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ID Card Number:.
 
 
Correspondence Address:                                                      
 
Post Code :
....Telephone：                                 
.
Nationality:                         Birth Place:                                .
.
Diploma:                           School of Graduation:                       
.
 
Details about License (if applicable): applying to function signatures, new categories added into the license, or renewal thereof
 
License No.:          Issuance Date:         Category(s):                  
 
Applied Items: (mark √ in the suitable□as follows)
Initial Application□ Added Category□ Renewal□ Function Signature□
STR□ PWT□  LGR□ MEC□  ELC□   AVC□
Maintenance Functions:                                                        
 
.............................................................................
.
 
Time           Performed Maintenance                  Referee
 
 
 
 
.
 

F66-4（8/2005）                                                    1-2.
.
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Attachment Ⅵ：.
Application for the Issuance/Renewal of the Certificate for the Civil Aircraft Maintenance Management Personnel.
 
Time                Training Record  Refere
.
.
.
.
.
.
.
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I hereby apply for the certificate for the maintenance management personnel and ensure the faithfulness and correctness of all the application materials while any incorrect information will affect the validity of my qualifications.
 
 
 
 
 
 
 
Signature：                             Date：                             
　
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本文鏈接地址：Management Rule of Civil Aircraft Maintenance Personnel Lice(17)