.

❏
DATE SIGNATURE

PLACE NAME

Online Submission Date & Time : 11/12/2018 & 16:20:23 Page No. 2
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Registration Temp Id: P-T2018/2020 P-T2018/2020

10. CERTIFICATION BY COMPETENT AUTHORITY

To be attested by CFI/PII/Gazetted Officer/Notary Public. In case of serving Defence Applicant should

personnel ,this may be attested by another serving Commissioned Officer paste recent color
passport size
This is to certify that all the above particulars furnished by LUIS AUGUSTO ALDANA have photograph.
been verified by me and found to be correct.

*Signature in full of attesting authority.......................

Date

Place

* Signature & stamp shall partly cover this page and photograph.

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