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FORM : 0-PEL020
NIGERIAN CIVIL AVIATION AUTHORITY
DIRECTORATE OF LICENSING
PERSONNEL LICENSING SECTION

AIRCRAFT MAINTENANCE ENGINEER’S LICENCE

(APPLICATION FOR INTIAL ISSUE, ADDITION OF RATING OR TYPE RATINGS
AND CONVERSION)

NOTE (1): Particulars required for the Initial Issue, addition of rating or type ratings of a License are to be
found in the Nigerian Civil Aviation Regulations Part 2.

NOTE (2): This form must be completed in dark blue or black ink, using block capitals.

PART 1
1. SURNAME:...........................................................................................................................
2. FIRST NAME:..................................................... MIDDLE INITIAL(S)..............................
3. (a) PERMANENT ADDRESS..................................................................................................
(b) ADDRESS (Permanent-For insertion in License).
........................................................................................................................................................
(c) TELEPHONE NUMBER……………………………E-MAIL ADDRESS…………………..

4. (a) DATE OF BIRTH................................................. PLACE OF BIRTH...........................

(b) NATIONALITY..............................................................................................................
5. NAME OF EMPLOYER.......................................................................................................
6. (a) EMPLOYED AT.............................................................................................................
(b) EMPLOYED AS............................................................................................................
(c) DATE OF EMPLOYMENT.................................... TELEPHONE NO..........................
(d) NAME AND ADDRESS OF PREVIOUS EMPLOYER................................................
...............................................................................................................................................
EMPLOYED AT.................................... AS............................. DATE LEFT...................
PART 2 (Addition of Rating or Type Ratings)

7. APPLICATION FOR (Check one)

BASIC LICENCE RATING UPGRADE TYPE

8. RATING ALREADY HELD......................................................................................................

..................................................................................................................................................
9. RATING NOW REQUIRED.....................................................................................................
..................................................................................................................................................

PART 3 ====================== (FOR NCAA USE ONLY)====================

Date Application Receive..........................……………………………………………………….
Payment (See Processing Form)...................................Receiving Officer Signature.....................

APPROVED DISAPPROVED ASI Signature...............................

REASON....................................................................................................................................
 FORM : 0-PEL020 AUGUST 2017 Page 1 of 2

PART 4: (Initial Issue, Addition of Rating or Type Ratings and Conversion)

9. LICENCE NUMBER:....................... DATE ISSUE..................... EXPIRATION DATE............................

10. State the date of the last Certification made by you under the authority of the above Licence.........................

................................................................................................................................................................

11. Are you conversant with the current Regulations, Airworthiness Directives, Requirements, and Recommendations

Appropriate to your License?............................................................................................................................

12. Are you the holder of any Aircraft Maintenance License issued by an Authority OTHER than Nigeria?...............

................................................................ if so then the following:

Issuing authority.................................................. (b) Date of Expiry ....................................................................

(c) License Number............................................ (d) Scope..................................................................................

PART 5: Practical Maintenance Experience

13. DUTIES/FUNCTION PERIOD CONFIRMED BY

(State Aircraft Types) Date – FROM/TO Quality Assurance Manager and
Stamp of Quality Assurance
Manager

Attach
 additional Pages when necessary

14. APPLICANT DECLARATION:

I hereby declare that all statements in this application are true and correct in every particular I have read and understood
the Civil Aviation Regulation requirement relevant to this application. I acknowledge that to knowingly make a false
statement is an offence against Part 1 of Nigerian Civil Aviation Regulations.

Signature:………………………………………….. Date:……………………………………………
FORM : 0-PEL020 AUGUST 2017 Page 1 of 2

FORM 0-PEL.020A
NIGERIAN CIVIL AVIATION AUTHORITY
DIRECTORATE OF LICENSING
PERSONNEL LICENSING SECTION

SCHEDULE OF PRACTICAL MAINTENANCE EXPERIENCE

Name of Applicant:…………………………………………………………………………………………..

Schedule Complied For:………………………………………………………………………………………

Licence Category:…………………………………………………………………………………………….

AIRCRAFT DETAILS OF WORK UNDERTAKEN DATE WORK NAME,

REG. NO. UNDERTAKEN SIGNATURE,
LICENCE NO. OF
PERSON IN
CHARGE AND
DATE

NOTE: The person in charge should only append his signature when he is satisfied that the applicant has
participated in or satisfactorily carried out the inspection.

An applicant may be considered to have participated when he has taken an active interest in the inspection.
 Page No. …………………………

AIRCRAFT DETAILS OF WORK UNDERTAKEN DATE WORK NAME,

REG. NO. UNDERTAKEN SIGNATURE,
LICENCE NO. OF
PERSON IN
CHARGE AND
DATE

NOTE: The person in charge should only append his signature when he is satisfied that the applicant has
participated in or satisfactorily carried out the inspection.
An applicant may be considered to have participated when he has taken an active interest in the inspection.