Application - Jamaica Civil Aviation Authority

Jamaica Civil Aviation Authority
Flight Safety Division
4 Winchester Road - Kingston 10 – Jamaica
Certificate of Registration - Application
(Complete in block capitals, using black or dark blue ink)
Applicant - Owner/Operator (custody and control of aircraft)
1 Name ___________________________________________________________________________
Address _________________________________________________________________________
Telephone: Off ________________ Res ________________ Fax ___________________________
(Enter additional owners on back of form)
Lessor (if applicable)
2 Name ___________________________________________________________________________
Address _________________________________________________________________________
Telephone: Off ________________ Res ________________ Fax ___________________________
Aircraft Details (details must be per the manufacturer’s data plates)
3 Description of Aircraft (see Reg 4(6)(a) for description) ____________________________________
Manufacturer __________________ Model ____________ Serial Number ____________________
Type Certificate (TC) No. ___________________ (Attach copy of TC to this application)
Number of Engines: _______ Engine Manufacturer __________________________________________
Engine Model & TC No. ______________/___________ Power Rating: _________________________
Engine Type:
 Turbofan/Turbojet  Turbo-propeller  Piston  Turbo-shaft
Rotor/Propeller Manufacturer : __________________________
Rotor/Propeller Model/TC No: ______________/____________
Aircraft (history)
4 Registration Status (check one only):
 Previous Marks (aircraft de-registered) ______________ Country of Registry ________________
 N/A (new or amateur built)  Registration Marks Requested ___________
NOTE: Registration marks are assigned based on availability and can only be reserved if the
appropriate fee is paid [Twenty-second Schedule].
The aircraft is wholly owned by (check one only):
 The Government of Jamaica  A citizen of Jamaica
 A company incorporated in Jamaica under the Companies Act and having its principal
place of business in Jamaica.
 Non-Jamaican lessor given above, but under custody and control of the applicant
Aircraft (operation)
5 Main Base of Operations ____________________________________________________________
Type of Operations:  Transport (Pax)  Transport (cargo)  Aerial Work Private
 Un-Certificated _________________________________________________________________
6 Noise Certificate Also Required  YES  NO
Reference Number of Noise Certificate being validated: _____________________________
JAA Form FS001 (Jan/08) - Continued overleaf - Page 1 of 2

7 Additional Information [Applicant]:
Certification by: Owner or Authorized Representative
“I hereby declare that the particulars provided are true in every respect and the enclosed fee of ________________ is
in accordance with the latest Scale of Charges and I agree to be responsible for the payment of any other charges
relating to this application.”
__________________________ _______________________________ _________________
Print Name Signature Date
8 ------------------------- JCAA Use Only --------------------------
Fee or receipt of payment received (d-m-y): ______________ Received by: ___________________
Comments:
 Approved  Not Approved  Follow-up required
Signature _______________________________________ Date ______________________
JCAA Form FS001 (Jan/08) Page 2 of 2