CIVIL AVIATION AUTI.

IORITY OF BANGLADESH
AIRWORTHINESS & ENGINEERING LIC=NSING DIVISION
RECORD OF FRACTICAL MAINTENANCE EXPERIENCE.

\
Note :

(i)
(ii)

lniormation and guidance to iill in this form is mentioned in the Air Navigation Orders (Airworthiness Requirements)
publishsd by the CAAB.
ln the Column No. (2), Experience shall be shown under applicable ATA Chapters/Systems related to the category.

ReJer to the BCAR (CAP- 468), Section L, Appendix- 4 for guidance.

(iii) The supervising AME should certify Column No. 4 each item only when he is satisfied that the applicant

has

participated or satisfactorily carried out the task mentioned-

(iv)

Bofer to the ANO D.1, Para 10.5 and 10.6 regarding submission of inlormation relating to maintenance experience.

hereby dctare that tho information given on this form is true in every respect.

Signature i ."............1.,.........
(Applicant)

Aircraftf,egistntbn
and Type ol Aircrafi

(1)

Date

Precise nature and Detaiis of Work undertaken

Signahrre and Licence

No. of SupeMsing
A.M.E-

(3)

(2)
From

To

(4)

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