Fillable APPLICATION FOR FCL CERTIFICATE OF VALIDATION (Bermuda Civil Aviation Authority)

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APPLICATION FOR FCL CERTIFICATE OF VALIDATION (Bermuda Civil Aviation Authority)

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bcaa.bm
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APPLICATION FOR FCL CERTIFICATE OF VALIDATION
The validation of flight crew licences granted by ICAO contracting States is in accordance with the provisions
of Article 57 of the Air Navigation (Overseas Territories) Order 2013, and with the standard set out in
paragraph 1.2.1 of Annex 1 (Personnel Licensing) to the Convention on International Civil Aviation and is
effected by the Bermuda Civil Aviation Authority for the purpose of operating Bermuda registered aircraft.
This form should be completed by the airman requesting the Certificate of Validation (CV) and
submitted electronically to licencing@bcaa.bm, together with scanned certified copies of the following
supporting documentation (the applicant must ensure that all scanned documents are legible – illegible
documents will delay the validation process):
1. Pilot’s Licence / Certificate showing applicable aircraft type rating and licence validity (including
Certificates of Test and/or Licence Proficiency Checks, see Note 4 & 5 below);
2. Documentary evidence from the issuing State, verifying the validity of the submitted Pilot’s
Licence /Certificate (initial & renewal applications - see Note 2 below);
3. Current medical certificate issued by same regulatory authority as pilot’s licence (not applicable to
EASA member States);
4. Evidence of proficiency in the English language (see Note 3 below);
5. Radio Operator’s Permit / Licence (issued by the same State as pilot’s licence); and
6. Confirmatory letter of employment (not applicable to “Freelance” applications, see Note 7 below).
NOTES – Applicants should read these notes carefully before completing the application form.
A. General
Note 1.
Note 2.
Note 3.
Note 4.
Note 5.
Note 6.
Note 7.
The Flight Crew Licence Validation Certificates (FCL CV) are issued for a period up to
but not exceeding five (5) years. To ensure compliance with ICAO Annex 1.2.2.1
requirements, the holder of a Bermuda issued Flight Crew Licence Validation certificate
must supply the Bermuda Civil Aviation Authority (BCAA) with certified true copies of
every Medical Certificate renewal and additionally, evidence of satisfactory completion of
each subsequent Pilot Proficiency Check (LPC), completed during the validity period listed
on the licence validation document.
Failure to supply this evidence will result in suspension of the Licence Validation.
All Applicants for an initial/renewal granting of a Certificate of Validation need to
have the particulars of their licence verified by the appropriate section or department
of the Aviation Authority that issued the licence.
Applications for a Certificate of Validation will not be entertained unless the Applicant
has been assessed as having achieved Level 4, or higher, proficiency in English
language in accordance with the ICAO standard in Annex 1.2.9.1.
Evidence of completion of a proficiency check on the aircraft type for which application
is made, within one year of application, must be provided. This must be in the form of a
licence endorsement or for FAA Certificate holders only, a completed pilot proficiency
check form. The Bermuda CAA does not accept F.A.A. Second in Command (SIC)
proficiency checks nor Temporary Certificates for initial issue of F.A.A. Licences.
Documents not in English must be accompanied by an official translation.
Incomplete applications, applications received without the required supporting
documentation or applications not accompanied by the requisite fee, if required, may
not be processed.
All initial applicants for a Certificate of Validation are to obtain a letter from the Owner
or Operator stating that the applicant is to be engaged as Flight Crew. This letter is to
be on paper with a Company logo or similar identifier.
FORM No.:
BCAA/PEL/9511/REV 4
Last Updated:
09-May-2019
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B. Fee
Initial Certificate of Validation (CV), linked to an Operator or specific registration mark(s)
$ 0.00
Renewal of a Certificate of Validation (CV), linked to an Operator or specific registration
mark(s)
$ 0.00
Initial issue of a “Freelance” Certificate of Validation (CV) from 1 April 09. see FAQ on
www.bcaa.bm
$ 2000.00 (or as per fee schedule)
Renewal of a “Freelance” Certificate of Validation (CV) from 1 April 09. see FAQ on
www.bcaa.bm
$ 2000.00 (or as per fee schedule)
The Fee Schedule is available on
www.bcaa.bm
Payment should be in the form of a wire transfer or cashier’s cheque drawn against a US bank,
payable in US$ and payable to Bermuda Civil Aviation Authority (Contact the BCAA for wire transfer
details). Payment must accompany this application.
C. Certification
The Bermuda Civil Aviation Authority will accept faxed or scanned documents in support of
applications for Certificates of Validation
Copies of documentation submitted in support of an application for a CV must be certified.
The following persons are acceptable to the Bermuda Civil Aviation Authority for the certification of
documentation:
1. Persons who have been found to be acceptable to the Director General of Civil Aviation, such
as Accountable Managers, Quality Managers, Chief Pilots and Check Airmen.
(Apply to BCAA Licencing for authority to certify documents as being true copies);
2. Officials of the Aviation Authority of the State that issued the pilot’s licence or the State
where the pilot or operator is located;
3. Persons holding a delegation, authorization or otherwise approved as Inspector, Flight
Examiner or Check Airman under the civil aviation regulations of the State that issued the
pilot’s licence or the State where the pilot or operator is located; and
4. Justices of the Peace, Notary Publics or persons otherwise similarly approved or authorized
under the law of the state in which the certification is made or the State of issuance of the
pilot’s licence.
Each copy of the document must be signed separately with the words “CERTIFIED TRUE COPY OF
THE ORIGINAL” and the signature of the certifying officer clearly shown. The name, office and
registration number (if applicable) of the certifying officer should be legibly printed below the
signature. A single certification (in the above format) of all supporting documentation may be
accepted provided it identifies all documentation by title, and number if applicable, and the
certification is affixed in a manner preventing separation from the documentation to which it relates
D. Form Items
1. Name – Enter your full name in the following order: Last (Surname), First (Given Name),
Middle Name.
2. Address & Contact Information – Enter your normal permanent address and contact
numbers.
If present contact information differs to permanent information, you should provide this
information in addition to the permanent contact information to enable BCAA to contact you
should there be any questions concerning the application.
3. Company Name, Address & Contact Information – Enter the name and address of the
company/operator who employs you. The address should reflect the normal address of the
company, not the registered address of the Bermuda registered company.
4. Application Information – Enter whether the application is for an Initial, Renewal CV or
Additional Aircraft Type to an existing CV.
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5. Aircraft information – Enter the type and registration of the Bermuda registered aircraft that
you will operate.
6. Crew Capacity – If you will be acting as PIC and SIC, check both boxes.
7. Date of Birth – In the following order: day – month – year.
8. Nationality – Enter citizenship.
9. Licence to be validated – Provide all requested information concerning the licence to be
validated.
10. Flight Time – Enter flight times as appropriate.
11. Date of Licence Proficiency Check – BCAA requires all applicants for a CV to complete an
annual proficiency check on the aircraft type. If an annual proficiency check is required to
maintain the validity of your pilot’s licence, for example an EASA Licence Proficiency Check,
enter the date of your most recent check here and include evidence of completion.
12. Date of Instrument Rating Renewal – If a flight test is required to maintain the validity of
your instrument rating, enter the date of last test here. If the instrument rating renewal is
accomplished concurrently with the test described at item 10, for example an EASA Licence
Proficiency Check, re-enter the date entered at 10 here.
13. Training – Enter dates of initial training in the aircraft type described in item 4 and the date
of most recent training in the aircraft type.
14. Name & Address & Authority of Certifying Agent – Enter the name, address (including
contact numbers), and authority (e.g. Notary
Public, Inspector, Examiner, etc.) of the person certifying the copies of the documentation
submitted in support of the application.
15. Legislation
(a) The Air Navigation (Overseas Territories) Order 2013 may be found on the ASSI
website (www.airsafety.aero).
(b) Overseas Territories Aviation Requirements (OTAR) Parts 61, 91 and 125 may
be found on A.S.S.I. website (www.airsafety.aero).
16. Compliance Statement – By checking the box, the applicant confirms the accuracy and
validity of the information supplied. If not checked the application will be refused.
Application Checklist – the following items must accompany any application:
Payment – in the form of a wire transfer or cashier’s cheque drawn against a US bank in accordance with
the fee schedule, payable to BERMUDA CIVIL AVIATION AUTHORITY;
Verification of licence details from State of issue (initial issues).
Certified copy of Current medical certificate;
Certified copy of pilot’s licence showing applicable aircraft type rating, language proficiency (note 2) and
licence currency (including Licence/Pilot Proficiency Checks);
Certified copy of radio operator’s licence;
Confirmatory letter of employment (not applicable to “Freelance” applications)
TYPE OR PRINT IN BLUE OR BLACK INK
1. FULL NAME
2. ADDRESS &
CONTACT
INFORMATION
Last First Middle
phone: fax: email:
3. OPERATOR’S
NAME, ADDRESS
& CONTACT
INFORMATION
phone: fax: email:
4. APPLICATION INFORMATION: INITIAL RENEWAL ADDITIONAL TYPE
5. AIRCRAFT FOR WHICH VALIDATION IS REQUIRED:
AIRCRAFT TYPE:
REG:
6. CREW CAPACITY OF APPLICANT: P.I.C. S.I.C. F.E. FREELANCE
7.
8. NATIONALITY:
9.
EXPIRATION. DATE
DATE OF MEDICAL
CLASS
MEDICAL LIMITATIONS
RADIO OP. LIC. NO.
10.
AEROPLANES
HELICOPTERS
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
11.
12.
13. TRAINING
AIRCRAFT TYPE DATE (DD-MM-YY) PLACE (FACILITY & LOCATION)
14. AUTHORITY, NAME & ADDRESS OF CERTIFYING AGENT: AUTHORITY
:
NAME
:
ADDRESS:
15. I certify that the licence I am applying to have validated is current. I certify that the above information is true and correct to the best of my knowledge and that I am fully
conversant with the requirements of the Bermuda legislation contained in the Air Navigation (Overseas Territories) Order 2013, as amended and Overseas Territories
Aviation Requirements (OTAR) Parts 61, 91 and 125. It is an offence to make, with the intent to deceive, any false representation for the purpose of procuring the
grant, issue, renewal, or variation of a Certificate of Validation. Any person so doing shall be liable on summary conviction, to a fine and on conviction on indictment
to
a
fine or imprisonment for a term not exceeding two years, or both.
16. COMPLIANCE STATEMENT: I agree that the information submitted is correct: DATE
(DD-MM-YY)
:
BCAA Form 9511 08/16)
BCAA/PEL/9511 (Rev 4)
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APPLICATION FOR FCL CERTIFICATE OF VALIDATION (Bermuda Civil Aviation Authority)

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Completed 22 July 2021

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