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Flight Test Report: Agricultural Flight Examiner Competency Demonstration (A) or (H) 1. Personal Details

CAA Client Number Last Name

Given Name(s) Chemical Rating expiry:

Licence type (A) (H) (Appropriate) Category E Flight Instructor Rating current Yes

Purpose of Test Issue Biennial Add privilege Yes N/A

2. Experience Assessment (Optional for Examiner Rating biennial)

Total flight time (2500 ag ops in appropriate category) PIC (2000 in appropriate category)

Flight instruction on a Part 137 aircraft (300 in category) Ag competency checks completed (10 minimum)

In addition, for multi-engine privileges; (as applicable)

P in C multi-engine aeroplane (300) P in C multi-engine helicopter (10)

In addition, for the Examiner privilege of Category E Flight Instructor biennial competency demonstration; Flight instruction in the appropriate category of aircraft (500)

3. Particulars of Demonstration

Operation type(s) Issue Grade 2 Issue Grade 1 E Cat Biennial

Topdressing Spraying VTA Operational competency

Aircraft Type Registration JU-

Duration - Air Duration - Ground

4. Assessment of DemonstrationEligibility assessment In flight assessment

Logbook assessment Debriefing

Flight test briefing Knowledge of fail aspects

Questioning Knowledge of remedial training required

Knowledge of relevant Rules and documents Knowledge of applicable logbook entries

5. Result

PASS FAIL Next Examiner Biennial demonstration of competency due:

Examiner comments

CAA Flight Examiner Client No

Signature Date of Test

Examiner training completed

6. Privileges

Current examiner privileges to be retained?

Additional privileges to be issued

Initial issue or renewal Grade 2 Agricultural Rating (Aeroplane)

Initial issue or renewal Grade 1 Agricultural Rating (Aeroplane)

Continued Competency Category E Flight Instructor Rating (Aeroplane)

Initial issue or renewal Grade 2 Agricultural Rating (Helicopter)

Initial issue or renewal Grade 1 Agricultural Rating (Helicopter)

Continued Competency Category E Flight Instructor Rating (Helicopter)

Additional Examiner comments (if applicable)

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