FLIGHT CLEARANCE

FOR
INDONESIAN TERRITORY
Republic of Indonesia Approval Number : SG1164

Penerbangan Pesawat Udara Asing ini telah diizinkan oleh Pemerintah Republik Indonesia:
The following Foreign Aircraft Flight has been approved by the Government of the Republic of Indonesia:

1. Pesawat Udara
Aircraft
a) Operator (Pemilik/Penyewa)
: Helicopter Transport Services (Canada) Inc.
Operator (Owner/Charterer)
b) Tipe
: Bell Helicopter 214ST
Type
c) Tanda Pendaftaran/Negara
: Canada
Registration/Country
d) Nama Panggilan
: C-FHTS
Call Sign
e) Nomor Registrasi
: C-FHTS
Registration Number
2. Penerbangan
Flight
a) Rute
: Wiladatika (WIHC) – Wiladatika (WIHC) Area - Wiladatika (WIHC)
Routes
b) Tanggal masuk ke Indonesia a.1) Wiladatika (WIHC)
Penerbangan Langsung
Date entering Indonesia : 29/07/2020 : – Wiladatika
Direct Flight
(UTC) (WIHC) Area - Wil
c) Tanggal keluar dari Indonesia a.2)
Pendaratan Teknis di
Date leaving Indonesia : 03/08/2020 : WIHC/HLP/PCB/ATS
Technical Landing at
(UTC)
d) Nama Pilot : Allan James S/ Carson G a.3) Menginap
Name of Pilot in Command Sutton/ Yanick Paquin/ Remain Overnight at
: WIHC/HLP/PCB/ATS
Yvon Benjamin/ Wade
Alex A.
e) Awak pesawat udara lainnya *1) Seth H/ Robert B W/ Jason R J B/David G/ Christopher D B/ Dominic R/
:
Other crew member(s) Cameron P
f) Penumpang/barang *2)
: BAMBI BUCKET
Passenger(s)/cargo
3. Keterangan
Remarks
: Test Flight for BNPB di Bandara Wiladatika (WIHC)

4. Catatan Teknis : 1. Subject to airport slot availability; 2. Ref surat nomor :

Technical Note AU.410/3/7/DRJU-DKPPU-2020; 3. FC ini berlaku apabila mendapatkan slot
time bandara setempat sesuai ketentuan yang berlaku; 4. Special fire
fighting by BNPB.

Note: Berlaku untuk 1 (satu) kali penerbangan PEMOHON

1) and 2) Name(s)/cargo should be written/attached Valid for one flight
Aircraft, crew, passengers and load are subject to the APPLICANT
terms of Chicago Convention and have to comply with the
Indonesian Regulations as for entry clearance,
immigration, customs, and quarantine. Possesion of this
flight clearance does not exempt an operator from PT MAKNA CITA
compliance with any of the technical operations ruler or
airworthiness requirements of the Directorate General of SEJAHTERA
Civil Aviation This flight clearance can be withdrawn
without previous notice. Should delay exceed the date as
prescribed in point 2b) and 2c) this fight will be regarded
as cancelled. (Signature and Name)

DISETUJUI OLEH
APPROVED BY
Kementerian Luar Negeri
Direktorat Konsuler
Ministry of Foreign Affairs
Markas Besar TNI
Sintel Mabes TNI
INDF - Headquarter
Kementerian Perhubungan
Direktorat Angkutan Udara
Ministry of Transportation