Ministry of Civil Aviation                                                                   FORM 1120-009

 

Application For Approval Of

 

MTC Schedule

 

 

MTC Schedule Extension

 

Aircraft Reweighin

 

Unit TBO Extension

 

Major Repair/Alteration

 

 

 

 

 

Section 1 : To be completed by the applicant

1- Owners Name 

 

 

 

 

2- Operator

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3- Mailing Address of Company

 

4- Telephone #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5- Fax #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6- A/C Nationality & Registration Marks

7- A/C Make & Model

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8- Engines Type and Manufacturer

 

9- Propellers Model and Type

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10- A/C Place:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11 - For unit TBO extension:

 

 

 

 

 

 

 

 

 

   a- TSN --------------------------------

TSo --------------------------

 

 

 

 

   b- TBO -------------------------------

Expiry Date ----------------------

 

 

 

12- Proposed Maintenance Schedule

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13- Detailed justification for extension

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14- Reasons for A/C reweighing /Repair

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15- Additional Information provided and attached

NO

 

 

 

Yes

 

 

1)

 

 

2)

 

 

3)

 

 

 

Name:

 

Title:

 

 

 

Signature:

 

 

 

Date:

 

 

Section 2. For Official Use Only

Received By

 

 

 

 

 

Date:

 

 

 

 

 

Department assigned responsibility:

 

 

Date forwarded to Department

 

      

AID

 

TLD

 

MD

 

 

 

 

 

 

 

Approval Number:

 

 

 

 

 

 

 

 

 

 

Remarks: