| Weather
Conditions - |
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CA - 187 |
| Turbulence
factor - * NIL/ SLIGHT/ MODERATE/ SEVERE |
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DEPARTMENT OF CIVIL AVIATION |
| Result and date renewal
test completed |
_______________________________ |
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INSTRUMENT RATING RENEWAL FLIGHT TEST |
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Signed |
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| * I / R Certificate |
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Candidate's name ( in full) |
______________________________________________ |
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Not available / eligible for signature |
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(BLOCK CAPITALS) |
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No. of
Attempt |
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______________________________________________ |
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I / R Privileges
have been withdrawn |
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| * Candidate advised
that |
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Type of Licence
held |
__________________ |
Licence No. |
__________ |
__________________ |
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CPL / ATP Licence
invalidated |
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Firm
or organization employing pilot |
________________________________________________ |
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| *
It is recommended that before applying for retest the candidate
undergoes |
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| at least ___________________________ |
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Test by Parts |
Date
Conducted |
Aircraft |
Chock to clock Times |
Result |
Examiner |
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Type |
Regn' |
Dep. |
Arr. |
Duration |
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Approved Examiner's Signature |
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(1) |
(2) |
(3) |
(4) |
(5) |
(6) |
(7) |
(8) |
(9) |
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Licence No. _____________________ |
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Date ___________________________ |
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| Notes * Delete as applicable |
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| This Certificate to be signed only if I / R
renewal test is passed within thirteen months of the date entered in section 5 of C. A . 144-B of Pilot Licence. |
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