Date of Birth (DD/MM/YYYY)/Company Identification Number

Date of Birth (DD/MM/YYYY)/Company Identification Number


KENYA CIVIL AVIATION AUTHORITY / KCAA/ASSR/RPA-001
APPLICATION FOR RPA IMPORTATION/REGISTRATION
May, 2016
Import Permit / Registration
Applicant information
  1. Name / Company Name
/
  1. Nationality/ State of Registration
/
  1. Date of birth (DD/MM/YYYY)/company identification number

  1. I.D no/ Passport no.

  1. KRA pin no.

  1. Address:

  1. Telephone number:
/
  1. E-mail address:

  1. Previous RPA Owned and
Registration Number(s) / (Number)
Owner (if different from Applicant)
  1. Name / Company Name
/
  1. Nationality/ State of Registration
/
  1. Date of birth (DD/MM/YYYY)/company identification number

  1. I.D no/ Passport no.

  1. KRA pin no.

  1. Address:

  1. Telephone number:
/
  1. E-mail address:

  1. Previous RPA Owned and
Registration Number(s) / (Number)
Importation details
  1. Supplying Company:
/
  1. Country of Manufacture:
/
  1. Port of Entry/Custom Clearance:
  1. Mode of Transport:

RPA Specifications
  1. Aircraft type (rotorcraft/fixed wing)
/
  1. Type and Model:
/
  1. Purpose:

  1. MTOM(kg):
/
  1. Wing span (m) :
or
Rotor diameter(m): /
  1. Length (m):
Height (m):
  1. Propulsion type
/
  1. Engine type:
Number : /
  1. Displacement(cm3)
Power (W):
Thrust (N):
Jet / Propeller
Combustion / Electric
  1. Speed governor:
Type:
Max current carrying capacity (A): /
  1. Propulsion Accumulator:
Type:
Capacity(Ah):
Number of cells (pcs): /
  1. Propeller:
Manufacturer:
Diameter(mm):
  1. Payload manufacturer & Serial no:
/
  1. Payload Information (cameras, sensors, mounting, image bandwidth)

  1. Payload Type:
/
  1. Relay of Images

  1. Payload weight (Kg):
/
  1. Night Operation capability

Estimated RPA performance
  1. Max endurance (min):
/
  1. Max speed (Km/h):
/
  1. Required distances:
Takeoff(m):
Landing(m):
  1. Max range (Km):
/
  1. Maximum Service Ceiling Above Sea Level (feet):

Ground Control Station (GCS)/ Remote control
  1. Transmitter/receiver (s) manufacturer:
/
  1. Transmitter / receiver(s) type:
/
  1. Frequency band: (MHz)

  1. Transmitter power (ERP/ EIRP):
/
  1. Radios:
/
  1. GPS:

  1. Datalinks:
/
  1. SATCOM:

Telemetry
  1. Manufacturer:
/
  1. Frequency band: (MHz)
/
  1. Scanned Parameters:

Operations
  1. Flight rules:
VFR
IFR /
  1. Type of operation:
VLOS
BVLOS /
  1. Purpose:
Recreation and sport
Private
commercial
  1. RPA detect and avoid capabilities:

  1. IFF Transponder/ Radar capability:

  1. Attachments:
  • Colour photograph of RPA( front and side, on the ground, serial no, occupying most of the image size)
  • Circuit diagram of onboard wiring with description of individual parts
  • Safety documentation containing at least emergency procedures in case of:
-Control failure
-Engine failure
-Accumulator issues
-Command and control data link failure
  • Copy of a liability insurance document related to RPAS operation
  • Type certificate (if applicable)
  • Personal Identification Documents (I.D. Passport, KRA pin, certificate of incorporation, Certificate of Good Conduct where applicable.)
  • Technical specifications.

  1. Declaration
I hereby declare that I am aware of the full accountability for the RPA technical condition and that
I will operate the RPA and maintain its airworthiness in accordance with the Civil Aviation (RPAS) Regulations, entirely at my own responsibility and
The information provided in this form is accurate and true to the best of my knowledge.
Name: / Date: (DD/MM/YYYY) / Signature:
Fill in according to the RPA type and equipment
CAA USE ONLY
Security
Clearance/Permit / YES
NO / Date issued:
Reference Number:
Registration Accepted: / Yes / No / Date issued:
Registration Number issued: / Applicable Charges
Official Signature: / Date:

KCAA/ASSR/RPA-001May, 2016

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