Application for Operation of a Small Unmanned Aircraft (SUA) in UK Airspace Air Navigation Order Articles 166 and 167 Please complete this form online (preferred method) then print, sign and submit as instructed. Alternatively, print, then complete in BLOCK CAPITALS using black or dark blue ink Please read the attached Guidance Notes before completing this form. CAA use only FALSE REPRESENTATION STATEMENT It is an offence under Article 231 of the Air Navigation Order 2009 to make, with intent to deceive, any false representation for the purpose of procuring the grant, issue, renewal or variation of any certificate, licence, approval, permission or other document. This offence is punishable on summary conviction by a fine up to £5000, and on conviction on indictment with an unlimited fine or up to two years imprisonment or both. 1. TYPE OF APPLICATION: (tick applicable box) Initial Issue of: Permission for Aerial Work for (SUA) SUSA Permission Renewal of: Permission for Aerial Work for (SUA) SUSA Permission Variation to: Permission for Aerial Work for (SUA) SUSA Permission Previous Permission (if applicable) Reference: ........................................................................................ Expiry date:................................ This application will be considered in respect of and, if appropriate, granted or issued to, the applicant(s) named below. 2. APPLICANT DETAILS (The Applicant is the person responsible for payment of CAA charges) a) Individual (including sole traders and partnerships) Title: ...................... Forename: .......................................................... Surname: ............................................................................... Address: ........................................................................................................................................................................................................ Country .................................................................................................... Postcode: .............................................................................. Telephone: .............................................................................................. Fax: ....................................................................................... E-mail: ..................................................................................................... Mobile Telephone: ................................................................ Trading Name: (if applicable) ......................................................................................................................................................................... Website address: .......................................................................................................................................................................................... In the case of a partnership, please complete details of all partners. Continued on a separate sheet This application will be considered in respect of and, if appropriate, granted to, the Company Name as registered under the Company Number provided on this form. b) A Company Registered Company Name (in full): ............................................................................................................................................................. Registered Company Number: ..................................................................................................................................................................... Country of Company Registration: ................................................................................................................................................................ Registered Office Address: ........................................................................................................................................................................... ................................................................................................................. Postcode: ....................................................... Telephone: .............................................................................................. Fax: ................................................................ E-mail: ........................................................................................................................................................................................................... Trading Name: (if applicable) ......................................................................................................................................................................... Trading Address (primary site): ..................................................................................................................................................................... Country .................................................................................................... Postcode: ............................................................................. Website address: .......................................................................................................................................................................................... Form SRG1320 Issue 04.1, Sept 2014 Page 1 of 5 Authorised Representative of Company This application is to be signed by either a Director or Company Secretary or a person authorised by the Board to act on behalf of the Company. Title: ........................................................ Forename: ........................................... Surname: ........................................................... Position in Company: .................................................................................................................................................................................... Telephone No: ........................................................................ E-mail: .................................................................................................... If you are not a Director or Company Secretary and have been authorised to sign the application form on behalf of the Company, proof of that authority must be provided with the completed application form. 3. ADDRESS FOR CORRESPONDENCE (if different from above) Postal Address (if different from above): ....................................................................................................................................................... .................................................................................................................................. Postcode: ............................................................ 4. SUA/SUSA REMOTE PILOT(S) Remote Pilot’s Name: ................................................................................................................................................................................... Remote Pilot’s Flying Experience*: ............................................................................................................................................................* ....................................................................................................................................................................................................................... Remote Pilot’s Qualification Held; BNUCTM BNUC-STM RPQ-s Other: .................................................... Additional Remote Pilot’s Name (if applicable): ............................................................................................................................................ (* continue in Section 8 if necessary) 5. SUA/SUSA SUA/ SUSA First SUA/ SUSA Second SUA/ SUSA SUA / SUSA Name: ................................................................. ............................................................. Manufacturer: ................................................................. ............................................................. Type: ................................................................. ............................................................. Registration / Serial Number: ................................................................. ............................................................. Wing/ Rotorspan (m) ................................................................. ................................................................. Overall Diameter (multi-rotors only) (m) .......................................................... .......................................................... Length (m) ................................................................. ............................................................. Command and Control Frequency ................................................................. ............................................................. Number of Engines ................................................................. ............................................................. Engine Type ................................................................. ............................................................. Piston ........................................................... (CC) .............................................................. Turbine ...................................................... (Thrust) ............................................................... Electric .........................................................(Size) ............................................................... ................................................................. ............................................................... Additional SUA/SUSA - Continue on a separate sheet 6. OPERATIONS MANUAL Version .......................................................................................... Form SRG1320 Issue 04.1, Sept 2014 Dated............................................................................................... Page 2 of 5 7. FLYING ACTIVITY DETAILS Location of Flying Activity: UK Or Specific Location: ....................................................................................... OS Grid Reference (XY 123 456): Range: Type of Flying: VLoS within 400ft (vertically) and 500m (horizontally) from Remote Pilot EVLoS within .......................... feet and ......................... metres from Remote Pilot BVLoS within .......................... feet and ........................ metres from Remote Pilot Survey (Forestry, Agriculture, Construction, Infrastructure) Photography Filming and Media Research and Development Security / Emergency Services Other ......................................................................................................................................... (* continue in below if necessary) 8. ADDITIONAL INFORMATION (continue separately if necessary, following the submission instructions given in Section 12) 9. DECLARATION I, the applicant, agree that the SUA/SUSA will be operated in accordance with the Air Navigation Order 2009 and as amended. I hereby declare that to the best of my knowledge the particulars entered on this application are accurate Signature: ................................................................................................. Date: ........................................................................... I have enclosed the following supporting documentation: Photograph of SUA / SUSA (Note 7) Operations Manual Copy of Remote Pilot Qualification Copy of Insurance Details (where applicable) Form SRG1320 Issue 04.1, Sept 2014 Page 3 of 5 10. CHARGES The charge(s) required as calculated in accordance with the CAA General Aviation Scheme of Charges (published in CAA Official Record Series 5) (www.caa.co.uk/ors5) to be paid on application are enclosed herewith. NB: This application will not be processed until the applicable charges have been received. Total charges included are: £ ..................................................... Where charges are to be paid other than by the applicant, please enter the name of the person/company who is paying: ....................................................................................................................................................................................................................... IMPORTANT NOTES: Additional Charges: Where the cost of the CAA investigations exceeds the application charge payable, the applicant shall pay additional charges to recover those excess costs incurred by the CAA in accordance with the Scheme of Charges. Overseas Visits: If a Member or employee of the CAA is required to travel overseas in respect of this application you are advised to read the CAA Scheme of Charges to which this application relates and the section entitled 'Additional charge where functions are performed abroad'. All expenses incurred in pursuance of this application by virtue of travelling overseas will be payable by the applicant on demand. Withdrawal/Cancellation of Application: In the event that this application is withdrawn or cancelled by the applicant, the application fee less the cost of any work carried out by the CAA to that date, may be refunded. Please see the CAA Refunds Policy at www.caa.co.uk/refunds for more information. 11. SUBMISSION INSTRUCTIONS Return the completed form, associated documents and payment, to arrive at least 28 days before any operations are due to commence, ‘to: E-mail: [email protected] Post: Flight Operations Operational Planning Shared Service Centre Civil Aviation Authority, Aviation House Gatwick Airport South West Sussex RH6 0YR 12. NOTES 1) Initial applications for UAs between 20 kg and 150 kg must include an Airworthiness Assurance, or details of how airworthiness assurance will be obtained. (Form AD 281 or A8-22 Certificate at Design and Construction) 2) Images must meet the following criteria: • The photographs must be in JPEG format or on paper. • The image file must be a maximum of 1 MB. • The image must be a maximum of 1,200 pixels in width. • The UA must not have been altered since the photograph was taken. • The photograph must have been taken within the previous 12 months and not modified. 3) Insurance needs to comply with Regulation (EC) No. 785/2004. 4) Airworthiness assurance (special survey) form AD 281 requires an additional fee to be paid. 5) Flight beyond VLoS (above 400 ft and/or beyond 500 m of the operator) may require a separate application for segregated airspace (RA(T) or Danger Area). The application form is obtained from the Airspace, Safety & Airspace Regulation Group at: Airspace Safety & Airspace Regulation Group CAA House 45-59 Kingsway London WC2B 6TE E-mail: [email protected] More information can be found online at www.caa.co.uk/uas Form SRG1320 Issue 04.1, Sept 2014 Page 4 of 5 PAYMENT AUTHORISATION Please complete this form online or in BLOCK CAPITALS using black or dark blue ink, before printing, signing and submitting as instructed on the associated Application Form. PLEASE NOTE: One Payment Authorisation Form is required for each application. 1. PAYMENT DETAILS a) Payment type (please tick your chosen method of payment). Visa Mastercard Debit Card Cheque/Banker’s Draft Bank Transfer Cash (max.£1000) The maximum single transaction using a Visa/Mastercard or Debit Card is limited to £25,000. We do not accept American Express, Diners Club or JCB cards. Cash payments will only be accepted in person at Aviation House, Gatwick. Please do not send cash by post. Cheques shall be made payable to 'Civil Aviation Authority'. Please write the CAA Application Form No. on the reverse of your cheque. National Westminster Bank plc Bloomsbury Parr’s Branch PO Box 158 214 High Holborn London WC1V 7BX Account Name: Civil Aviation Authority Account Number: 36029769 Sort Code: 60-30-06 Swift Code: NWBK GB 2L IBAN: GB90 NWBK 6030 0636 0297 69 Please supply the following information: Amount: £ ..................................................... BACS/CHAPS Reference*: ............................................................................ * When making a bank transfer please instruct your bankers to quote, i) in relation to an offline personnel licensing application, the CAA Application Form number followed by your PIMS reference number (Example: 1234 PIMS 12345678); or, ii) all other offline non-personnel licensing applications, the CAA Form Number and date of payment transfer (Example: SRG1234 ddmmyyyy; or, iii) in relation to an online application, the Automatic Submission Number (ASN) (e.g. CAI-123) must be quoted. Payer: .................................................................. Payers Email Address: ...................................................................................... Date of Transfer: ....................................................................... b) Card Details (for payment by Credit/Debit Card) Card number: Expiry date: / Security Code (last 3 digits on signature strip on reverse of card) Debit cards only: Start date: Issue No: / Amount: £ ........................................................................... (if applicable) Name (as written on card): ..................................................................................................................................................................... (BLOCK CAPS) Full postal address of card holder: ......................................................................................................................................................... ..................................................................................................................................................... Postcode: ....................................... Card holder’s signature: .............................................................................................................. Please tick box if paying with Company Card Company Name: ....................................................................................... Do not send your credit/debit card details by email. Email is inherently insecure and hence it is not possible to guarantee the security of card details sent this way. Form SRG1320 Issue 04.1, Sept 2014 Page 5 of 6 Application For Operation Of Small Unmanned Aircraft (SUA) – Guidance Notes NOTE 1: General Before completing this form applicants are advised to read the further information relating to this application process, available on the CAA website. NOTE 2: Applicability (Applications for Unmanned Aircraft (UA) over 20kg must be made on Form SRG 1321 (www.caa.co.uk/SRG1321) This form must be used to apply for: 1 A Permission for Aerial Work to fly a Small Unmanned Aircraft (SUA) in accordance with ANO 2009 Article 166 2 A Permission for Aerial Work to fly a Small Unmanned Surveillance Aircraft (SUSA) with ANO 2009 Article 167 NOTE 3: Completeness This application should be completed in full. Failure to do so may result in its return for re-submission or a delay in the processing of the application. If there is insufficient space to list all items, they can be listed on a separate sheet. NOTE 4: Timescale Application should be made at least 30 working days before the Permission is required. NOTE 5: Definitions 'Small Unmanned Aircraft' ('SUA') means any unmanned aircraft, other than a balloon or a kite, having a mass of not more than 20 kg without its fuel but including any articles or equipment installed in or attached to the aircraft at the commencement of its flight. 'Small Unmanned Surveillance Aircraft' ('SUSA') means a small unmanned aircraft which is equipped to undertake any form of surveillance or data acquisition. 'Unmanned Aircraft' ('UA') means an aircraft which is intended to operate with no human pilot on board, as part of an Unmanned Aircraft System. Moreover a UA: • is capable of sustained flight by aerodynamic means; • is remotely piloted or capable of autonomous operation; • is reusable; and • is not classified as a guided weapon or similar one-shot device designed for the delivery of munitions. NOTE 6: Airworthiness Assurance Initial applications for UA between 20 kg and 150 kg must include an Airworthiness Assurance, or details of how airworthiness assurance will be obtained. There are two methods of obtaining Airworthiness Assurance - either through the CAA using form AD281 or through a Qualified Entity (A8-22). The Airworthiness Assurance (special survey) form AD281 requires an additional fee to be paid. NOTE 7: Images Images must meet the following criteria: • The photographs must be in JPEG format or on paper. • The image file must be a maximum of 1 MB. • The image must be a maximum of 1,200 pixels in width. • The UA must not have been altered since the photograph was taken. • The photograph must have been taken within the previous 12 months and not modified. NOTE 8: Insurance Insurance needs to comply with Regulation (EC) No. 785/2004. NOTE 9: Segregated Airspace Flight beyond VLoS (above 400 ft and/or beyond 500 m of the operator) may require a separate application for segregated airspace (RA(T) or Danger Area). The application form is obtained from the Directorate of Airspace Policy (DAP) at: E-mail: [email protected] Airspace Safety & Airspace Regulation Group CAA House 45-59 Kingsway London WC2B 6TE Form SRG1320 Guidance Notes Issue 04, June 2014 Page i of i
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