IOSA Self Evaluation Form - 31 October 2014

IOSA Form:
Self-Evaluation
AIRLINE(S) INVOLVED
Click here to enter text.
DATE SELF EVALUATION

COMPLETED
DATE(S) OF COMPLETION OF ANY

PREVIOUS SELF- EVALUATIONS
(IF APPLICABLE)
COMPLETED BY
REVIEWED BY
October 2014
INTRODUCTION
The IOSA Program Manual (IPM) Section 7.7, Reporting Responsibility, requires airlines on the IOSA
registry to report any significant changes to IATA.
This IOSA Form: Self Evaluation is designed to record the details of all operational and structural
changes to airline(s) that have, or are, taking place, when any major event such as a merger, takeover,
acquisition, consolidation, cessation of operations, etc., has occurred.
To enable IATA to fully evaluate all circumstances and the impact of the changes that have taken
place, the airlines involved should ensure that all relevant details are provided.
TERMS USED
Changes: Changes result from various inputs anywhere from audit findings to proposals from
employees within the company. The IOSA objective, as stated in the IPM, is to be accurately
informed about any major organizational, operational and aircraft maintenance changes made within
the applicable IOSA certified organization.
Organizational changes: Organizational changes shall be notified to IATA SFO Quality Department
within 30 working days from the moment they become effective.
All organizational changes which affect or have an indirect effect on the safety management, quality
assurance, operational and maintenance procedures, shall be adopted, where relevant, in the
applicable manuals.
Major Changes: These are changes that will affect procedures, standards, limitations, processes,
contracts, programs, and/or their status.
Minor Changes: These are considered to be all other changes than major changes including the
text and layout of handbooks, minor procedural changes (name, number and restrictiveness) and the
use of different software, which will not affect the primary procedures.
Note: Changes to software affecting a core part of a primary process is considered to be a major
change.
Contracted activities: Activities delegated and executed by a contracted party, other than the
original organization, that has the final responsibility for the correct implementation and results of the
total final product. The original organization fully depends on the skills, processes, resources, etc. of
the contracted party, actually certified for the agreed deliverables, activities and products as stated in
the contract.
Sub-Contracted activities: Activities delegated and executed by a sub-contracted party, other than
the original contracted organization that has and will keep the final responsibility for the correct
implementation and results of the total final product as agreed upon per initial, original contract. The
sub-contracted party will operate under the original contracted organizations Quality Management
System. The original contracted organization decides to what extent they will provide input, data,
guidance, know how, procedures to follow, instructors, training syllabi etc. to the sub-contracted
party related with the activities as stated in the sub-contract.
GENERAL DISCLOSURE
This IOSA Form: Self Evaluation is completed/reviewed by and signed, as of the date as stated below,
as so declares to be duly authorized for this purpose.
By completing and signing this report, the Operator hereby represents and warrants that it has
exercised due care in evaluating its current status, as required hereunder and with reference to the
applicable IOSA standards (ISARPs) and that, to the best of its knowledge with due inquiry, all data,
document and other information submitted hereunder are true and correct as of the date hereof.
(insert complete name of airline) shall be responsible for ensuring that no misrepresentations are
made hereunder and shall indemnify IATA and keep it harmless of any damages it may incur as a
result of any error, omission, misrepresentation, incompleteness or inaccuracy made with respect to
any data, document or other information required to be disclosed in this Report, and as a result of any
non-conformity that may be discovered thereafter or during any future IOSA audit.
All data, documents or other information retrieved from this form shall only be used by IATA and its
agents for the benefit of the IOSA Program and in accordance with conditions thereof and shall remain
confidential.
This IOSA Form: Self Evaluation is duly signed by a duly authorized representative. Any
developments thereafter are not included in this report.
________________________
(Signature)
Name: Click here to enter text.
Title, Department, Company: Click here to enter text.
On:
City, Country: Click here to enter text.

IOSA Form: Self Evaluation
IPM 7.7
No. Type of event as per IPM 7.7 No Changes Comments

changes, Or Yes
or Not
Applicable
or No
Cessation of operations Click here to
enter text.
Air Operator Certificate (AOC) Click here to
changes, such as: enter text.
suspensions;
revocation; or
restrictions;
Changes to fleets as follows: Click here to

disposal of the fleet(s) on enter text.
the AOC which were
audited during the last
audit;
the addition of aircraft
type(s) not previously
operated;
Sanctions imposed by a regulatory Click here to

authority; enter text.
An event involving the operation of Click here to

an aircraft that meets the criteria enter text.
of a Serious Incident or an
Accident as defined in ICAO Annex
13, Chapter 1;
Any takeover, merger, Click here to

consolidation, or other significant enter text.
structural change to the
management or operating
structure of the organization.
Operations over excluded routes; Click here to

or enter text.
Any other excluded area(s) of
operations. (s) not previously
operated;
IPM 7.7
No. Type of event as per IPM 7.7 No Changes Comments

changes, Or Yes
or Not
Applicable
or No
Other: Click here to

enter text.
Summary of events
Please summarize the events undergone by your organization:
1 ORGANISATION (ORG)
Summary of events
Summary of events
Summary of events
Summary of events
Summary of events
Summary of events
Summary of events
Summary of events
Summary of events
1.2 Quality and Safety Management

No. IOSA content or question No Changes Description / Response / Comment
changes, Or Yes
or Not
Applicable
or No
Are there any changes to the Click here to enter text.
Quality Assurance department?
In case of a merger, who will

coordinate the QA during the
merger?
Will there be any changes in the Click here to enter text.
Safety and Quality Assurance
areas, specifically:
Policies
Management
Scope
Position in the organizational
structure of the company
Employees
If yes, then please describe in

detail.
Will the QA programs be merging, Click here to enter text.
and from what date?
If yes, then please include the

effects on implementation for the
sub-contracted organizations.
Will the Quality and/or Safety Click here to enter text.
Manual(s) be revised?
If yes, please describe the changes

involved.
1.2 Quality and Safety Management

changes, Or Yes
or Not
Applicable
or No
Will there be a change in the Click here to enter text.
structure for meetings in Quality /
Safety?
If yes, then please state the

frequency of meetings and who will
attend.
1.3 Improvements, Findings and Recommendations

changes, Or Yes
or Not
Applicable
or No
Have any of the involved Click here to enter text.
company(ies) in the change/merger
experienced any accident (as
defined in ICAO Annex) in the last
five years?
If yes, then please give a brief

summary about the accident
including:
Date
Brief description
Status of the investigation
Parties involved in the
investigation
Please include current corrective

actions taken to prevent recurrence
1.3 Improvements, Findings and Recommendations

changes, Or Yes
or Not
Applicable
or No
Have the involved company(ies) in Click here to enter text.
the change/merger experienced
any serious incident within the last
three years?
If yes, then please include a brief

summary and state the corrective
actions taken to prevent a
recurrence.
Do you have a plan to handle Click here to enter text.
unresolved issues resulting from
audits or investigations?
Please include details.

Has the system of safety database Click here to enter text.
handling been changed in the
involved company(ies)?
If yes, then please provide details

on the methodology for the merging
and integration of the databases.
1.4 Facilities and Equipment

changes, Or Yes
or Not
Applicable
or No
Does the change/merger of the Click here to enter text.
airlines involved create reasons for
concern about the fleet integration?
If yes, please include the following

details:
What will the average age of
the total fleet (before and after
the change/merger)?
Does the integrated fleet
include aircraft from different
manufacturers?
Are there differences in flight
deck layout for the same fleet?
Is different equipment installed
on-board?
1.5 Document Control

changes, Or Yes
or Not
Applicable
or No
Will there be a change in the Click here to enter text.
document structure or the
distribution method?
If yes, which documents are

affected and what is the transition
plan?
Will there be a migration of any Click here to enter text.
paper documents to electronic
document?
1.4 Facilities and Equipment

changes, Or Yes
or Not
Applicable
or No
Does the change/merger of the Click here to enter text.
airlines involved create reasons for
concern about the fleet integration?
If yes, please include the following

details:
What will the average age of
the total fleet (before and after
the change/merger)?
Does the integrated fleet
include aircraft from different
manufacturers?
Are there differences in flight
deck layout for the same fleet?
Is different equipment installed
on-board?
1.5 Document Control

Has someone been appointed to be Click here to enter text.
responsible for the maintenance
and protection of all applicable
manuals, documents, records,
and/or forms?
Consider:
Editorship
Distribution of amendments to
manuals, documents, forms in
use
Retention of documents and
accessibility
External sources document
data exchange
1.6 Emergency Response Planning (ERP)

changes, Or Yes
or Not
Applicable
or No
Does the Emergency Response Click here to enter text.
Plan (ERP) require restructuring?
If yes, what is or was the

completion date?
Do all of the airlines involved in the Click here to enter text.
change/merger have departmental
ERPs?
If yes, will any plans be restructured
during /after the change / merger?
Describe any significant changes.

Will there be a change of personnel Click here to enter text.
involved in the actual ERP(s) or the
newly issued ERP(s)?
If yes, will the new personnel
involved with the ERP(s) require
training?
Will there be a drill executed for all Click here to enter text.
ERP(s) after the change/merger?
If yes, what is the planned date?

Will there be any outsourcing of Click here to enter text.
ERP provisions?
Consider:
Contracts
Telephone Centers
Facilities
Other airlines
2 FLIGHT OPERATIONS (FLT)
2.1 Management and Control

changes, Or Yes
or Not
Applicable
or No
Are there changes to the Air Click here to enter text.
Operator Certificates (AOC) or
Operations Specifications of the
airlines involved in the change /
merger?
If yes, then please provide copies

of the AOCs.
Is the delegation of Operational Click here to enter text.
duties and managerial continuity
ensured during and after the
change / merger?
If yes, please provide the Transition

plan, schedule etc.
2.2 Fleets
changes, Or Yes
or Not
Applicable
or No
Is there a change in the fleet (type Click here to enter text.
or total)?
If yes, please provide details,

including the induction or phase out
of fleets.
2.3 Flight Deck Crew

changes, Or Yes
or Not
Applicable
or No
Will flight crew from the merging Click here to enter text.
airlines be operationally mixed?
If yes, what is the projected time

frame for complete integration of
crews?
Will the Operations Manuals (OM) Click here to enter text.
from the merging airlines be
integrated and revised to one new
OM?
If yes, then please indicate the
areas that will be revised and the
effectivity date(s).
2.4 Training
changes, Or Yes
or Not
Applicable
or No
Will the flight deck crew from the Click here to enter text.
merging airlines require training
before they can operate together?
If yes, what is the projected

completion date of the training?
If not, then please explain why

there will be no training requirement
prior to the mixed operation.
Will there be a significant change in Click here to enter text.
the number of pilots in the
organization?
If yes, please provide details.

Will there be a significant change in Click here to enter text.
the number of training pilots in the
organization?

2.4 Training
changes, Or Yes
or Not
Applicable
or No
Are there changes in the conduct of Click here to enter text.
simulator training?
Consider simulators and

outsourced training

Have you planned for the additional Click here to enter text.
training that may be required? If
yes, then please provide details.
Consider
Route and aerodrome
familiarization
Security procedures
EDTO / ETOPS
Fuel policies
Crew Resource
management (CRM)
MEL dispatch procedures
RNP /RNAV
Flight safety
Dangerous goods
Documents/forms in use
Supporting departments
3. OPERATIONAL CONTROL AND FLIGHT DISPATCH (DSP)
3.1 Personnel
changes, Or Yes
or Not
Applicable
or No
Is there a change in the system of Click here to enter text.
Operational Control (shared or non-
shared)?
3.1 Personnel
changes, Or Yes
or Not
Applicable
or No
Will sub-contracted services Click here to enter text.
obtained before the change /
merger continue to be sub-
contracted after the change /
merger?
Consider:
New services involved;
Certification(s) required;
Workload;
Accessibility;
Training involved;
Administration and reporting
requirements.
Will the route network expand or Click here to enter text.
change due to the change/merger?
Consider:
Extended over water flights;
Isolated airports;
RVSM?
ETOPS?
Polar flights;
Winterization;
Mountainous terrain;
Any other operational changes.
Will all operational control and flight Click here to enter text.
dispatch personnel be familiar with
the different types of fleets?
If yes, will their function be specific

aircraft type-related or will they be
trained to handle all fleet types?
3.2 Training
changes, Or Yes
or Not
Applicable
or No
Will the operational control and Click here to enter text.
flight dispatch personnel need
training on the following topics:
Routes and their exposure
Aircraft types
Adopted policies
MEL procedures
Mass and balance
Dangerous goods
CRM
Security
Other(s)
Does operational control and flight Click here to enter text.
dispatch training need to be
conducted?
If yes, please provide the training

plan with completion dates and
confirm that there are sufficient
resources available to meet agreed
deadlines?
3.3 Operational Control and Flight Dispatch Facilities

changes, Or Yes
or Not
Applicable
or No
Is the flight dispatch and operations Click here to enter text.
control equipment appropriate for
the required functions, planned
activities and active personnel?
4 AIRCRAFT ENGINEERING AND MAINTENANCE (MNT)
4.1 Management and Administration

changes, Or Yes
or Not
Applicable
or No
Will Aircraft Maintenance personnel Click here to enter text.
operationally mixed?

frame for completion?
Is the delegation of duties and Click here to enter text.
managerial continuity ensured
during and after the
change/merger?
If yes, then please provide a copy

of the Transition plan, schedule etc.

changes, Or Yes
or Not
Applicable
or No
Are there changes in the Click here to enter text.
organizations fleet maintenance
and administration?
Please consider sub-contracted

services.
If yes, please provide the name of

the MO and stipulate up to what
level the following maintenance
activities have been sub-
contracted. Include activities such
as:
Administration;
Log books;
Aircraft Maintenance Program
(AMP) and its maintenance;
AMP reliability evaluation;
Service Bulletins (SB) and
Airworthiness Directive (AD)
notes from type-certificate
holders?
Maintenance Review Board
(MRB) advisories?
Extensions;
Airworthiness review
certification;
Scheduled and non-scheduled
maintenance;
Structural repairs;
Deferred defect administration;
Inspections;
De-icing.

changes, Or Yes
or Not
Applicable
or No
Will sub-contracted services being Click here to enter text.
used before the change / merger
continue to be sub-contracted after
the change / merger?
Consider:
Involved new services
Certification(s) required
Workload
Accessibility
Training involved
requirements.
Is there a defined process and Click here to enter text.
deadline for the merging of
databases used by maintenance?
If yes, please provide details of the

processes and the deadlines.
Consider:
AMP reliability program;
AD and SBs data bases;
Spare part tools;
Modifications;
Structural Repairs;
Components certificates;
Logbooks (Aircraft, Engines,
APU, other);
Deferred Defects;
Applicable extensions;
Maintenance Review Board
data;
Escalation programs.
4.2 Training Maintenance Personnel

changes, Or Yes
or Not
Applicable
or No
Will training of maintenance Click here to enter text.
personnel be required due to the
change/merger?
If yes, please indicate which

personnel will require training and
will this training be completed
before the change / merger?
Will the company Minimum Click here to enter text.
Equipment List (MEL) be revised?
If yes, will training of aircraft

maintenance personnel, flight
operations crew and dispatch
personnel be needed?
Will sub-contracted parties need to Click here to enter text.
be trained for revised maintenance
policies and procedures?
Consider:
Administration forms in use
Release for service procedure
Safety reporting system
Pre-flight walk around
Deferred defect procedures
Structural repair procedures
Spare parts and quarantine
room
Communication system
EDP system
Other maintenance
procedures)
4.3 Maintenance Equipment and Facilities

changes, Or Yes
or Not
Applicable
or No
Is the Maintenance Organization Click here to enter text.
certified and adequately equipped
for all existing and new aircraft
type(s) it will be maintaining?
Consider:
Calibration tools
Applicable Maintenance data
Approved repair manuals, such
as, Aircraft Structural repair(s)
history data and/or manuals,
Illustrated Parts Catalogue
(IPC) and Wiring Diagram
Manual (WDM), etc.
Jacks, Ground Support
Equipment, specific tools
Hangar size and lay-out
Emergency equipment
Sufficient adequately licensed
and trained aircraft
maintenance technicians
Communication work stands
Other maintenance functions
5 CABIN AND CARGO COMPARTMENT OPERATIONS (CAB)
5.1 Cabin and Cargo Compartment Operations

changes, Or Yes
or Not
Applicable
or No
Are there changes in the Cabin Click here to enter text.
Operations?

Will cabin crew from the changed / Click here to enter text.
merging airlines, be operationally
mixed?
frame for full integration?
Is the delegation of Cabin and Click here to enter text.
Cargo duties and managerial
continuity ensured during and after
the change / merger?

plan, schedule etc.
Will the Operations Manuals from Click here to enter text.
merging airlines be integrated into
one new Operations Manual?
If yes, will this change affect cabin

and cargo compartments
operations?
Consider:
Cabin Flight safety procedures;
Communication procedures;
Emergency procedures;
Security procedures;
Line qualification;
Pre-flight, in-flight and post-
flight inspections (i.e., cargo
inspection requirements);
Fuelling procedures;
Other cabin procedures.
5 CABIN AND CARGO COMPARTMENT OPERATIONS (CAB)
5.2 Training Cabin Crew

changes, Or Yes
or Not
Applicable
or No
Will the cabin crew from the Click here to enter text.
before they can operate together?
If yes what is the date for

completion of the training program?
If not, then explain why there will be

no training or integration
requirement, prior to the combined
operation.
What will be the total number of Click here to enter text.
staff for the following positions for
the restructured organization after
the change/merger:
Consider:
Cabin Attendants
Cabin Supervisors;
Line Evaluators;
Crew Leaders.
Is there a change in the total Click here to enter text.
number of available:
Cabin Training trainers?
Consider:
Instructors
Examiners
Other(s).
Will the required cabin training be Click here to enter text.
conducted in house?
If not, then what portions of the

training will be sub-contracted and
to which organization? Please
provide details.
6 AIRCRAFT GROUND HANDLING (GRH)

changes, Or Yes
or Not
Applicable
or No
1. Will Ground Handling personnel Click here to enter text.

frame to have this in place?
2. Is the delegation of Ground Click here to enter text.
Handling duties and managerial
continuity ensured during and after
the change/merger?
If yes, please provide us the

Transition plan, schedule etc.
3. Will the Operations Manuals from Click here to enter text.
the merging airlines integrate and
be revised to one new Operations
Manual?
Consider:
Emergency procedures
including response plans
Communication procedures
Handling activities
Security procedures
Administration activities
Automated recording systems
Documentation and data
control
Managerial Continuity
Aircraft maintenance related
activities
De-/Anti-icing program
4. Have ground handling Click here to enter text.
responsibilities been clearly
determined for the period during
and after the change/merger?
Consider the sub- contracted

services (when used) and/or
activities.
5. After the change / merger, will the Click here to enter text.
carrier become a dangerous
goods carrier?
6.2 Training of Ground Handling Personnel

changes, Or Yes
or Not
Applicable
or No
1. Will ground handling personnel Click here to enter text.
from the merging airlines require
training before they can operate
together?
If yes, then what is the projected

training program?
If not, then explain why there will be

no training requirement prior to the
combined operation.
2. Are there enough GRH training Click here to enter text.
resources (facilities and trainers) in
the new organization?
Consider the training requirements

for the
Incremental staff
New capabilities, such as DG.
6.3 Ground Handling Operations

changes, Or Yes
or Not
Applicable
or No
1. Will the supervision of the ground Click here to enter text.
handling operations be assured
during the change / merger and
when the change / merger
becomes effective, with respect to
the following:
Passenger handling
Airside operations
Load control
Aircraft aft loading
7 CARGO OPERATIONS (CGO)

changes, Or Yes
or Not
Applicable
or No
1. Will personnel involved with cargo Click here to enter text.
acceptance, handling etc. from the
changing / merging airlines be

2. Is the delegation of cargo related Click here to enter text.
change / merger?

plan, schedule etc.
3. Will there be a change to the sub- Click here to enter text.
contracted cargo handling services
that existed before the change /
merger?
Consider:
New services & capabilities
Workload
Accessibility
Training involved
requirements
4. Will the Cargo Operations Manual Click here to enter text.
(COM) from the merging / changed
airlines integrate and be revised to
one new COM?
Consider:
Emergency procedures
including response plans;
Communication procedures;
Handling activities;
Security procedures;
Administration activities;
Automated recording systems;
control;
Training requirements;
Protocols to follow;
Quality Requirements.

changes, Or Yes
or Not
Applicable
or No

change / merger?

plan, schedule etc.
merger?
Consider:
Workload
Accessibility
Training involved
requirements
7.2 Training of Personnel

changes, Or Yes
or Not
Applicable
or No

changes, Or Yes
or Not
Applicable
or No

change / merger?

plan, schedule etc.
merger?
Consider:
Workload
Accessibility
Training involved
requirements
1. Will cargo handling personnel from Click here to enter text.
the merging/changed airlines
require training before they can
operate together?
Consider:
Dangerous goods training
Changes to recurrent training
requirements
Security and emergency
procedures
Integration of training records
and subsequent training
schedules
Communication system
EDP system
If yes, then when will the training be

completed?

changes, Or Yes
or Not
Applicable
or No

change / merger?

plan, schedule etc.
merger?
Consider:
Workload
Accessibility
Training involved
requirements
2. Are there enough CGO training Click here to enter text.
resources (facilities and trainers) in
Consider the training requirements

for the
Incremental staff
New capabilities, such as DG.
7.3 Cargo/Mail Acceptance and Handling

changes, Or Yes
or Not
Applicable
or No
1. Is there a plan to change or Click here to enter text.
integrate or adopt new cargo
activities?
Consider Valuable cargo, Unit Load

Devices (ULDs), Dangerous Goods
Live animals, Perishables, Mail,
Human Remains, Heavy, Fragile or
outsized goods.
7.4 Cargo Handling Facilities

changes, Or Yes
or Not
Applicable
or No
1. Are the cargo handling equipment Click here to enter text.
and facilities at all new adopted
locations (if applicable) appropriate
and adequate for the required
functions, planned activities and
active personnel?
Consider the following:

Storage rooms for corrosives,
explosives and other
dangerous goods, perishables
and livestock;
Weighing equipment;
X-ray equipment;
Calibration tools and
documentation of equipment in
use
Communication systems;
EDP systems.
8 OPERATIONAL SECURITY (SEC)

changes, Or Yes
or Not
Applicable
or No
1. Is there a change in the Security Click here to enter text.
Management structure?
Consider:
Relevant states and their
requirements and procedures
Communication procedures
Required equipment, facilities
and documentation
Administration and
documentation requirements,
equipment and tools
Automated recording systems
control
Aircraft maintenance related
activities
(Sub) Contracted organizations
activities
Ground handling procedures
Cargo and mail handling
associated activities.
2. Will the change / merger require the Click here to enter text.
issuance of a new Security
Manual?
If yes, when will the new SM be

issued?
3. Is the delegation of security related Click here to enter text.
change/merger?

plan, schedule etc.
8.2 Training of Security Personnel

changes, Or Yes
or Not
Applicable
or No
1. Will security personnel from the Click here to enter text.
following the change/merger?
This may be due to the adoption /

incorporation of each others
security manuals or due to other
reasons such as additional
requirements from the relevant
competent authorities?
Consider:
Number of personnel involved;
Availability of instructors;
schedules.
If yes, what is the projected training

program and date of completion?
If no training is required, then

explain how integration will be
completed.
2. Will operational personnel including Click here to enter text.
flight and cabin crew, dispatchers,
ground handling personnel, cargo
handlers, and others such as
outsourced personnel, require
training due to the changes made
to the security manual?
Consider:
Number of employees involved
Availability of instructors
schedules
If yes, what is the projected training

program and date of completion?
If no training is required, then

explain how integration will be
completed.
8.3 Security Operations

changes, Or Yes
or Not
Applicable
or No
1. As a result of the change/merger, Click here to enter text.
have any adjustments or changes,
including the introduction of new
procedures and policies been made
to the following operational security
subjects;
Access control procedures;
Aircraft security procedures;
Policies regarding the carriage
of weapons;
Passengers, supernumeraries,
cargo attendants and cabin
baggage processes;
Special category passengers;
Hold baggage process;
Cargo, mail and supplies
process?
If yes, how they were embedded

into the new organization?
8.4 Security Threat and Contingency Management

changes, Or Yes
or Not
Applicable
or No
1. Were the threat management Click here to enter text.
procedures / processes revised as
a result from the change/merger,
the new organization (including the
new destinations, if applicable) or
new competent authorities?
Consider the following

Assessment of associated risks
Development of appropriate
response measures
8.4 Security Threat and Contingency Management

changes, Or Yes
or Not
Applicable
or No
2. Was the Contingency Plan Click here to enter text.
evaluated and approved for the
new organizations use following
the change/merger?
Please provide details.

3. Is the security investigation Click here to enter text.
procedure integrated throughout
4. Is there a change in the notification Click here to enter text.
procedures?
Is it communicated with all relevant

parties?

IOSA Self Evaluation Form - 31 October 2014

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IOSA Self Evaluation Form - 31 October 2014

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IOSA Form:

DATE SELF EVALUATION

DATE(S) OF COMPLETION OF ANY

Name: Click here to enter text.

Title, Department, Company: Click here to enter text.

City, Country: Click here to enter text.

No. Type of event as per IPM 7.7 No Changes Comments

Changes to fleets as follows: Click here to

Sanctions imposed by a regulatory Click here to

An event involving the operation of Click here to

Any takeover, merger, Click here to

Operations over excluded routes; Click here to

No. Type of event as per IPM 7.7 No Changes Comments

Other: Click here to

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

Click here to enter text.

Please summarize the events undergone by your organization:

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1.2 Quality and Safety Management

In case of a merger, who will

If yes, then please describe in

If yes, then please include the

If yes, please describe the changes

1.2 Quality and Safety Management

If yes, then please state the

1.3 Improvements, Findings and Recommendations

If yes, then please give a brief

Please include current corrective

1.3 Improvements, Findings and Recommendations

If yes, then please include a brief

Please include details.

If yes, then please provide details

1.4 Facilities and Equipment

If yes, please include the following

1.5 Document Control

If yes, which documents are

1.4 Facilities and Equipment

If yes, please include the following

1.5 Document Control

1.6 Emergency Response Planning (ERP)

If yes, what is or was the

Describe any significant changes.

If yes, what is the planned date?

2.1 Management and Control

If yes, then please provide copies

If yes, please provide the Transition

2 FLIGHT OPERATIONS (FLT)