AIRCRAFT MAINTENACE ENGINEER WORK RECORD / LOG BOOK

1. PERSONAL DETAILS
Affix recent
CEO Computer passport size
No. photo graph
duly attested on
the front side
Name in full

Date of birth
Nationality
Educational GENDER M/F AME Licence No.
Qualification

Permanent Address……………………………………………................………………………………………………………………………
……………………………………………………………………………………………………..……… PIN Code....................................

Changed Permanent Address

Address for Communication (if different from above)………………………...........................................................

………………………………………………………………………………………………………………..….PIN Code...................................

Changed Address for Communication:

Applicant Contact Phone Number ………………………….............. E-mail…….………………………………..……………….

Name of the Current Employer……………………………………………………………………………………………………………….

Contact Phone Number of Employer ………………….................... E-mail…….…………………………………………………

Log Book Owners Name…………………………………………………………….... Signature ………………………………………..

 2. Record of Training

Training
Training Completed Establishment From To Result
and Location

Log Book Owners Name…………………………………………………………….... Signature ………………………………………..

 3. Details of Employer / Organization at which engaged in Aircraft Maintenance

(i) Employer / Organization:

FROM To Position Nature of Work

Types of Aircraft or other products

Confirmation of the Organization

NAME SIGNATURE POSITION & STAMP DATE

(ii) Employer / Organization:

FROM To Position Nature of Work

Types of Aircraft or other products

Confirmation of the Organization

NAME SIGNATURE POSITION & STAMP DATE

(iii) Employer / Organization:

FROM To Position Nature of Work

Types of Aircraft or other products

Confirmation of the Organization

NAME SIGNATURE POSITION & STAMP DATE

Note: - It is an offence to make, with intent to deceive, any false representations for the purpose of
procuring the grant, issue, renewal or variation of any certificate, licence, approval, permission or
other document. Persons doing so render themselves liable to administrative/legal actions as per
Aircraft Rules 1937. Further the licence is liable for revocation / cancellation / suspension or
permanently makes the person ineligible to have an Aircraft Maintenance Engineer’s Licence.

Log Book Owners Name…………………………………………………………….... Signature ………………………………………..

 AIRCRAFT MAINTENANCE ENGINEER’S LOGBOOK DGCA INDIA
CA Form 19-10
4. Maintenance Experience
Aircraft Type: ____________________ Organization ____________________
Engine combination: __________________
ATA Chapter: ________________________ CAR 66 Addendum II Ref: _________________________

Date Maintenance Task Detail *Supervisor’s Name,

A/c Reg. Work order, Task no, Signature and AME Lic
Job no, No./Auth No.

*The work has been carried out correctly by the logbook owner under my supervision and in accordance with the appropriate technical
documentation.

LOG BOOK OWNER’S NAME…………………………………………………………….... SIGNATURE ………………………………………..

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