CA-39

Flying experience for period from ……………….. to ……………….. {Preceding 5 years/ preceding 6 mont
Name of Licence Holder …………… Valid upto……..…………

Aircrafts flown……………………………………………………….
Write years for SINGLE ENGINE AIRCRAFT
year wise, months DAY
for month wise or
Aircraft for Aircraft Dual Solo
Wise -1 -2

TOTAL

Note: write P1 U/s experience separately and do not include in Co-pilot column.

This is to certify that I have examined the logbooks of Mr. …………………………………………… and the a

Countersigned……………..…………………..…
Name………………………………………………
Signature of License Holder Designation………………………………………
Date..………………………… Company name………………………………….
Seal of the Organisation
Date……………………………………………
Note: Fill up separate CA-39 form for flying in preceding 5 years/ preceding 6 months/ preceding 12 months/ preceding 18 months, (as require
Separate form shall be used for helicopter flying and Aeroplane flying. This form shall be countersigned by competent authority who is authori
Aircraft Rules 1937.
5 years/ preceding 6 months/ preceding 12 months/ preceding 18 months}

MULTI ENGINE AIRCRAFT

NIGHT DAY NIGHT
P1 P1
Dual Solo U/T Co-pilot (U/S) PIC U/T Co-pilot (U/S) PIC
-3 -4 -5 -6 -7 -8 -9 -10 -11 -12

…………………… and the above is a true summary.

hs/ preceding 18 months, (as required by respective schedule-II of the Aircraft Rules).
y competent authority who is authorisd to sign log book as per Rule 67A of the
 INSTRUMENT TIME Instruc- Remark
ON AIRCRAFT Synthetic tional
Simulator Flying
Total Simulated Actual hrs
-13 -14 -15 -16 -17 -18