LuqaAirport, Luqa LQA3290, Malta Tel: +356 21222936 Fax: +356 25552334, , /
Request for Annotation at the National Aircraft Register of Rights in Engines
Section 1 / Engine DetailsTick the appropriate engine type in the list:
• / Turbofan / Turbo Prop / Piston / Turbo Shaft / Other
Name of Engine Manufacturer / Model of Engine / Serial No / Spare Engine
• / YesNo
• / YesNo
• / YesNo
• / YesNo
Section 2 / Details of Rights
2.1 / Engine Owner(s)
Full Name / Address / % of Ownership
•
•
•
•
Please provide the original or a certified true copy of the Bill of Sale, duly notarised and legalised evidencing title to the engines
2.2 / Engine Lessor/Lessee
Full Name / Address / Lessor * / Lessee*
•
•
•
•
* Tick where applicable
Please provide the original or a certified true copy of the applicable lease agreement, duly notarised and legalised evidencing title to the engines
2.3 / If the applicant is a qualified trustee, please indicate the % interests of each of the beneficiaries of the trust.
Name of Beneficiary / Address / % of interest
•
•
•
•
Please provide Indicatation of qualification as trustee
Section 3 / Declaration of holder of rights in engines
I/We hereby declare that to the best of my/our knowledge, information and belief the particulars given on this form are true in every respect and request the annotation of my/our right/s at the National Aircraft Register.
Signature(s) of Applicant(s) / Date
Name(s) in block capitals / (DD/MM/YYYY)
If body corporate, please indicate the authority of the signatory
(tick as appropriate) / Director Company Secretary *Power of Attorney
*notarized and legalized by apostille if executed outside Malta
Section 4 / Declaration of Registrant*
*‘registrant’ means that person in whose name an aircraft is registered in the National Aircraft Register (ARA 2010)
I/We hereby give my/our consent to the annotation of the ownership rights on the referenced engine/s in Sections 1, & 2, with respect to the following Aircraft*:
9H- Type: Serial number: 9H- Type: Serial number:
9H- Type: Serial number: 9H- Type: Serial number:
*(alternatively this information can be submitted as an appendix enclosed with this form)
Appendix enclosed: YesNo
The particulars given on this form are true in every respect.
Signature(s) of Applicant(s) / 1 / Date
Name(s) in block capitals / (DD/MM/YYYY)
Signature(s) of Applicant(s) / 2 / Date
Name(s) in block capitals / (DD/MM/YYYY)
If body corporate, please indicate the authority of the signatory
(tick as appropriate) / Director Company Secretary Power of Attorney
Application for Annotation of Engine Details Transport Malta is the Authority for Transport in Malta set up by ACT XV of 2009 Page 1 of 2
Civil Aviation Directorate Form TM/CAD/0071 Issue 1 – Nov 2010