Civil aviation directorate

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CIVIL AVIATION DIRECTORATE

^{Luqa Airport, Luqa LQA3290, Malta Tel: +356 21222936 Fax: +356 21239278 email: civil.aviation@transport.gov.mt www.transport.gov.mt}

Details of Management Personnel required to be accepted as specified in Part -

1. Name:

Position:

3. Qualifications relevant to the item (2) position:

Enclose relevant CV and qualifications certificates (certified true copy)

4. Work experience relevant to the item (2) position:

Enclose relevant CV and qualifications certificates (certified true copy)

Signature of Nominee: ………………………………………………..

Date:

On completion, please send this form under confidential covering letter to the Head of Airworthiness Inspectorate of the Civil Aviation Directorate, Luqa Airport, Luqa, Malta.

Transport Malta Civil Aviation Directorate use only

Name and signature of authorised Transport Malta Civil Aviation Directorate staff member accepting this person:

Signature: …………………………………………………….. Date: ………….…………………….

Name: ………………………………………………………… Head of the Airworthiness Inspectorate

^{EASA Form 4 Transport Malta is the Authority for Transport in Malta set up by ACT XV of 2009 Page of}

^{Civil Aviation Directorate Form TM/CAD/0039}^{Issue 2 - July 2012}