AFGHANISTAN CIVIL AVIATION AUTHORITY

SUA/ROZ REQUEST FORM – (SUA-2017)

Proponent Details

Contact Name
Name of Organization
Nature of Organization
Country Telephone
Email Address
Number of Pages
Number of Attachments
Date of Event/Start Date
Date of Submission
ROZName / SUA Number:
(KACC ASM Use Only)
Special Use Airspace Details
Please describe the activity or change, in detail. Include supporting information such as: coordinates/depiction, etc.Information/details can be attached separately.
ACAA/KACC/RS HQ APPROVAL – Official use only
NAME: ACAA ATM / SIGNATURE
NAME: KACC ASM / SIGNATURE
NAME: RS HQ ASM / SIGNATURE
Contact details: ACAA/RMS AIS:
Aeronautical Information Services
Email:
Email:
Mobile: +93 (0) 799849388
NOTAM
Email:
Email:

Mobile: +93 (0) 799854734

/
  • All sections in ROZ/SUA FORM are mandatory to publish in the AIP, if it is a permanent request and approved.
  • SPONSOR contact details should possess one local Afghanistan mobile or telephone number.
  • Paperwork and approval from local airport authority / Air Space Manager is required.
  • Afghanistan Civil Aviation Authority approval is required 30 days prior to activity and publication.

Please answer the following:
Question 1.
Is this a new SUA or a repeat of previously submitted SUA? / New> Go to question 2.
Repeat > Complete details below
Repeat activity:
The last SUA FORM Number :
Question 2.
Is this a Temporary or Permanent SUA? / TemporaryPermanent
Question 3.
Has another organization been consulted about this SUA? e.g. CAOC, OCC-R, etc. / Yes>Attach Response
No
Question 4.
Has Air Traffic Control been consulted about this SUA? / Yes>Attach Response

No
Question 5.
Is this a recurring activity? / Yes> Complete details below
No> Go to question 6.
5a. Recurring activity:
How often will this activity occur?
Question 6.
What consultation has been undertaken with operators and stakeholders? (Please list with whom, when and outcomes.)
Question 7.
Has a risk assessment been carried out? / Yes>Please attach signed copy
No
Question 8.
Who will be providing Control Services within the requested airspace?
Submitted by:
Name :
Title :
Organization :
Nationality : / Signature:

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