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89
Forms
[[insignia]]
Canada
_______

Air Regulations
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APPLICATION FOR LIMITED COMMERCIAL AIR PILOT'S CERTIFICATE
_______

(To be submitted in duplicate)
See conditions printed on back of this form

Name in full.............................................
(In Block Capitals, Surname Preceding)
Permanent Address........................................
.........................................................
(Any change in address to be notified immediately)
Nationality..............................................
(If naturalized give full particulars)
Date of birth.............Place of birth.................
Controller of Civil Aviation,
Department of Transport,
Ottawa, Ontario.
1. I hereby apply for a Limited Commercial Air Pilot's Certificate for the following types of aircraft. The total of my experience has been as follows:
__________________________________________________________________________________________________________________
|Type|         Hours Flown         |Area or Route|Year|
|    |1st Pilot|2nd Pilot|Passenger|             |    |
|....|.........|.........|.........|.............|....|
|....|.........|.........|.........|.............|....|
|....|.........|.........|.........|.............|....|
|....|.........|.........|.........|.............|....|
|....|.........|.........|.........|.............|....|
|....|.........|.........|.........|.............|....|
|....|.........|.........|.........|.............|....|
|Totals|.......|.........|.........|.............|....|
_________________________________________________________
(If space insufficient, give information on separate sheet)
2. I am ready upon notice to undergo the practical tests prescribed and to pass the prescribed technical and medical examinations. Arrangements have been made for carrying out the prescribed tests at.....................
...................on a.........................aircraft.
3. I enclose two unmounted photographs of myself (not larger than 3" x 2").
4. I am a member of (Flying Club or School)..............

Signature of Applicant...................................
Date of Application......................................