HKAR-66 Aircraft Maintenance Licence - 民航處

香 港 特 別 行 政 區 政 府 民 航 處 Civil Aviation DepartmentThe Government of the Hong Kong Special Administrative RegionHKAR-66 Aircraft Maintenance LicenceApplication for Written ExaminationNote: 1. The following information is collected for the purpose of HKAR-66 Aircraft Maintenance Licensing. It will not be disclosed toother person(s) without the consent of the applicant.2. For initial application, all boxes should be completed if applicable. If the application has been accepted by CAD and there is nochange to the submitted information since last application, only pages 3 & 4 should be submitted for examination arrangement.3. Where the applicant is not a resident of Hong Kong, the application will only be accepted if Director-General is satisfied thatthere is a need for such licence to maintain Hong Kong registered aircraft.4. Please use separate sheet if the space provided is insufficient.Personal Information : (In Block Letters)HK CAD IA / Licence No : ________________________Title: Mr./Mrs./Miss/Ms.^ Surname : Given Name: Nationality :Date of Birth: (dd/mm/yyyy)HK ID Card/Passport^ No. : _________________________Residential Address : ________________________________________________________ Phone : ___________________ Fax:Postal Address : (If differs from above)Email : ____________________________________Present Employment Details : Company :Phone : Address : Current Position :Duty :Period : (From / To)Valid Non-CAD aircraft maintenance engineer licence : Licence Number : Issuing Authority :Issue Date : (dd/mm/yyyy) __________________________Expiry Date : (dd/mm/yyyy) ____________________________Supporting document(s) attached with this application :DocumentsCADCopy of valid Non-CAD licences :Copy of HK Identity Card / Passport :DCA 35E (07/2013) ^Delete as appropriate Page 1 of 4

Authority for Disclosure of Licence Details and Examination Result :I hereby authorise / not authorise^ the Hong Kong Civil Aviation Department to release full details of my licence & examinationresult to .Note: The completion of this box is optional.Declaration & Signature :I declare that the details I have given on this form are true & accurate to the best of my knowledge & belief. I understand thatit is an offence to make, with intent to deceive, any false representation for the purpose of procuring the grant, extension,renewal, variation or conversion of any licence.Date : (dd/mm/yyyy) __________________________Signature of Applicant : __________________________DCA 35E (07/2013) ^Delete as appropriate Page 2 of 4

Hong Kong, China Civil Aviation Department HKAR-66 AML – Application for Written ExaminationName : HK CAD IA / Licence No :Address :Basic Category / Sub-category applied for : (Please tick box) Examination Module :A B I am applying examinations: Please specify• Aeroplane Turbine A1 B1.1 • For the standard grant/extension of Licence• Aeroplane Piston A2 B1.2 • To convert from a HKAR-AML Licence• Helicopter Turbine A3 B1.3 • To convert from an Non-CAD Licence• Helicopter Piston A4 B1.4• AvionicsB2• Avionics (Revised B2 effective on 1 August 2013) B2* Venue: (Please tick box)• Simple light aeroplane B3 CAD HAECO Exam CentreSelect the module(s) you wish to take by placing a tick in the relevant box. For partial module examination, please use the table on p.4. Module Subject Fee1. Mathematics $3152. Physics $3153. Electrical Fundamentals $3154. Electronic Fundamentals $3155. Digital Techniques / Electronic Instrument Systems $3156. Materials and Hardware $3157. Maintenance Practices $3158. Basic Aerodynamics $3159. Human Factors $31510. Aviation Legislation $31511. Aeroplane Aerodynamics, Structures and Systems $31512. Helicopter Aerodynamics, Structures and Systems $31513. Aircraft Aerodynamics, Structures and Systems $31514. Propulsion $31515. Gas Turbine Engine $31516. Piston Engine $31517. Propeller $31519. Wooden Aeroplanes $315Essay To include questions from Module 7 / 9 / 10^ $775ProposedDate(MM/YY)For CAD use onlyConfirmed DateNote: 1. Please refer HKAR-66 & HKAR-2 for details of examination requirements. Candidates may select theexam venue in CAD or HAECO by making a tick in the relevant box.2. If CAD exam venue is selected, please enter the proposed exam dates. Application must be made atleast two (2) months in advance. Candidates will be notified about the time and date of theexamination four (4) weeks prior the scheduled examination.3. A notification will be returned to the applicant within two (2) weeks after the application is acceptedby CAD to notify the applicant the status of his/her application.4. If the above mentioned notifications are not received, the applicant should call the PersonnelLicensing Office Tel:2910 6095 or email to plo@cad.gov.hk for advice.5. If HAECO Exam Centre is selected, no proposed exam dates entry is required. Candidate No. andpassword will be provided to candidate to book the exam date through the HAECO internet.6. Personal details & examination result will be disclosed to HAECO Exam Centre if it is selected forexamination.Not valid without HKCAD Official ChopDCA 35E (07/2013) ^Delete as appropriate Page 3 of 4

Hong Kong, China Civil Aviation Department HKAR-66 AML – Application Written Examination Select the partial module(s) you wish to take by placing a tick in the relevant box.PartialModulePartial ModuleFeeProposedDate(MM/YY)For CAD use onlyConfirmed Date3. Electrical Fundamentals $3154. Electronic Fundamentals $3155. Digital Techniques / Electronic Instrument Systems $3156. Materials and Hardware $3157. Maintenance Practices $31510. Aviation Legislation $31511. Aeroplane Aerodynamics, Structures and Systems $31512. Helicopter Aerodynamics, Structures and Systems $31513. Aircraft Aerodynamics, Structures and Systems $31515. Gas Turbine Engine $31516. Piston Engine $315Essay To include questions from Module 7 / 9 / 10^ $775Note:Please see Notes 1 to 6 at page 3 of this Form.Not valid without HKCAD Official ChopPayment Detail :I enclosed Cheque /Bank Draft for HK$made payable to “The Government of the Hong Kong Special AdministrativeRegion”, & crossed “A/C Payee Only”.Cheque Number :Statement of Consent :To whom it may concernI, (name), agree and consent that my Non-CAD Aircraft MaintenanceEngineer Licence / Maintenance Authorisation / Training details can be disclosed by the issuing Aviation Authority/ Maintenance Organisation _________________________________ to Hong Kong Civil Aviation Departmentand used for the purpose of processing my HKAR-66 Aircraft Maintenance Licence application.Date : (dd/mm/yyyy) ___________________ Signature :Note: Please also submit pages 1 & 2 of this application form if personal information detail has been changed.DCA 35E (07/2013) ^Delete as appropriate Page 4 of 4