Material Issuance Certificate

Technical Department
Quality Assurance Office

Material Issuance Certificate

This is to certify that:

P/N: …………………………………………………………………………………….

Description: ………………………………………………………………………….

Quantity: ……………………………………………………………………………..

Batch No.: ……………………………………………………………………………..

S/N (if applicable): ……………………………………………………………..

Had been issued from Libyan Airlines Services Store No. : ………………………………………………… Based on: ………………………………………………………

1. Certificate No.: ……………………………………………………….Dated ………………………………………….. For a total quantity of

……………………………………..
2. Serviceable Tag No. ………………………………………………. Dated ………………………………………….. Both are kept at material directorate.

Name: …………………………………………………………………………. Date: …………………………………………………………………

Storekeeper Signature & Stamp: ………………………………………………………………………………..

Issue 3, Revision 0 Form No. QATS 142

Date: April.2016
Issue 3, Revision 0 Form No. QATS 142
Date: April.2016