d a safety authority application for issue/amendment of … · 2019-11-24 · defence aviation...

DEFENCE AVIATION SAFETY AUTHORITY

Application for issue/Amendment of DASR 66 Military Aircraft Maintenance Licence

DASR Form 19

Guidance These guidelines are designed to assist you to complete the DASR Form 19 under Defence Aviation Safety Regulation (DASR) 66.

Please carefully read this document and any relevant Acceptable Means of Compliance and Guidance Material issued by DASA. This information is available on the DASA website and will assist with the application process.

About this form and application process

Application Process Completing this application form is the first step in the application process. Once received, DASA will review your application including all supporting documentation provided.

Where an applicant is employed by an organisation that holds a DASR 145 approval certificate, the form is to be validated by the organisations quality manager and supporting records retained.

Where the applicant is not employed by an organisation that holds a DASR 145 approval certificate, the form is to be validated by DASA DAVCOMP 66 staff and all supporting records are to be attached with the application.

This DASR Form 19 is the official DASR form to apply for a Military Aircraft Maintenance License (MAML) under DASR 66.

Completion of Application All form fields are to be accurately completed or marked not applicable by the applicant. Where the form is incomplete DASA will not process the application and will return it via the applicant email address provided with no further action.

The application form must be completed electronically and submitted using the form workflow properties. Handwritten and scanned copies of the form will not be processed if received.

Evidence Standard Any records provided to support this application must be certified true and correct by a person that meets the qualification requirements outlined in Schedule 2 of the Commonwealth Statutory Declarations Regulation of 1993.

Where evidence is provided that has not been previously recognised or approved, it is the applicants responsibility to ensure a copy of the relevant procedure or process and objective evidence records are provided to DASA for assessment.

Processes, procedures and records generated will only be considered by DASR assessment staff when:

• They form part of an Aviation State Safety Program regulation recognised by DASR and records have been issuedby the regulatory organisation.

• They form part of the quality system of an organisation that holds a continuing airworthiness regulatory approvalunder a state safety program and records have been issued by an organisation that holds a current approvalcertificate (M,145), and is the current employer of the applicant.

• They form part of the quality system of an organisation that holds a Maintenance Training regulatory approval underan aviation state safety program, or Nationally Recognised Competency based training program and records havebeen issued by an organisation that holds a current approval certificate (Part 147, RTO). Any records issued muststate the approval they have been issued under that relates to their approval certificate.

Withdrawal of Application An application can be withdrawn in writing at any time.

DASR Form 19 – V11.0 Template ID: U6906120 – Guidance - Page 1 of 1


Application for Issue/Amendment of DASR 66 Military Aircraft Maintenance Licence

DASR Form 19

DASR Form 19 – V11.0 Template ID: U6906120 – Application Page 1 of 5

SECTION 1 - Applicant’s Personal Information

Applicant Contractor Identification No Y N ID Number

Applicant PMKeyS No (Cur or Ex Serv) Y N PMKeyS

Title Surname

Firstname Middle Name

Nationality Country of Birth

DOB Town of Birth

Section 2 - Applicant Contact Details

Home Address

Town or Suburb

State Post code Country

Email:

Work Phone Mobile Phone

Section 3 - Other Aviation Maintenance Licenses Held

CASA Ref Date of Issue

EASA Ref Date of Issue

Other Date of Issue

Section 4 - Applicant Work Details

Organisation & Entity

Work Venue Address

State Post code Country

Work Venue QM Email

I am a current Employee of a DASR 145 Y N

N Y

Please attach a copy of any other maintenance license with application for recognition purposes. Please do not attach CASA ARN where a maintenance license has not been issued, such as, Radio operator certificates &Maintenance Authorities


Application for Issue/Amendment of DASR 66 Military Aircraft Maintenance License

DASR Form 19

DASR Form 19 – V11.0 Template ID: U6906120

Section 5 – Application TypeFirst Category Additional Category Aircraft Type rating

Category Exclusion removal Aircraft Type Exclusion removal

Section 6 – Basic Category/s Applying for

Aeroplane Turbine A1 B1.1

Helicopter Turbine A3 B1.3

Avionics B2

Base Maintenance C

Section 7 – Aircraft Type Rating Applying for

Aircraft type Full or Partial S1000D system coverage Date Complete Certificate No

F P Detail

F P Detail

F P Detail

F P Detail

F P Detail

F P Detail

Please provide any retired or civilian aircraft Types endorsements and dates below

Section 8 – Trade and Aviation Qualifications

Qualification Attained Course Detail Date Complete Certificate No

Aviation Technical Training

Aeroskills Cert IV/Diploma

ADF Trade Supervisor Course

ADF Tech Manager Course

Aviation Higher Education

Application – Page 2 of 5



DASR Form 19


Section 9 – Aeroskills Competency Units AchievedCore/Common Units

MEA101 MEA103 MEA105 MEA107 MEA108


MEA118 MEA142 MEA148

Avionic Units









MEA279 MEA280

Mechanical Units






MEA343 MEA362 MEA365 MEA366

Other Units



MEA432 MEA433 MEA434 MEA435


List all other PMKeyS proficiencies/Course codes and relevant Units of Competency here

DASR MOD 10 Date

MEA units achieved through approved transitional provisions are to be listed as additional information within section 10 - Transitional Provisions for Exclusion removal


http://www.defence.gov.au/DASP/Docs/DASR-Documents/Part66/Transitionalprovisionsforexclusionremoval.pdf



DASR Form 19


Section 10 – Recognition Based on Aviation Technical Training Completed I request the following Basic DASA Modules be credited

Note: List the License Category the Module/s applies to, and if the training completed supports a Full or Partial credit against 66 Syllabus. Only request training for assessment where the content is not covered in an Aeroskills Competency unit issued by a approved training organisation.

A1 A3 B1.1 B1.3 B2

Module 1 F P Module 2 F P Module 3 F P Module 4 F P Module 5 F P




Based on Aviation Maintenance Experience I request the following Basic Experience be assessed

Note: Provide Authorisation summary and attach ERTE/RTE/AATTR/PEX reports, Include Journal of industrial experience, or Schedule of experience where applicable. Where recognition for basic modules are sought, outline the program title, training organisation name, and duration of training here.

Trade Training / Certification privileges / Additional Information Years / Months

Section 11 – Declaration I hereby declare that I am the applicant: • I have never held an aircraft maintenance license issued under a CASA/EASA/EMAR approval which has been

revoked or suspended.• I understand that a person who intentionally provides false or misleading information may be disqualified from

holding a DASR 66 MAML, and I believe that the information in this application is true in every particular.

Date Name/Position Sign I hereby declare that I am a the organisation QM, or am employed in a quality role that reports directly to the QM : • All records provided by the applicant meet the requirements of DASR 66 and have been sighted by me and have

been certified true and correct. Copies of records supporting this application are kept on the applicant’s personal file for verification by DASR staff.

Date Name 145 Quality Owner Sign


http://www.defence.gov.au/DASP/Docs/Manuals/8000-011/DASRWeb/index.htm#10508.htm#o16059



DASR Form 19


Section 12 – DASA Assessment

Record Objective Folder ID:

Application filed Records attachments filed

Record Defence Aviation Reference Number (DARN-P):

Record Exam credits granted:

Module 1 Module 2 Module 3 Module 4 Module 5




Detail: Partial exam credits against applicable basic category/s & MEA UOC underpinning knowledge achieved

Record basic Category/s Granted:

A1 A3 B1.1 B1.3 B2 C

Record Exclusions and Inclusions granted and record in Fast-track:

Detail: Exclusion codes against each basic category from exclusion list

Record Type Ratings and Type exclusions and record in Fast-track:

Detail: Type rating and Exclusion codes against each basic category from exclusion list

Record Category Experience Credits and record in Fast-track:

A1 Y M A3 Y M B1.1 Y M B1.3 Y M B2 Y M C Y M

Date PMKeyS Assessor Name Assessor Signature

Date PMKeyS Review Assessor Name Review Assessor Signature Note: Where application request does not reflect assessment outcome undertaken by a DASR license assessor, a second Assessor must review the decision before license is granted

Note: Exam credits may only be granted against the category/s of license the applicant undertook training for. i.e: If a person achieves all relevant modules to the training level prescribed for an A license syllabus they wont be able to claim B credits


1 Applicant Middle Name: 1 Applicant Surname: 1 Applicant Firstname: 1 Applicant Nationality: 1 Applicant Date of Birth: 1 Applicant Country of Birth: 1 Applicant Town of Birth: 2 Applicant Home Address: 2 Applicant Town or Suburb: 2 Applicant Country: 2 Applicant Post code: 2 Applicant Email: 2 Applicant Home Phone number: 2 Applicant Mobile Phone number: 3 CASA License date of Issue: 3 EASA License Date of Issue: 3 CASA License Reference Number: 3 EASA License Reference Number: 3 Other NAA/MNAA License Date of Issue: 3 Other NAA/MNAA License Reference Number: 1 Applicant Title: [Select]4 Organisation Type: [Select Entity]4 Organisation Name: 4 Work Venue Address: 4 Work Venue Country: 4 Work Venue State: [Select]4 Work Venue QM Email: 4 Work Venue Post Code: 4 Current 145 Employee: Off6 Aeroplane: Off6 Helicopter: Off6 Avionics: Off6 Base Maintenance: Off7 1st Type date of completion: 7 5th Type date of completion: 7 4th Type date of completion: 7 3rd Type date of completion: 7 2nd Type date of completion: 7 6th Type date of completion: 7 3rd Type rating: Partial7 4th Type rating: Partial7 5th Type rating: Partial7 6th Type rating: Partial7 1st Type Certificate Number: 7 2nd Type Certificate Number: 7 3rd Type Certificate Number: 7 4thType Certificate Number: 7 5th Type Certificate Number: 7 6thType Certificate Number: 7 1st Type Course Code Proficiency: 7 2nd Type Course Code Proficiency: 7 4th Type Course Code Proficiency: 7 5th Type Course Code Proficiency: 7 6th Type Course Code Proficiency: 7 1st Type rating: Partial7 Retired Type Date 1: 7 Retired Type Date 2: 7 Retired Type Date 4: 7 Retired Type Date 3: 7 Retired Type Detail 1: 7 Retired Type Detail 3: 7 Retired Type Detail 2: 7 Retired Type Detail 4: 5 Aircraft Type: Off5 Category: Off8 Aviation Technical Training Certificate number: 9 MEA142: Off9 MEA111: Off9 MEA103: Off9 MEA101: Off9 MEA109: Off9 MEA118: Off8 Aeroskills Cert IV/Diploma: [Select Qualification]8 Aviation technical training Date completed: 8 Aeroskills CERT IV/DIPLOMA Qualification Date completed: 8 Aeroskills CERT IV/DIPLOMA Qualification Certificate Number: 8 Aviation Technical Training: [Select Technical Training]8 Trade Supervisor Course Date completed: 8 Trade Supervisor Course Certificate Number: 8 Aviation Trade Supervisor Course: [Select Trade Supervisor Course]8 Tech Manager Course Date completed: 8 Tech Manager Course Certificate Number: 8 Aviation Tech Manager Course: [Select Tech Manager Course]8 Aviation Higher Education Date completed: 8 Aviation Higher Education Course Certificate Number: 9 MEA105: Off9 MEA107: Off9 MEA108: Off9 MEA112: Off9 MEA113: Off9 MEA148: Off9 MEA116: Off1 PMKEYS Selection: Off1 PMKEYS Number: 9 MEA201: Off9 MEA207: Off10 Aeroplane Training: Off10 Avionics: Off10 Module 1: Off10 Module 6: Off10 Module 11: Off10 Module 51: Off10 Module 2: Off10 Module 7: Off10 Module 13: Off10 Module 52: Off10 Module 3: Off10 Module 8: Off10 Module 14: Off10 Module 53: Off10 Module 4: Off10 Module 9: Off10 Module 15: Off10 Module 5: Off10 Module 10: Off10 Module 17: Off10 Module 55: Off10 Module 54: Off10 Helicopter Training: Off11 Applicant declaration date: 11 Applicant Name and Position: 11 Quality Manager declaration date: 11 Quality Manager Name: 9 MEA204: Off9 MEA209: Off9 MEA214: Off9 MEA208: Off9 MEA213: Off9 MEA218: Off9 MEA205: Off9 MEA210: Off9 MEA215: Off9 MEA220: Off9 MEA206: Off9 MEA211: Off9 MEA216: Off9 MEA221: Off9 MEA226: Off9 MEA225: Off9 MEA219: Off9 MEA223: Off9 MEA212: Off9 MEA217: Off9 MEA222: Off9 MEA227: Off9 MEA246: Off9 MEA232: Off9 MEA279: Off9 MEA228: Off9 MEA233: Off9 MEA260: Off9 MEA280: Off9 MEA229: Off9 MEA334: Off9 MEA261: Off9 MEA230: Off9 MEA235: Off9 MEA266: Off9 MEA231: Off9 MEA241: Off9 MEA278: Off9 MEA224: Off9 MEA203: Off9 MEA301: Off9 MEA302: Off9 MEA306: Off9 MEA312: Off9 MEA307: Off9 MEA314: Off9 MEA318: Off9 MEA319: Off9 MEA303: Off9 MEA308: Off9 MEA315: Off9 MEA320: Off9 MEA304: Off9 MEA305: Off9 MEA309: Off9 MEA316: Off9 MEA321: Off9 MEA310: Off9 MEA317: Off9 MEA322: Off9 MEA323: Off9 MEA343: Off9 MEA362: Off9 MEA325: Off9 MEA365: Off9 MEA328: Off9 MEA366: Off9 MEA339: Off9 MEA327: Off9 MEA401: Off9 MEA422: Off9 MEA432: Off9 MEA601: Off9 MEA405: Off9 MEA423: Off9 MEA433: Off9 MEA602: Off9 MEA410: Off9 MEA425: Off9 MEA434: Off9 MEA603: Off9 MEA420: Off9 MEA430: Off9 MEA435: Off9 MEA604: Off9 MEA421: Off9 MEA431: Off9 MEA605: Off9 Additional Code 1: 9 Additional Code 4: 9 Additional Code 2: 9 Additional Code 3: 9 Additional Code 5: 9 Additional Code 6: 9 Additional Code 7: 9 Additional Code 8: 9 Additional Code 9: 9 Additional Code 10: 9 Additional Code 15: 9 Additional Code 20: 9 Additional Code 19: 9 Additional Code 14: 9 Additional Code 13: 9 Additional Code 12: 9 Additional Code 18: 9 Additional Code 17: 9 Additional Code 16: 9 Additional Code 11: 12 Partial exam credits granted: 12 Record Objective Folder ID: 12 Record Objective application file ID: 12 Defence Aviation Reference Number DARNP: 12 Record Objective support doc file ID: 12 B1: 1 License Granted: Off3 License Granted: Off1 Years granted: 1 Months granted: 3 Years granted: 3 Months granted:

12 Module 1: [Select]12 Module 55: [Select]12 Module 17: [Select]12 Module 10: [Select]12 Module 5: [Select]12 Module 4: [Select]12 Module 9: [Select]12 Module 54: [Select]12 Module 53: [Select]12 Module 14: [Select]12 Module 8: [Select]12 Module 3: [Select]12 Module 2: [Select]12 Module 7: [Select]12 Module 13: [Select]12 Module 6: [Select]12 Module 11: [Select]12 Module 51: [Select]12 Module 52: [Select]12 Module 15: [Select]Clear Form: 10 Off Job Training Post trade training: 10OFFJT Claimed years and months: 12 A1 License Granted: Off12 B2 License Granted: Off12 A3 License Granted: Off12 C License Granted: Off12 Detail Exclusion codes from exlusion list here: 12 Detail Type rating and Exclusion codes against each basic category from exclusion list: 12 Assessor Name: 12 Assessor PMKeyS Number: 12 Date of Assessment: 12 Date of Assessment review: 12 Review Assessor PMKeyS Number: 12 Review Assessor Name: 11 Submit to DASA: 7 1st Aircraft Type: [Select Aircraft Type]7 2nd Aircraft Type: [Select Aircraft Type]7 3rd Aircraft Type: [Select Aircraft Type]7 4th Aircraft Type: [Select Aircraft Type]7 5th Aircraft Type: [Select Aircraft Type]7 6th Aircraft Type: [Select Aircraft Type]8 Aviation Higher Eductaion: [Select Higher Education Qualification]11 Email to applicant: 12 A1 Years granted: 12 A1 Months granted: 12 A3 Years granted: 12 A3 Months granted: 12 B2 Years granted: 12 B2 Months granted: 12 C Years granted: 12 C Months granted: 2 Applicant State: [Select]7 3rd Type Course Code Proficiency: 7 2nd Type rating: Partial1 Page Reset: 6 Section Reset: 7 Section Reset: 8 Section Reset: 10 Section Reset: 9 Attach Files: 1 Contractor ID Number: 1 Contractor ID Selection: Off3 Other Maintenance License: No9 Module 10: 11 Submit: