Form No.

RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 1 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

NOTE: European Commission Regulation (EU) No. 1178/2011 as amended, requires that an individual has all of
their licences administered by the National Aviation Authority that holds their medical records (Part MED.A.030
and FCL.015).
If your medical records are not held by the IAA, your application will be rejected.

Please complete the form in BLOCK CAPITALS having read the guidance notes attached to this form.

1. PERSONAL DETAILS

Surname ......................................................................................... First Name(s) …...............................................................................

Title (Mr / Mrs / Ms etc) ................................................................... Date of Birth (dd/mm/yyyy) .............................................................

Nationality ....................................................................................... Place of Birth (Town) …....................... (Country) ….......................

Permanent address ………........................................................................................................................................................................

......................................................................................................... Postcode .........................................................................................

Contact Tel. No. ............................................................................. Mobile Tel. No. ...............................................................................

E-mail address .........................................................................................................................................................................................

Address for correspondence (if different from above) ..............................................................................................................................

......................................................................................................... Postcode .........................................................................................

2. DETAILS OF ALL FLIGHT CREW LICENCE(S) HELD OR PREVIOUSLY HELD

State of Issue Type of Licence Category of Licence Licence No. Expiry Date
(e.g. PPL) (e.g. Aeroplane, Helicopter etc)

3. APPLICATION (tick as appropriate) *delete as applicable

I am applying for the issue of a Part-FCL CPL(A) with* / without IR*, including the Class rating(s) indicated below;

Single-engine Piston (Land) __ Multi-engine Piston (Land) __ Other __ (please specify):…………………………..

Type of course completed:

ATP Integrated Course __ CPL/IR Integrated Course __ CPL Integrated Course __

4. CLASS 1 MEDICAL CERTIFICATE

State of Issue Date of Expiry Date AME Name, Medical Centre & AME No. Details of any IAA use only
Medical of Class 1 Location Limitations /
privileges Endorsements
 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 2 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

5. FLIGHT EXPERIENCE

Hours Credit given for IAA use only

completed on flight time as
Integrated holder of an ICAO
course PPL(A) / PPL(H)
(if applicable)
1. Total Flight Time
(a) Pilot-in-Command (PIC)
(b) Student Pilot-in-Command (SPIC)
(c) Dual instruction (Pu/T) – in Aircraft
(d) Dual instruction (Pu/T) – Instrument Ground Time
Total

2. Cross-Country Flight Time IAA use only

(a) Pilot-in-Command (PIC)

(b) Student Pilot-in-Command (SPIC)
Total
(c) Date of a VFR cross-country flight as Pilot-in-Command of an
aeroplane, totalling at least 540km (300NM) in the course of which
full stop landings at two aerodromes different from the aerodrome Date ...../.…../……
of departure have been made

3. Night Flight Time IAA use only

(a) Pilot-in-Command (PIC)

(b) Dual instruction (Pu/T)
(c) Dual cross-country navigation (Pu/T)
Total

(d) Solo take-offs & full stop landings No. ……… No. ………

4. Instrument Time IAA use only

(a) Dual instruction (Pu/T)

(b) Student Pilot-in-Command (SPIC)
(c) Instrument Ground Time – FNPT I
(d) Instrument Ground Time – FNPT II
(e) Instrument Ground Time – FFS
(f) Instrument Ground Time – FTD 2
MCC
(g) Instrument Ground Time – FFS
(h) Instrument Ground Time – FNPT II
Total

6. DECLARATION OF COURSE COMPLETION (to be completed by the Head of Training)

 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 3 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

I certify that (name) …………………………………………………………………… has completed an integrated course of training for the
grant of a Commercial Pilot Licence (Aeroplane), the flight training for which, is summarised in Section 5. I further certify that I have
examined the applicants flying logbook(s) and that the entries contained therein meet, in full, the flying experience requirements for the
grant of a Part-FCL Commercial Pilot’s Licence (Aeroplane) with*/ without* an Instrument Rating and has completed;

PBN theoretical knowledge course in accordance with FCL.615 of Annex I (Part-FCL) YES] NO]
PBN flight training in accordance with FCL.615 of Annex I (Part-FCL) YES] NO]

Date course started: ……………………………………………….. Date course completed: ……………………………………………………

Approved Training Organisation (ATO) ……………………………………………………. ATO Approval No. ..……………………………….

Competent Authority issuing Approval ………………………………………………………………………………………………………………

Name of Head of Training ……………………………………………………………………………………………………………………………..

Signature of Head of Training: ……………………………………………………………………… Date: ………………………………………..

7. THEORETICAL KNOWLEDGE

Level of examinations Member State under whose Date of final Expiry date of IAA use only
passed authority exams were passed examination pass examination pass
(e.g. CPL(A) or ATPL(A))

8. ENGLISH LANGUAGE PROFICIENCY (ELP)

Date of ELP Assessment Level achieved Name of Examiner Examiner Number IAA use only

9. CPL(A) SKILL TEST (to be completed by the Examiner)

I certify that I have examined the applicants flying logbook(s) and the entries contained therein meet, in full, the flying experience
requirements for the grant of a Part-FCL Commercial Pilot Licence (Aeroplane).

I further certify that (Name) ……………………………………………………….. has passed the CPL(A) skill test, as follows;.

Pass date: ……/……../……. Aircraft type: …………………… Aircraft registration: ……………………..

Examiner’s Name: ……………………………………………………… Examiner’s Number: …….………………………………………..……

Issuing Competent Authority: …………………………………………. Date of ‘Non-IAA Examiner’s Briefing’ (if applicable): ...…/….../……

Examiners signature: ……………………………………………………............................................................... Date: ……./………/……….

Note: Examiners are reminded that they must complete the Skill Test Report Form and submit to the IAA’s Personnel Licensing
Office within 14 days of the date of skill test, and if applicable, a copy of the confirmation email(s) from the IAA in respect of the ‘Non-
IAA Examiner’s Briefing’ and ‘Notification of Test’.
 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 4 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

10. IR SKILL TEST (to be completed by the Examiner)

I certify that I have examined the applicants flying logbook(s) and the entries contained therein meet, in full, the flying experience
requirements for the grant of an Instrument Rating (Aeroplane).

I further certify that (name) ……………………………………………………….. has passed the IR(A) skill test.

Pass date: ……/……../……. Aircraft type: …………………… Aircraft registration: ……………………..

Has successful demonstration of competency in PBN YES] NO]

Examiner’s Name: ……………………………………………………… Examiner’s Number: …….………………………………………..……

Issuing Competent Authority: …………………………………………. Date of ‘Non-IAA Examiner’s Briefing’ (if applicable): ...…/….../……

Examiners signature: ……………………………………………………............................................................... Date: ……./………/……….

Note: Examiners are reminded that they must complete the Skill Test Report Form and submit to the IAA’s Personnel Licensing
Office within 14 days of the date of skill test, and if applicable, a copy of the confirmation email(s) from the IAA in respect of the ‘Non-
IAA Examiner’s Briefing’ and ‘Notification of Test’.

11. IAA SUMMARY PRIVACY NOTICE

How will we use your information?

The information you provide to us via this form will be used to enable us to carry out our regulatory duties including processing your
request to issue a flight crew licence (FCL), the administration and maintenance of said licence and of subsequent licences/certificates
and for enforcement purposes. We will not disclose any of your information to any organisation without your explicit consent, except
where we are obliged to do so under relevant EU and Irish legislation, or to comply with law enforcement agencies.

Where can you find out more?

To find out more about how the IAA respects your privacy, please read our detailed privacy notice at https://www.iaa.ie/home/footer-
tools/privacy or contact our Data Protection Officer at dataprotection@iaa.ie, or write to Data Protection Officer, Irish Aviation Authority,
The Times Building, 11-12 D'Olier Street, Dublin 2, D02 T449.

12. APPLICANT’S DECLARATION

I hereby declare that: -
1) I do not hold a Part-FCL licence issued by another Member State;
2) I have not applied for a Part-FCL licence in another Member State;
3) I have never held a flight crew licence, issued in another Member State, which was revoked or suspended.

I further declare that the information given in this form is true and correct to the best of my knowledge and belief.

Applicant’s Signature .................................................................................................... Date ..............................................................

Note: It is an offence for a person to make, procure to be made, or assist in making any false representations for the purpose of
procuring for any reason the issue, validation, extension or re-issue of a licence or the issue, renewal or revalidation of a rating,
authorisation or certificate, whether for that person or any other person.
 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 5 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

PART 2 – EXAMINER REPORT FOR CPL (A) SKILL TEST

Name of applicant: ………………………………………………………………………………..… Date of Birth: (dd/mm/yyyy) .....................................

Attempt No.: ………………………………. Date of Test: ………………………… Place of Test: …………………………………………………………….

Applicant’s signature: …………………………………………………………………………………………………………………………………………………

I certify that I have examined the training records (as applicable) and pilot logbook(s) of (name) ….…………………………………………
and that the entries contained therein meet, in full, the qualification, training and experience requirements for the initial issue of a Part-
FCL Commercial Pilot Licence (Aeroplane). I have made the applicant aware of the consequences of providing incomplete, inaccurate
or false information related to their training and flight experience.

Examiner’s Name: …………………………………………………………….... Examiner Number: …….………………………………………..

Issuing Competent Authority: ………………………………………........……. Date of Skill Test Notification to the IAA: …...…/…….../…..…
(of Examiner Certificate)

Examiners signature: ……………………………………………………............................................................................................................

Note: Examiners are reminded that they must complete Part 2 (Examiner report for CPL (A) skill test) and submit the original to the
IAA’s Personnel Licensing Office as soon as practicable but at within 14 days of the date of skill test together with a copy of the
‘Notification of Test’ confirmation email (including signed declaration).

DETAILS OF FLIGHT(S)

Attempt No. ………

Block Times
Date Aircraft Type Registration Duration
Departure Arrival

Result: Pass __ Partial Pass __ Fail __

Partial pass / Fail only: If applicable, specify any further training requirement (hours) prior to re-test:
A/C …………………………………………..… Sim/FNPT II …..………………………………. Ground ……………………………………

Partial Pass Re-test

Block Times
Date Aircraft Type Registration Duration
Departure Arrival

Result: Pass __ Fail __

Fail only
If applicable, specify any further training requirement (hours) prior to the next attempt::
A/C …………………………………………..… Sim/FNPT II …..………………………………. Ground ……………………………………
 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 6 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

Name of applicant ………………………………………………………………………………………Date of Birth (dd/mm/yyyy) .....................................

SECTION 1 PRE-FLIGHT OPERATIONS AND DEPARTURE

Use of the aeroplane checklists, airmanship, control of the 1st Attempt 2nd Attempt
aeroplane by external visual reference, anti-icing/de-icing
Pass Fail Pass Fail Comments
procedures and principles of threat and error management
apply in all sections. (✓) (✓) (✓) (✓)

Pre-flight, including: Flight planning, Documentation, Mass and

a balance determination, Weather brief, NOTAMS

b Aeroplane inspection and servicing

c Taxiing and take-off

d Performance considerations and trim

e Aerodrome and traffic pattern operations

f Departure procedure, altimeter setting, collision avoidance (lookout)

g ATC liaison – compliance, R/T procedures

Result of Section (circle as applicable) Pass Fail Pass Fail

SECTION 2 GENERAL AIRWORK

1st Attempt 2nd Attempt
Pass Fail Pass Fail Comments
(✓) (✓) (✓) (✓)
Control of the aeroplane by external visual reference, including
a
straight and level, climb, descent, lookout
Flight at critically low airspeeds including recognition of and recovery
b
from incipient and full stalls
c Turns, including turns in landing configuration. Steep turns 45°
Flight at critically high airspeeds, including recognition of and
d
recovery from spiral dives
Flight by reference solely to instruments, including:
(i) level flight, cruise configuration, control of heading, altitude and
airspeed
(ii) climbing and descending turns with 10°–30° bank
e
(iii) recoveries from unusual attitudes

(iv) limited panel instruments

f ATC liaison – compliance, R/T procedures

Result of Section (circle as applicable) Pass Fail Pass Fail

SECTION 3 EN-ROUTE PROCEDURES

1st Attempt 2nd Attempt
Pass Fail Pass Fail Comments
(✓) (✓) (✓) (✓)
Control of aeroplane by external visual reference, including cruise
a
configuration Range/Endurance considerations

b Orientation, map reading

c Altitude, speed, heading control, lookout

d Altimeter setting. ATC liaison – compliance, R/T procedures

Monitoring of flight progress, flight log, fuel usage, assessment of

e
track error and re-establishment of correct tracking
 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 7 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

SECTION 3 EN-ROUTE PROCEDURES

Observation of weather conditions, assessment of trends,
f
diversion planning
Tracking, positioning (NDB or VOR), identification of facilities
g (instrument flight). Implementation of diversion plan to alternate
aerodrome (visual flight)

Result of Section (circle as applicable) Pass Fail Pass Fail

SECTION 4 APPROACH AND LANDING PROCEDURES

1st Attempt 2nd Attempt
Pass Fail Pass Fail Comments
(✓) (✓) (✓) (✓)

a Arrival procedures, altimeter setting, checks, lookout

b ATC liaison - compliance, R/T procedures

c Go-around action from low height

d Normal landing, crosswind landing (if suitable conditions)

e Short field landing

f Approach and landing with idle power (single-engine only)

g Landing without use of flaps

h Post flight actions

Result of Section (circle as applicable) Pass Fail Pass Fail

SECTION 5 ABNORMAL AND EMERGENCY PROCEDURES

1st Attempt 2nd Attempt
This section may be combined with sections 1 through 4 Pass Fail Pass Fail Comments
(✓) (✓) (✓) (✓)

a Simulated engine failure after take-off (at a safe altitude), fire drill

Equipment malfunctions including alternative landing gear

b
extension, electrical and brake failure

c Forced landing (simulated)

d ATC liaison - compliance, R/T procedures

e Oral questions

Result of Section (circle as applicable) Pass Fail Pass Fail

SECTION 6 SIMULATED ASYMMETRIC FLIGHT AND RELEVANT CLASS OR TYPE ITEMS

1st Attempt 2nd Attempt
This section may be combined with sections 1 through 5 Pass Fail Pass Fail Comments
(✓) (✓) (✓) (✓)
Simulated engine failure during take-off (at a safe altitude unless
a
carried out in an FFS)

b Asymmetric approach and go-around

c Asymmetric approach and full stop landing

 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 8 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

SECTION 6 SIMULATED ASYMMETRIC FLIGHT AND RELEVANT CLASS OR TYPE ITEMS

d Engine shutdown and restart

e ATC liaison – compliance, R/T procedures, Airmanship

As determined by the FE — any relevant items of the class or

type rating skill test to include, if applicable:
(i) aeroplane systems including handling of autopilot
f (ii) operation of pressurisation system

(iii) use of de-icing and anti-icing system

g Oral questions

Result of Section (circle as applicable) Pass Fail Pass Fail

Use of the aeroplane checklists, airmanship, control of the aeroplane by external visual reference, anti-icing/de-
icing procedures and principles of threat and error management apply in all sections.

Note.
The aeroplane used for the skill test shall meet the requirements for training aeroplanes and shall be certificated
for the carriage of at least four persons, have a variable pitch propeller and retractable landing gear.

The route to be flown shall be chosen by the FE and the destination shall be a controlled aerodrome. The
applicant shall be responsible for the flight planning and shall ensure that all equipment and documentation for
the execution of the flight are on board. The duration of the flight shall be at least 90 minutes.

The applicant shall demonstrate the ability to:

a) operate the aeroplane within its limitations,
b) complete all manoeuvres with smoothness and accuracy,
c) exercise good judgement and airmanship;
d) apply aeronautical knowledge; and
e) maintain control of the aeroplane at all times in such a manner that the successful outcome of a
procedure or manoeuvre is never seriously in doubt.

FLIGHT TEST TOLERANCES

4. The following limits shall apply, corrected to make allowance for turbulent conditions and the handling
qualities and performance of the aeroplane used.
— Height
— normal flight ±100 feet
— with simulated engine failure ±150 feet
— Tracking on radio aids ±5°
— Heading
— normal flight ±10°
— with simulated engine failure ±15°
— Speed
— take-off and approach ±5 knots
— all other flight regimes ±10 knots

Items in section 2 (c) and (e)(iv), and the whole of sections 5 and 6 may be performed in an FNPT II or an FFS.
Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 9 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 10 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

GUIDANCE NOTES

Guidance Notes
In order for the IAA to process your application as quickly as possible, it is important that you complete the application form correctly.
Please complete the form in conjunction with the following guidance notes.

Section 1 – Personal Details

The permanent address will be entered on your IAA-issued Part-FCL Flight Crew Licence and will also be the address to which the
licence will be sent, if not collecting in person. If you want the licence sent to an alternative address, please enter the details under
‘correspondence address’.

Section 2 - Details of all Flight Crew Licence(s) held or previously held

Please enter details of any flight crew licence(s) held.

Section 3 - Application

Please indicate the Class rating(s) for which you are applying, and the type of Integrated course completed.

Section 4 – Class 1 Medical Certificate

Please enter details of your valid Part-FCL Class 1 medical certificate.

Section 5 – Flight Experience

Please enter details of the flight training completed on the integrated course under each section. If credit was given for flight time as
the holder of an ICAO PPL(A) or PPL(H), please enter the amount of credit given against each section, as applicable.

Section 6 – Declaration of Course Completion

This section must be completed by the ATO’s Head of Training or nominated Deputy.

Section 7 – Theoretical knowledge

Please enter details of your Part-FCL theoretical knowledge examinations.

Section 8 – English Language Proficiency (ELP)

Please enter details of your ELP assessment.

Section 9 – CPL(A) skill test

This section must be completed by the Examiner who conducted the CPL(A) skill test.

Section 10 – IR(A) skill test (if applicable)

This section must be completed by the Examiner who conducted the IR(A) skill test, if applicable.

Section 12 – Applicant’s Declaration

This section must be completed by the applicant after reviewing all information entered on the application form. If you are unable to
agree with any of the statements in the declaration, please contact the Personnel Licensing Office for further advice before
submitting this application..
 Form No. RPPL-F-104AE
APPLICATION FOR THE ISSUE OF A
AMDT No. 3.0 PART-FCL COMMERCIAL PILOT LICENCE
Page No. 11 of 11 (AEROPLANE)

Issue Date: 17/05/2021 (Integrated Course ONLY)

SUBMISSION INSTRUCTIONS

Please note that failure to complete this form fully and submit all required
documentation may result in the return of your application
Send your completed application form to:
Personnel Licensing Office, Irish Aviation Authority, The Times Building, 11-12 D’Olier Street, Dublin 2, Ireland.
Please enclose the following: -
__ Copy of any Flight Crew Licence(s) (all pages) held
__ Copy of your valid Part-Med Class 1 Medical Certificate
__ Copy of your Passport (State of Issue / Passport Number / Photograph page(s) only) or National Identity Card
__ Copy of ATPL theoretical knowledge examination results
__ All Pilot logbook(s)
__ Course completion Certificate issued by your FTO
__ Completed payment form.

PAYMENT FORM

I am paying by:-

CREDIT / DEBIT CARD __ CHEQUE __ POSTAL ORDER __

- PLEASE DO NOT SEND CASH -
Please make cheques payable to ‘Irish Aviation Authority’.
Please note that we do not accept AMERICAN EXPRESS or DINERS CARD.
If paying by credit or debit card, please complete the information required below (in block capitals). Note: All card details are
destroyed upon completion of the transaction.

Name of Card holder (as stated on the card) ____________________________________________________________________

Card Number __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Valid from: __ __ / __ __ Expiry Date __ __ / __ __

Security Code (last 3 digits on signature strip on reverse of card) __ __ __