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TAD/01/2012 Form 1

(Rev 1 dated May 2013)

Directorate General Technical Airworthiness (DGTA) Menara TH Selborn, 153, Jalan Tun Razak, 50400 Kuala Lumpur, MALAYSIA Tel: 03 2687 3125 Faks: 03 2687 3094

APPLICATION FOR REGISTRATION OF AIRCRAFT

1. AIRCRAFT DETAILS Manufacturer of Aircraft: Country of Manufacturer: Model: Serial Number: MTOW (kg): Aircraft Classification Propose Registration Mark 2. OWNERSHIP DETAILS Malaysian Armed Forces (MAF) State Agency (please state) Non-State Agency (please state) Owner Name & Address

Fixed Wing M RMA

Helicopter

Unmanned Aerial Vehicle RMAF

RMN

I HEREBY DECLARE that the above particulars are true in every respect and I apply for the aircraft to be registered with Malaysian State Airworthiness Authority.

.............................. .................... Date of Application

................................. Signature of Owner

For DGTA Use Registration Mark: Certificate Number:

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