LEASING/INTERCHANGE AGREEMENT APPROVAL REQUEST FORM

1. Operators (lessee) registered name and trading name if different: Mailing address: Telephone: Fax: E Mail:

2. Operators (lessor) registered name and trading name if different: Mailing address: Telephone: Fax: 3. Type of Agreement: Wet Lease Duration of the lease: Type of Operation: 4. Aircraft: Dry lease

E Mail:

Interchange Agreement

Effective Date: Areas of operation:

Registered owner Name: Owner Address: Aircraft Type/Model/Series: State of Registry: Aircraft Serial Number: Nationality and registration marks: Yes/ No

The aircraft fully complies with the airworthiness requirements of the State of Registry? Airworthiness certificate basis and status: 5.

Lessee or person responsible for operational control, including dispatch and flight following of the aircraft under the lease agreement Name: Address: Signature: 6. Parties to the lease agreement fully understand their respective responsibilities under the applicable regulations Name: Address: Signature: 7. Responsibilities of the parties for:

Flight crew member licensing and training: Cabin crew member training: Airworthiness of the aircraft and the performance of Line and Base maintenance: Scheduling of flight crew and cabin crew members: Signing the maintenance release: keeping the aircraft maintenance records: Ground handling arrangements: Flight operations arrangements:

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8.

Aircraft Airworthiness Status*

Non-repetitive airworthiness directives:

All applicable airworthiness directives through (specify date, issue, etc.) have been incorporated as listed on the (specify name of operators) airworthiness directive summary (specify date) with the exception of those AD requiring initial or repetitive action.
Status of repetitive airworthiness directives:

All AD listed on the (specify operator) airworthiness directive control summary dated (specify date) require initial or repetitive action at the date, time or cycles listed.
Operational and maintenance control of the aircraft and a list of major repairs accomplished:

This aircraft has been under the direct operational and maintenance control of (specify operator) since (specify date). During this time the aircraft underwent the following major repairs/modifications in accordance with approved technical data documented in the aircraft records. (List all major repairs/modifications).
Accomplishment of the last major inspection

The last (specify type of major inspection) was accomplished by (specify operator/maintenance organization) between (specify date) and (specify date) at (specify operator/maintenance organization) maintenance facility in (specify city, country). Airframe total hours and total cycles were FH/CY.
Status of the installed engines and any spare engines

The following engines are currently installed on the aircraft with the total accumulated and remaining hours and cycles listed for each (List engines here). The (specify operator) life-limited parts report has been prepared using the (list manufacturer's controlling document here), and reflect accurate times and cycles of the life-limited parts as of the engine time/cycles noted above
Current component status

The components/inspection times listed on the (specify operator) component control summary represent the latest component installation information as of (specify date).
Approved maintenance Organisation name and approval number: Maintenance Representative Name 9. Signature Date (d-m-y)

Attached documents Lessors certified true copy of the Air Operator Certificate (AOC) Copy of the leased aircraft Certificate of Airworthiness Copy of the lease agreement Lessors copy of the Third Party Liability Insurance Certificate Copy of the lessors Air Carrier License Copy of the operating authority issued by the responsible regulatory authority of the last operator* Copy of the export certificate of airworthiness (if any). Proposed arrangements for the continued airworthiness/maintenance of the aircraft Copy Technical and operational audit of the lessors safety and liability standards, according to AAC requirements * Current Inspection Status Summary * Summary ff Current Status of Life -Limited Parts installed on the aircraft * Current Status of Airworthiness Directives applicable to the aeroplane, powerplants, components and appliances.* Recurring AD should be listed separately* Aircraft Maintenance Program Integration if applicable*

* Not required Leasing of aeroplane by a Air operator TO & FROM a Country Air operator
10. Quality Certification The above referenced aircraft and its documents have been inspected and evaluated in accordance with the Civil Aviation Regulations currently in force and it is considered satisfactory. Representative Name AAC Use Only : RECEIPT Fee receipt of payment received (dd-mm-yyyy): Receipt n : Received by : Signature Date (d-m-y)

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