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NAME: CPL No:

Sortie wise list of 500 Hrs. of PIC

A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
A/c Co - Departu Arrival

NM
Date Regn. Pilot In Command From To P1 Co- P1 Co-
Type Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
(U/S) Pilot (U/S) Pilot

Current Page Total


Previous Page Total
Total
A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
A/c Co - Departu Arrival

NM
Date Regn. Pilot In Command From To P1 Co- P1 Co-
Type Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
(U/S) Pilot (U/S) Pilot

Current Page Total


Previous Page Total
Total

I CERTIFY THAT ALL ENTRIES IN THIS STATEMENT ARE CORRECT Total X Counrty Flying by Day P1 (U/S)
Total X Counrty Flying by Night P1 (U/S)
F/O Arish Adil Daver CPL - Total X Counrty Flying by Day & Night P1(U/S)
Total PIC X Counrty Flying by Day & Night
PIC Flying by Day & Night
SIGNATURE Effective PIC Flying by Day & Night
NAME: CPL No:

Sortie wise list of X - Country Flying

A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To Co- P1 Co- P1
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
Pilot (U/S) Pilot (U/S)

Current Page Total


Previous Page Total
Total
A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To Co- P1 Co- P1
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
Pilot (U/S) Pilot (U/S)

Current Page Total


Previous Page Total
Total

I CERTIFY THAT ALL ENTRIES IN THIS STATEMENT ARE CORRECT


Total X Country Flying by Day
F/O Arish Adil Daver CPL - Total X Country Flying by Night
Total X Country Flying

SIGNATURE
NAME: CPL No:

Sortie wise list of Instrument Flying

A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To Co- P1 Co- P1
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
Pilot (U/S) Pilot (U/S)

Current Page Total


Previous Page Total
Total
A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To Co- P1 Co- P1
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
Pilot (U/S) Pilot (U/S)

Previous Page Total


Total

I CERTIFY THAT ALL ENTRIES IN THIS STATEMENT ARE CORRECT

F/O CPL - TOTAL INSTRUMENT FLYING

SIGNATURE
NAME: CPL No:

Sortie wise list of PIC X - Country Flying by Night ( more than 100 nm )

A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To P1 Co- P1 Co-
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
(U/S) Pilot (U/S) Pilot

Current Page Total 11:36


Previous Page Total 00:00
Total 11:36
A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To P1 Co- P1 Co-
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
(U/S) Pilot (U/S) Pilot

Current Page Total


Previous Page Total
Total

I CERTIFY THAT ALL ENTRIES IN THIS STATEMENT ARE CORRECT

F/O CPL - Total X Counrty Flying by Night P1 (U/S)


Effective PIC X Counrty Flying by Night 1

SIGNATURE
NAME: CPL No:

Sortie wise list of PIC X - Country Flying by Day & Night ( more than 100 nm )

A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To P1 Co- P1 Co-
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
(U/S) Pilot (U/S) Pilot

Current Page Total


Previous Page Total
Total
A/c Details Crew Details Flight Details Single Engine Multi Engine Aircraft IF
Day Night Day Night

Distance in
Simulated
Actual
Co - Departu Arrival

NM
Date A/c Type Regn. Pilot In Command From To P1 Co- P1 Co-
Pilot re Time Time Dual PIC Dual PIC U/T PIC U/T PIC
(U/S) Pilot (U/S) Pilot

Current Page Total


Previous Page Total
Total

I CERTIFY THAT ALL ENTRIES IN THIS STATEMENT ARE CORRECT


Total X Counrty Flying by Day P1 (U/S)
F/O CPL - Total X Counrty Flying by Night P1 (U/S)
Total X Counrty Flying by Day & Night P1(U/S)
Effective PIC Flying by Day & Night
SIGNATURE
NAME: IGA NO.:
S.NO DESCRIPITION STATUS DOCUMENTS REQUIRED FILED/CHECKED
1 CPL NO- VALID UPTO: ORIGINAL & COPY
2 FRTOL NO- VALID UPTO: ORIGINAL & COPY
3 RTR NO- VALID UPTO: ORIGINAL & COPY
4 PHOTOGRAPHS- 5 NO PASPORT SIZE Enclsoure
ALL LOG BOOKS TILL
5 LOGBOOKS DATE Original
6 ATPLAPPLICATION FORM FILLED FORM Enclsoure
7 RESULT CARD WRITEEN/ VIVA Original
Total Flying,12 Month
8 CA-39 & 6 Month Enclsoure
9 P 1 UNDER SUPERVISION LOG BOOK Original
SORTIE WISE
10 CROSS COUNTRY SORTIES STATEMENT > 1000 HRS Enclsoure
SORTIE WISE
11 PIC SORTIES CROSS COUNTRY STATEMENT > 200 HRS Enclsoure
SORTIE WISE
12 SORTIE WISE PIC NIGHT FLYING STATEMENT > 50 HRS Enclsoure
SORTIE WISE INSTRUMENT SORTIE WISE
13 FLYING STATEMENT > 100 HRS Enclsoure
STATEMENT OF TOTAL PIC SORTIE WISE
14 FLYIING STATEMENT > 500 HRS Enclsoure
15 MEDICAL ASSESSMENT LATEST COPY
16 LAST 2 IR-LR REPORTS COPY
17 LAST 2 ALRC REPORTS COPY
18 A-320 P 2 RELEASE CHECK COPY
10TH BOARD PASED CERTIFICATE
19 & MARKSHEET COPY
12TH BOARD PASED CERTIFICATE
20 & MARKSHEET COPY
21 INCIDENT/ACCIDENT REPORT ENCLOUSURE
10 TAKE OFF & LANDING
22 CERTIFICATE ENCLOUSURE

PILOT SIGNATURE CHECKED BY


CA-39
For a period FROM TO
Name of Licence Holder

Licence Class: CPL. License Number Valid Upto

Aircrafts flown

SINGLE ENGINE AIRCRFAT MULTI ENGINE AIRCRAFT INSTRUMENT TIME


Write DAY NIGHT DAY NIGHT On Aircraft
Synthetic
Year Co- P1 Co- P1 Simu-
Dual Solo Dual Solo U/T PIC U/T PIC Total Actual Simulator hrs
pilot (U/S) pilot (U/S) lated
* (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)

TOTAL

Note: write P1 U/s experience separately and do not include in Co-pilot column.

This is to certify that I have examined the logbooks of Mr.


and the above is a true summary.
Countersigned……………..…………………..…
Name……………………………………………..
Designation………………………………………
Company name …………………………………
Seal….……………………………………………
Date……………………………………………
Signature of License Holder ………………….
Date………………………………………………

Note: fill up separate CA-39 for total flying, flying in preceding one year and preceding 6 month (total 3
CA-39)
CA-39
For a period FROM TO
Name of Licence Holder

Licence Class: CPL. License Number Valid Upto

Aircrafts flown , AIRBUS – 320

SINGLE ENGINE AIRCRFAT MULTI ENGINE AIRCRAFT INSTRUMENT TIME


Write DAY NIGHT DAY NIGHT On Aircraft
Synthetic
Year Co- P1 Co- P1 Simu-
Dual Solo Dual Solo U/T PIC U/T PIC Total Actual Simulator hrs
pilot (U/S) pilot (U/S) lated
* (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

TOTAL - - - -
Note: write P1 U/s experience separately and do not include in Co-pilot column.

This is to certify that I have examined the logbooks of Mr.


and the above is a true summary.
Countersigned……………..…………………..…
Name……………………………………………..
Designation………………………………………
Company name …………………………………
Seal….……………………………………………
Date……………………………………………
Signature of License Holder ………………….
Date………………………………………………

Note: fill up separate CA-39 for total flying, flying in preceding one year and preceding 6 month (total 3
CA-39)
CA-39
For a period FROM TO
Name of Licence Holder

Licence Class: CPL. License Number Valid Upto

Aircrafts flown , AIRBUS – 320

SINGLE ENGINE AIRCRFAT MULTI ENGINE AIRCRAFT INSTRUMENT TIME


Write DAY NIGHT DAY NIGHT On Aircraft
Synthetic
Year Co- P1 Co- P1 Simu-
Dual Solo Dual Solo U/T PIC U/T PIC Total Actual Simulator hrs
pilot (U/S) pilot (U/S) lated
* (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)

- - - -

- - - -

- - - -

- - - -

- - - -

- - - -

TOTAL - - - -
Note: write P1 U/s experience separately and do not include in Co-pilot column.

This is to certify that I have examined the logbooks of Mr.


and the above is a true summary.
Countersigned……………..…………………..…
Name……………………………………………..
Designation………………………………………
Company name …………………………………
Seal….……………………………………………
Date……………………………………………
Signature of License Holder ………………….
Date………………………………………………

Note: fill up separate CA-39 for total flying, flying in preceding one year and preceding 6 month (total 3
CA-39)
ENCLOSED STATEMENT CONTAINING 1000 HRS OF X COUNTRY FLYING BY DAY &
NIGHT
IN RESPECT OF

CPL –
(FOR ALTP ISSUE)
X COUNTRY BY DAY
X COUNTRY BY NIGHT
TOTAL X COUNTRY HOURS

AUTHORISED SIGNATORY

DATE DATE
ENCLOSED STATEMENT CONTAINING 500 HRS OF PIC
BY DAY & NIGHT
IN RESPECT OF

CPL –
(FOR ALTP ISSUE)
BY DAY
(50% OF P1 U/S )
BY NIGHT
(50% OF P1 U/S )
PIC HOURS
TOTAL PIC HOURS

AUTHORISED SIGNATORY

DATE DATE
ENCLOSED STATEMENT CONTAINING 200 HRS OF PIC
BY DAY & NIGHT
IN RESPECT OF

CPL –
(FOR ALTP ISSUE)
BY DAY
(50% OF P1 U/S )
BY NIGHT
(50% OF P1 U/S )
TOTAL PIC HOURS

AUTHORISED SIGNATORY

DATE DATE
ENCLOSED STATEMENT CONTAINING 50 HRS OF PIC
BY NIGHT
IN RESPECT OF

CPL –
(FOR ALTP ISSUE)
BY NIGHT
(50% OF P1 U/S )
TOTAL PIC HOURS

AUTHORISED SIGNATORY

DATE DATE
ENCLOSED STATEMENT CONTAINING 100 HRS OF ACTUAL INSTRUMENT
IN RESPECT OF

CPL -
(FOR ALTP ISSUE)
TOTAL INSTRUMENT HOURS

AUTHORISED SIGNATORY

DATE DATE
Date:
Ref. IGOPS/DGCA/15/
Director General of Civil Aviation,
Opp. Safdarjung Airport,
New Delhi – 110003
Kind Attention: Directorate of Training & Licensing
SUB: ISSUE OF INDIAN ATPL & IR ENDORSEMENT IN RESPECT OF
F/O CPL NO.
Dear Sir,

Enclosed please find the application of F/O… .CPL …. for issue of ATPL, Sorties& flying hours of
CA-39 & hours logged in log book certified by F/O …. CPL NO- with the following documents:

1. DGCA File No-1- / L-2


2. CPL No. Original Valid up to
3. FRTOL No Original Valid up to
4. RTR (A)–COP Original Valid up to
5. Copy of Medical Assessment Dated Valid up to
6. Aircraft needs to be endorsed from CPL to ATPL
a. As Pic –
b. As co- pilot - A-320

7. Result card for written / oral examination ( Printout from the DGCA website)
8. Certificates, Marks Statement of 10th & 12th
9. CA 39 (Total flying,12 months and 6 months )
10. Incident/Accident –Certificate attached
11. Certificate of Under Supervision Flying
12. Total Cross Country by Day & Night -
Total PIC Cross Country by Day & Night - .
13. Total PIC Cross Country by Night -
14. Under Supervision Flying –
15. Instrument Flying Statement –.

16. Pilots Proficiency Check/IR report dated & and last two license renewal
Route Checks &

17. Log Book (02 No)


18. Demand Draft No. of Rs. /- dated
19. Released on
20. STL Certificate
21. Pilot self-declaration certificate

It is requested that his ATPL may kindly be issued at the earliest.

Yours truly,
Date:

To Whom So Ever It May Concern

This is to certify that F/O (CPL ) has flown as PIC under


supervision with the captains who met the supervised take-off and landing criteria
in accordance to DGCA requirement designated as Examiner, Instructor, Check Pilot
and Sr. Commanders.

Thanks & Regards


Date:

Certificate

To Whom So Ever It May Concern

This is to certify that F/O (CPL ) has flown Hrs. under


P1 supervision.

Thanks & Regards


Date:

Certificate

To Whom So Ever It May Concern

This is to certify that F/O (CPL ) has joined Indigo on . He


has not been involved in any incident / accident till date.

Thanks & Regards


CERTIFICATE

TO WHOM SO EVER IT MAY CONCERN


I, ______________________________________, CPL – __________ hereby

declare and certify, that the attached sorties, flying hours and details as

mentioned below are true to the best of my knowledge and I am solely

responsible for any discrepancies’ arising in the same at any point of time.

1) DGCA File No:

2) CA 39 (Total Flying,12 months and 6 months) – Details attached

3) Incident/Accident – Certificate attached

4) Certificate of Under Supervision Flying – Details attached

5) Sortie of Cross Country 1000 Hours – ______________

6) Sortie PIC Cross Country by Day & Night– __________________

7) Sortie of PIC Cross Country by Night – _________________

8) Under Supervision Flying after STL clearance – _______________

9) Instrument Flying Statement – ________________

Signature: ______________________

Pilot Name: _____________________

License No: ____________

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