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KEMENTERIAN PERHUBUNGANDIREKTORAT JENDERAL PERHUBUNGAN UDARA

Menimbang

Mengingat

Rshep-10-29A/IUSBUS/Sept07

PERATURAN DIREKTUR JENDERAL PERHUBUNGAN UDARANOMOR : SKEP/350/ VI/2011

TENTANG

PERUBAHANI

PETUNJUK PELAKSANAAN (STAFF INSTRUCTION) (SI)NOMOR 47-01 TENTANG PROSEDUR PENDAFTARAN PESAWAT UDARA

(AIRCRAFT REGISTRATION PROCEDURES)

DENGAN RAHMAT TUHAN YANG MAHA ESA

DIREKTUR JENDERAL PERHUBUNGAN UDARA,

bahwa dalam Keputusan Menteri Perhubungan Nomor KM 49 Tahun 2009telah diatur mengenai Peraturan Keselamatan Penerbangan Sipil (CivilAviation Safety Regulations) Part 47 tentang Pendaftaran Pesawat Udara{Aircraft Registration);

bahwa untuk melaksanakan hal sebagaimana dimaksud pada huruf a, perluditetapkan Perubahan I Petunjuk Pelaksanaan (Staff Instruction) (SI) nomor47-01 tentang prosedur pendaftaran pesawat udara (Aircraft RegistrationProcedures), dengan peraturan Direktur Jenderal Perhubungan Udara;

Undang-Undang Nomor 1 Tahun 2009 tentang Penerbangan (LembaranNegara Republik Indonesia Tahun 2009 Nomor 1, Tambahan LembaranNegara Republik Indonesia Nomor 4955);

Peraturan Pemerintah Nomor 3 Ta'un 2001 tentang Keamanan danKeselamatan Penerbangan (Lembaran Negara Tahun 2001 Nomor 9,Tambahan Lembaran Negara Nomor 4075);

Peraturan Presiden Nomor 47 Tahun 2009 tentang Pembentukan danorganisasi Kementerian Negara;

Peraturan Presiden Nomor 24 Tahun 2010 tentang Kedudukan , Tugas danFungsi Kementerian Negara sella Susunan Organisasi, Tugas dan FungsiEselon I Kementerian Negara ;

Keputusan Menteri Perhubungan Udara Nomor T.11/2/4-U tentangPeraturan - Peraturan Keselamatan Penerbangan Spil sebagaimana telahdiubah terakhir dengan Peraturan Menteri Perhubungan Nomor KM 57Tahun 2010;

Peraturan Menteri Perhubungan Nomor KM 60 Tahun 2010 tentang StukturOrganisasi dan Tata Kerja Kementerian Perhubungan;

MEMUTUSKAN

Menetapkan : PERUBAHAN I PETUNJUK PELAKSANAAN (STAFF INSTRUCTION) (SI)NOMOR 47-01 TENTANG PROSEDUR PENDAFTARAN PESAWAT UDARA(AIRCRAFTREGISTRATION PROCEDURES).

Pasal 1

(1) Memberlakukan Perubahan I Petunjuk Pelaksanaan (Staff Instruction) (SI)nomor 47-01 tentang prosedur pendaftaran pesawat udara (AircraftRegistration Procedures).

(2) Perubahan I Petunjuk Pelaksanaan (Staff Instruction) (SI) nomor 47-01tentang prosedur pendaftaran pesawat udara (Aircraft RegistrationProcedures), tercantum dalam Lampiran Peraturan ini.

Pasal2

Direktur Kelaikan Udara dan Pengoperasian Pesawat Udara mengawasipelaksanaan Peraturan ini.

Pasal 3

Peraturan ini mulai berlaku pada tanggal ditetapkan.

Ditetapkan di : JakartaPada tanggal : 20 JUNI 2011

DIREKTUR JENDERAL PERHUBUNGAN UDARA

ttd

HERRYBAKTI

SALINAN Peraturan ini disampaikan kepada :

1. Sekretaris Jenderal Departemen Perhubungan;2. Inspektur Jenderal Departemen Perhubungan;3. Sekretaris Direktorat Jenderal Perhubungan Udara;4. Para Direktur di lingkungan Ditjen Hubud.

Salinan Sesuai dengan aslinya

K£RATA'BAGIAN HUKUM DAN HUMASSEf DtTJEN HUBUD

\ it i

/>-—I^AFULHAYAT, SH.- •

Rskep-10-29A/IUSBUS/Sept07

May 2011 SI 47-01 Amdt. 1

FOREWORD

1. PURPOSE : This Staff Instruction prescribes responsibilities, policies, andprocedures to be used by the Directorate of Airworthiness and AircraftOperations (DAAO) for the evaluation and issuance of Certificate ofRegistration. This Staff Instruction may be made available to the public sothat they may better understand the authority and responsibilities of DGCA.

2. REFERENCE : This Staff Instruction should be used in accordance with theapplicable regulations.

3. CANCELLATION : Staff Instruction Number 47-01 Amendment Original iscancelled

4. AMENDMENT: Amendment ofthis Staff Instruction shall be approved by theDirector General of Civil Aviation.

DIRECTOR GENERAL OF CIVIL AVIATION

ttd

HERRY BAKTI

Salinan Sesuai dengan aslinya

KEPALA BAGIAN HUKUM DAN HUMASSESpIJJENHUBUD

W ^^^Th^^tX \\

Table of Content

May 2011SI 47-01 Amdt. 1

SUMMARY OF AMENDMENTS

AmendmentNo. Source/s Subject/s Approved

May 2011 SI 47-01 Amdt. 1

TABLE OF CONTENT

SUMMARY OF AMENDMENTSFOREWORD

TABLE OF CONTENT

CHAPTER I - GENERAL M1. PURPOSE M

2. REGULATORY AND REFERENCES M3. KNOWLEDGE OF REQUIREMENTS u4. DEFINITIONS M

CHAPTER II - INITIAL CERTIFICATE OF REGISTRTION |M1. RESPONSIBILITIES IM2. APPLICATION IM

3. REVIEW APPLICATION H_2

4. ISSUANCE CERTIFICATE OF REGISTRATION, DAAO FORM47"02 II-5

5. ISSUANCE TEMPORARY CERTIFICATE OF REGISTRATIONDAAO FORM 47-14 H_5

6. COMPLETION AIRCRAFT DETAIL CARD, DAAO FORM 47-2B II-6CHAPTER III - RENEWAL CERTIFICATE OF REGISTRATION |||-1

1. PURPOSE HM

2. REVIEW OF APPLICATION HM

CHAPTER IV - CANCELLATION OF AIRCRAFT REGISTRATION IV-11. PURPOSE |V-1

2. REVIEW OF APPLICATION IV-1

3. ISSUE CANCELLATION OF AIRCRAFT REGISTRATION IV-1CHAPTER V - AIRCRAFT REGISTRATION DATABASE V-1

1. PURPOSE v-12. RESPONSIBILITY v.-|3. ENTERING DATA v.-,

4. REPORTS OF CIVIL AIRCRAFT REGISTER DATA V-1CHAPTER VI - RECORD AND RETENTION vi-1

Table of Content

..i

.ii

May 2011

Appendix 1 -

Appendix 2 -

Appendix 3 -

Appendix 4 -

Appendix 5 -

Appendix 6 -

Appendix 7 -

Appendix 8 -

Appendix 9 -

Appendix 10 -

SI 47-01 Amdt. 1

Application for Certificate of Registration, DAAO Form47"11 APP 1-1

Document Evaluation for New Registered Aircraft List,DAAO Form 47-2A APP 2-1

Certificate of Registration, DAAO Form 47-02 APP 3-1

Temporary Certificate of Registration, DAAO Form 47-14. APP 4-1

Aircraft Detail Card, DAAO Form47-2B APP 5-1

Application for Renewal of Certificate of Registration,DAAO Form 47-13 .' APP 6-1Application for Cancellation of Aircraft Registration,DAAO Form 47-17 APP 7-1

Checklist Cancellation of Registration, DAAO Form 47-17 APP 8-1

Sample Confirmation Letter of Cancellation ofRegistration APP 9-1

Sample Confirmation Letter of Never Been Registered ... APP 10-1

Table of ContentIV

May 2011 SI 47-01 Amdt. 1

CHAPTER I-GENERAL

PURPOSE

This staff instruction prescribes responsibilities, policies and procedures to beused by the Directorate General of Civil Aviation (DGCA) Inspector forprocessing civil aircraft registration and maintenance of the Indonesian CivilAircraft Register.

2. REGULATORY AND REFERENCES

Civil Aviation Safety Regulations (CASR) Part 47 establishes the regulatorybasis for aircraft registration. CASR Part 45 establishes the regulatory basisfor aircraft marking.

a. Chapter VII Registration And Nationality of Aircraft, of the IndonesiaAviation Law No. 1, 2009, requires every aircraft operated in Indonesiashall be obligated to have a registration marks.

b. Chapter VIII Aircraft Airworthiness and Operation, of the IndonesiaAviation Law No. 1, 2009, requires each aircraft operated shall meet therequirements for airworthiness standard.

c. CASR Section 47.14 permits the operation of an aircraft using DAAOForm 47-14 Temporary Certificate of Registration. The temporarycertificate must be carried in the aircraft as evidence of temporaryauthority to operate the aircraft without a Certificate of Registration undercertain conditions.

3. KNOWLEDGE OF REQUIREMENTS

The DAAO Inspectors should be thoroughly familiar with the regulatory andadvisory references when using these instructions.

4. DEFINITIONS

a. Eligible person

A person or persons qualified to be the owner or owners of an aircraftregistered in Indonesia includes an Indonesian citizen or Indonesian legalentity, a foreign citizen or foreign legal entity and operated by anIndonesian citizen or Indonesian legal entity for a minimum utilizationperiod of 2 (two) years continuously based on an agreement/contract.

CHAPTER I 1-1

May 2011 SI 47-01 Amdt. 1

b. Owner

Owner includes a buyer in possession or if an aircraft is owned by morethan one person, it must be appointed one to Law on their behalf inorder to register the aircraft.

CHAPTER I-2

May 2011—LJLL^ SI 47-01 Amdt. 1

CHAPTER II - INITIAL CERTIFICATE OF REGISTRTION

1. RESPONSIBILITIES

a. The Sub-Directorate of Aeronautical Product (SDAP) is the office ofprimary responsibility for aircraft registration.

b' ™e„SDAp will distribute the application to the Head of Processcertification Section to assign an Inspector to review and evaluate theapplication and required evidence.

c. The assigned Inspector will ensure that all requirements are fulfilled andKo FaomT-02e)ndati°n f°r th6 ISSUanCe °f Certificate of Registration

2. APPLICATION

a. Application for an aircraft registration shall be made on DAAO FormForm 47-11 Application for Certificate of Registration, submitted withthe following attachments:

1) Aircraft procurement approval from DGCA for aircraft to beregistered;

2) Astatement of aircraft historical of ownership from Manufacturer tothe last owner;

3) Evidence of ownership as required by CASR 47.9;

4) Aircraft leasing agreement for leased aircraft;

5) Evidence that all duties due and payable under the laws ofIndonesia in respect of the importation of the aircraft into Indonesiahave been paid;

6) Radio permit issued by Ministry of Communications and InformationTechnology;

7) Export Certificate of Airworthiness or equivalent issued by the CivilAviation Authority Country of Registry;

8) Confirmation of aircraft deregistration from the Civil AviationAuthority of the Country of Registry;

9) Evidences that the aircraft is covered by insurance as required byArticle 62 of the Indonesia Aviation Law No. 1, 2009

CHAPTER

May 2011 SI 47-01 Amdt. 1

b. Compliance with the requirements of Ministry Decree No. 5 Year 2006:

1) After January 17, 2006, initial registration for passenger operation oftransport category aircraft, the total flight cycle must not exceed50.000 cycles or the age of the aircraft must not exceed 20 years;

2) After January 17, 2006, initial registration for passenger operation oftransport category aircraft, which was previously registered inIndonesia, the total flight cycle must not exceed 70.000 cycles or theage must not exceed 35 years;

c. Application for an aircraft registration ofan amateur-built aircraft.

The owner of an amateur-built aircraft who applies for registration mustdescribe the aircraft by class (airplane, rotorcraft, glider, or balloon),serial number, number of seats, type of engine installed (reciprocating,turbo propeller, turbojet or other), number of engine installed, andmake, model, and serial number of each engine installed; and muststate whether the aircraft is built for land or water operation. Also he/shemust submit as evidence of ownership an affidavit of ownership, andstating that the aircraft was built from parts and that he/she is theowner. If he/she built the aircraft from a kit, the applicant must alsosubmit a bill of sale from the kit Manufacturer.

REVIEW APPLICATION

a. Upon received DAAO Form 47-11 Application for Aircraft Registration.Inspector will:

1) Review the application, DAAO Form 47-11 Application for AircraftRegistration

All applicable portion of the application form must be filled outcorrectly and signed by accountable manager, the person designatedby applicant who is responsible for and has the authority over alloperations.

2) Review the aircraft procurement approval from DGCA

Check availability and validity of Aircraft procurement approval andconformity to aircraft to be registered

3) Review the statement of aircraft historical of ownership

Statement of aircraft historical of ownership contains history ofaircraft ownership from the delivery date from manufacture until thelast owner of the aircraft and it shall be supported by adequateevidence of ownership.

CHAPTER II

May 2011SI 47-01 Amdt. 1

Statement of aircraft historical of ownership shall be signed by theperson who signed the application.

4) Review evidence of ownership

a) Review evidence of ownership as follows:(1) Reference number, if applicable;

Make and model object (aircraft type and serial numberengine type and serial number, propeller type and serialnumber) and other as necessary;

Parties (seller and purchaser) name and address;(4) Signatoryand tittle;

(5) Date.

(2)

(3)

b) Transfer of ownership can be done by purchase or grantRecognized evidence of ownership from purchase is normally inthe form of Bill of Sale and from grant is a Grant Certificate otherthan shall be accepted by DAAO.

5) Review aircraft lease agreement for leased aircraft

a) In accordance with Article 25 of Indonesia Aviation Law No 12009 the minimum leasing period for a leased aircraft eligible forregistration is 2 (two) years.

b) If the lessor is not the owner of the aircraft, awritten consent fromhe owner shall be obtained. Normally, it is in the form of HeadLease Agreement or Letter of Owner Acknowledgement.

c) The content of Aircraft Leasing Agreement shall be reviewed inaccordance with the guidance provided in the SI 8300 Chapter 72Evaluating Aircraft Lease and Interchange Agreements

6) Review evidence that alaircraft have been paid

duties due and payable for the respective

CHAPTER

a) Evidence that all duties due and payable have been paid shall beobtained from Directorate General of CustomsMinistry of Finance.

and Excise,

b) For the aircraft evaluated or inspected outside of RepublicIndonesia, evidence of release from the customs will be obtainedafter the aircraft is delivered into Republic of Indonesia

May 2011SI 47-01 Amdt. 1

7) Review the Radio License

Radio Permit contains all communications and naviqationsfrequencies used on aircraft and approved by Sry ofCommunications and Information Technology.

8) Review the Export Certificate of Airworthiness

a) The Export Certificate of Airworthiness contains specificinformation of the aircraft, engine, and propeller (as applicable)cycle ^cnUfaCtUrer' type< model' serial "umber, flight hours, flight

b) Any non-compliance to Indonesian applicable requirementsshould be submitted to DAAO for approval The approval of thenon-compliance shall be written in the Export Certificate ofAirworthiness as an exception.

c) Validity of Export Certificate of Airworthiness is 60 (sixty) daysfrom the date of issuance. y; y

d) Exporting country shall be Republic of Indonesia.

e) Some ICAO member state, use other than form Export Certificatea0cce^d°bynDMOWhiCh * ""**" l° be 6qU'Va,ent and

9) Review confirmation of deregistration

a) Confirmation of deregistration shall be obtained from the CivilAviation Authority of the country where the aircraft was lastregistered, containing the statement that the aircraft has been

, Reregistered from their Civil Aircraft Register, effective from thedate as specified on the confirmation.

b) For a new manufactured aircraft, a confirmation of never beenregistered issued by country of manufacture can be recognizedas confirmation of deregistration.

10) Review Insurance

Insurance should be reviewed carefully to ensure that:

a) The aircraft identification (type, model, serial number) arecorrect. '

b) ^Sa^ ?,Tditi°nS by artide 62 of Indonesia Aviation Law no1, 2009, shall be covered.

c) Insurance policy is still valid.

CHAPTER II " •II-4

May 2011 SI 47-01 Amdt. 1

b. DAAO Form 47-2A Document Evaluation for New Registered AircraftList will be used by the assigned Inspector as a checklist,documentations and recommendations for the issuance of Certificate ofRegistration.

c. Determination to issue Certificate of Registration is given by DeputyDirector for Aeronautical Product of DAAO by signing DAAO Form 47-2A Document Evaluation for New Registered Aircraft List.

4. ISSUANCE CERTIFICATE OF REGISTRATION, DAAO FORM 47-02

After evaluation complete and DAAO Form 47-2A Document Evaluation forNew Registered Aircraft List has been signed a Certificate of Registration willbe issued.

When preparing Certificate of Registration, the following criteria shall beassured:

a. Registration Number and Registration Mark shall be crosschecked withCivil Aircraft Register database; it should be specific for one aircraft onlyand cannot be used for other aircraft at the same time.

b. Registration number shall be written in Arabic number

c. Nationality and Registration Marks shall be written in Roman capital letter

d. Manufacturer and Manufacturer's Designation of Aircraft shall be writtenin accordance with Type Certificate;

e. Aircraft serial number shall be written in accordance with Manufacturerdesignation serial number;

f. An aircraft may be registered only by and in the legal name of its owner;

g. Address as written on the certificate shall be a legal address of theowner;

h. The validity ofthe Certificate of Registration shall not exceed three years.

ISSUANCE TEMPORARY CERTIFICATE OF REGISTRATION, DAAOFORM 47-14

a. Temporary Certificate of Registration, may be issued when:

1) Aircraft produced by Indonesian Manufacturer for which theregistration administration is not register in Indonesian Civil AircraftRegister; or

CHAPTER II I-5

May 2011 o, „-, «„ .—— SI 47-01 Amdt. 1

2) Customs clearance cannot be shown during the time of registrationfor the aircraft evaluated or inspected outside Republic of IndonesiaEvidence of release from the customs will be obtained after theaircraft is delivered into Republic ofIndonesia; or

3) Radio permit from the Ministry of Communications and InformationTechnology cannot be shown during the time of registration.

b. Reason for the issuance of a Temporary Certificate of Registration shallbe written clearly on the certificate.

c. Validity of a Temporary Certificate of Registration shall not exceed threemonths from the date of issuance.

d. Certificate of Registration shall be issued when all pending items havebeen completed.

6. COMPLETION AIRCRAFT DETAIL CARD, DAAO FORM 47-2B

After the Certificate of Registration is issued, the Assigned Inspector willcomplete and sign a DAAO Form 47-2B Aircraft Registration Card:

a. All specific information can be written in Bahasa Indonesia or EnqlishLanguage.

b. Data from the detail card will be used as basis information for IndonesiaCivil Aircraft Register.

CHAPTER IIII-6

May 2011SI 47-01 Amdt. 1

CHAPTER III - RENEWAL CERTIFICATE OF REGISTRATION

1. PURPOSE

o^SS^S^T"is t0 de,ermine requirements for renewal

2. REVIEW OF APPLICATION

Upon received DAAO Form 47-13 Application for Renewal Certificate ofRegistration, the assigned inspector will review the application to determineits compliance with the requirement to renew Certificate of Registration

a' 23^35£&n"° F°rm 47"13 App,ication for R—All applicable portion of the application form must be completedh^nnr 8n? S,K9ned by accountable manager, the person designatedby applicant who is responsible for and has the authority over alloperations. '

b. Review validity of Certificate of AirworthinessCertificate of Airworthiness shall not be expired more than three years.

c. Review validity of Insurance.Insurance shall be valid at the time of application

d. Review of Aircraft Leasing Agreement for leased aircraftLeasing agreement shall be valid at the time of application

e. Any changes to previous data shall be indicated on the application letterand attached with the evidence.

After evaluating document of renewal for Certificate of Registration and foundsatisfactory, Certificate of Registration will be issued.

CHAPTER III

May2011 SI 47-01 Amdt. 1

CHAPTER IV - CANCELLATION OF AIRCRAFT REGISTRATION

PURPOSE

The purpose of this chapter is to determine requirements for cancellation ofregistration.

With reference to CASR 47.25 cancellation of registration can be done uponwritten request using DAAO Form 47-17 Application for Cancellation ofAircraft Registration, under IDERA refer to SI 47-02 IrrevocableDeregistration and Export Request Authorization or automatically whenCertificate of Airworthiness can not be maintained continuously for more thanthree years.

2. REVIEW OF APPLICATION

Assigned Inspector will use DAAO Form 47-17A Check List Cancellation ofRegistration to review application for deregistration.

a. DAAO form 47-17 Application for Cancellation of Aircraft Registrationshall be signed by accountable manager.

b. Acknowledgement/Consent Letter to cancellation of registration fromparties other than applicant shall be available and complete.

c. Power of Attorney shall be attached when correspondence made byapplicant's attorney.

d. When cancellation caused by total loss of aircraft during accident,applicant must attach evidence release of custody from NationalTransport Safety Committee/KNKT.

e. When reason of cancellation caused by termination of lease agreement,applicant must attach termination evidence.

f. It shall be ensure that no record of mortgage or any recorded mortgagehas been cancelled prior to deregister of aircraft.

3. ISSUE CANCELLATION OF AIRCRAFT REGISTRATION

After evaluation is completed and recommendation for the issuance ofConfirmation Letter of Cancellation of Aircraft Registration is given byDirector of DAAO a Confirmation Letter will be issued.

CHAPTER IV IV-1

May2011 SI 47-01 Amdt. 1

CHAPTER V - AIRCRAFT REGISTRATION DATABASE

1. PURPOSE

The purpose of the database is to store data for later recall and to displaythem in various forms that will aid in monitoring and management of aircraftregistration in Indonesia and as basis information for ICAO web base.

2. RESPONSIBILITY

The Head of Production Certification Section of SDAP is responsible formaintaining the aircraft registration files. Access to the database for additionor updating data, shall be limited to designated persons only.

3. ENTERING DATA

The information on aircraft registration database should be the followings:a. Aircraft make and model;

b. Nationality and Registration Mark;

c. Serial number of the aircraft;

d. Registration number of the aircraft;

e. Aircraft Procurement Approval from DGCA;

f. Bill of Sale;

g. The owner's name and address;

h. The operator's name and address;

i. The lessor's name and address (if applicable);

j. Date of registration;

k. The expiry date of Certificate of Registration;

I. Lease agreement(s) (if applicable).

4. REPORTS OF CIVIL AIRCRAFT REGISTER DATA

Reports of Civil Aircraft Register data is made in a form of Indonesia CivilAircraft Register and is published in yearly basis.

CHAPTER V ~vTf

May2011 SI 47-01 Amdt. 1

CHAPTER VI - RECORD AND RETENTION

Sub Directorate of Aeronautical Product of DAAO is responsible for the record andretention of aircraft registration data:

a. DAAO Form 47-2A Evaluation Document for New Registered Aircraft,including DAAO Form 47-11 Application for Certificate of Registration andDAAO Form 47-13 Application for Renewal of Certificate of Registration shallbe retained with all evaluation documents;

b. DAAO Form 47-2B Aircraft Registration Card shall be maintained to controlany changes to the registration status, including changes to ownership data,additional or revision to registration data, renewal of the certificate

c. Registration records shall be maintained as long as the aircraft registered inthe Indonesia Civil Aircraft Register

d. Records of Cancellation of Aircraft Registration shall be maintained for twoyears.

CHAPTER VI vT^f

May 2011SI 47-01 Amdt. 1

Appendix 1-Application for Certificate of Registration, DAAO Form 47-11

KEMENTERIAN PERHUBUNGANMINISTRY OF TRANSPORTATION

DIREKTORAT JENDERAL PERHUBUNGAN UDARADIRECTORATE GENERAL OF CIVIL AVIATION

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARADIRECTORATE OF AIRWORTHINESS AND AIRCRAFT OPERATIONS

PERMOHONAN SERTIFIKAT PENDAFTARAN PESAWAT UDARAAPPLICATION FOR CERTIFICATE OF REGISTRATION

in.

KETERANGAN PEMOHONApplicant Data1. Nama

Name

AlamatAddress

OPERATOROPERATOR

NamaNama

4. AlamatAddress

PEMILIK PESAWAT UDARAOWNER OF AIRCRAFT

KETERANGAN PESAWAT UDARA:Aircraft Data

I. Nama Pembuat:Name of Manufacturer

2 Model:Model

Nomor Seri:Serial NumberKeadaanStatus

7. Tanda PendaftaranRegistration Mark

BaruNew

Pesawat TerbangFixed Wing

Bekas

Used

NegaraCountry

KETERANGAN KEPEMILIKAN PESAWAT UDARA:Aircraft Ownership Data1. Dasar Kepemilikan

Reference of ownership

HelikopterHelicopter

Lain-lain (sebutkan):Others (specify)

Nomor Sertifikat Produk / PCProduction Certificate / PC

Tahun Pembuatan-Year of ManufactureTanggal PembatalanPendaftaran:Date of Cancellation

Beli TunaiCash Purchase

PemberianGift'

Lain-lain(sebutkan):Others(specify)

IV.

Bukti Kepemilikan:•der.ze 3f ownership

Nomoribe

DASAR PENGUASAAN PESAWAT UDARA :Re'e^enceofAi-aif Pcssess-on

1 uasar

Penguasaan"Reference ofPossession

BeliPurchase

Referensi- (Bukti Kepemilikan/Perjanjian)Reference jB.ilof Sale/Agreement)

Sewa Guna UsahaLeasing

3. Penjual* (SeiHr) IPemberi Sewa (Lessor) / Penjual Bersyarat{Conditional Seller) ILainnya'(other):

Pen;;

(Condi!i [Bjyrj IPenenma Sewa {Lessee) IPembeli Bersyaratoral Buyei)I Lainnya' (other):

V. KETERANGAN LAIN-LAIN:Other Data

t Pangkalan PesawatAircraft Base

2. Tempal Pemenksaaan PesawatPlace of Inspection

Tanggal:Date

Pembelian BersyaratConditional Sale

Alamat:(Address)

Alamat:(Address)

Lain-lain(tuliskan)(Other) specify

?nl«h%Zot'aa% *ZatLTeme"'i0ned inhma,tom ar° <™ «"™<°« «""» underfed wi,l comply »i,h Indonesia Aviation Act to. I. 2009Dibuat Rangkap 2Made in 2 copies

Corel yang tidak diperlukanCross as necessaryBeri tanda X pada kotak yang terkaitTickApplicable Box

DAAO Form47-11 (04/11)

APPENDIX 1

Tempat:Place

TanggalDate

NamaName

Jabatan :Title

Meterai

danCap Perusahaan

Tanda TanganSignature

APP 1-1

May 2011SI 47-01 Amdt. 1

Appendix 2-Document Evaluation for New Registered Aircraft List DAAOForm 47-2A

KEMENTERIAN PERHUBUNGANMINISTRY OF TRANSPORTATION

D'REnK»2r?^LJENDERAL PERHUBUNGAN UDARADIRECTORA TE GENERAL OF CIVIL AVIA TIONDIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARA

DIRECTORATE OF AIRWORTHINESS AND AIRCRAFT OPERATIONS

DOKUMEN EVALUASI UNTUK PENDAFTARAN PERTAMA PESAWAT IinT^TEVALUATION DOCUMENT FOR INITIAL%GKTErBa!rIm^

No. Ref.: '1. PersetujuanPengadaanPesawat UdaraAircraftProcurementApproval

E Bukti KepemilikanEvidence ofOwnership

. Ref. NoOperatorOperator

Tipe PesawatAircraft Type

Referensi.:Reference

Pesawat Udara!"Aircraft

Tanggal:Date

NamaPembuat &TipePesawat Udara:Make & Model

Nomor Seri:Serial NumberoGnei ivumoer

Nama danAlamat Pembeli / Penenma / Lainnya" (sebutkan)-Name &Address of Purchaser /Acceptor /OtherTtspecity)'

Nama dan Alamat Penjual / Pemben / Lainnya'- (sebulkan)-Name i Address of Seller / Donator (grantor) IOthers (specify)

Ditandatangam oleh:Signed By

3. Casar Penguasaan : HiDah atau Pembenan I KelerensiTerm nf Cift.rc.v.. ^n#«^« —. .Term of Possession Grant or Gift Reference

Namadan Alamat Uonatur:DonatorName andAddress

PembelianPurchase

i\omor Order Pembelian:Purchase OrderNumberNama danAlamat Penjual:Seller Name and Address

; sewa Guna UsahaLease

Heterensi:Reference

Hembelian BersyaratCondional Sale

Nama dan Alamat PembenSewa-Lessor Name and Address

Nama dan Alamat PenenmaSewa:Lessee Name and Address

Nomor Henanjian: "Title Reservation AgreementNama daTTATanWPeTnBeTniieTiyaraFConditional SellerNameandAddress

Nama dan Alamat Penjual Bersyarat"Condional Buyer NameandAddress

DAAO Form 47-2A (04;11)

APPENDIX 2

Ianggal:Date

totalTotal

TotalTotal

Tanda Pendaftaran:Registration Mark

Jabatan:Tittle

Ianggal:Date

Ianggal:Date

I anggal:Date

I anggal:Dale

dan

of

dariof

Halaman 1 dari 2

APP 2-1

May 2011 SI 47-01 Amdt. 1

4. PenghapusanRegistrasi sebelumnyaCancellation ofRegistration

Tanda Pendaftaran:Registration Mark

Nomor Surat Penghapusan:Cancellation Letter Number

Tanggal:Date

Tanggal BerlakuEffective Dale

5. Export CertificateOf Airworthinessditerbitkan olehissued by

Nama:Name:

Jabatan.Title:

Negara:CAA

Nomor:Number

Tanggal:Date

Pesawat

UdaraAircraft

Jenis Produk*Product Type

Pesawat Terbang| Ftt-eo* Wing

HelikopterRotary Wing

I Lainnya (sebutkan).| Others (specify)

Pabrik Pembuat:Manufacturer

Model:Model

Nomor Seri:Serial Number

Keadaan"

Condition

Barutow

BekasUsed

Lainnya (sebutkan):Others (specify)

Mesin /

Baling-baling"

Engine tPropeller

Pabrik Pembuat:Manufacturer

Model:Model

Nomor Seri:Serial Number

1. 1.

2. 2.

3. 3.

4. 4.

6. Ijin RadioRadio Permit

Referensi:Reference

Berlaku sampai:Validity

7. AsuransiInsurance

Refer ensi:Reference

Nama penanggung:Insurer Name

Berlaku sampai:Validity

8. KepabeananCustoms Clearance

Nomor dan tanggal PIB:Dare & No. of PIB

Jems Impor*:Import Type

TetapPermanent

I SementaraTemporary

Nomor dan Tanggal SPPB:Date i Nc of SPPB

9. Pernyalaan Sejaran KepemilikanStatement of Historicalof Ownership

1anggal:Date

landa Pendaftaran:Registration Mark n .,

Nomor Pendaftaran:Registration Number

1anggal:Date

CATATAN

Pf-a'-s

* Piiih tcctak >arg sesja'

" Coret yang : -2a< pertucross as apt'•:;.'. e

JAKARTA.

KEPALA SUB DIREKTORAT PRODUK AERONAUTIKADEPUTY DIRECTOR OF AERONAUTICAL PRODUCT

Inspektur / inspector

DAAOForm 47-2A (04/111Halaman 2 dari 2

APPENDIX 2 APP 2-2

- x

May 2011 SI 47-01 Amdt. 1

Appendix 3 - Certificate of Registration, DAAO Form 47-02

^

REPUBLIK INDONESIARepublic of Indonesia

DEPARTEMEN PERHUBUNGANMinistry of Transportation

DIREKTORAT JENDERAL PERHUBUNGAN UDARADirectorate General of Civil Aviation

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARADirectorate ol Airworthinessand Aircraft Operations

SERTIFIKAT PENDAFTARAN(Certificate of Registration)

2. Tanda Kebangsaan dan Pendaftaran(Nationality andRegistration Marks)

Pabrik Pembuat dan Tipe/ModelPesawat Udara(Manufacturer and Manufacturer's Designation of Aircraft)

5. Nama pemilik(Name ol Owner)

6. Alamat Pemilik

(Address of Owner)

1. No. Pendaftaran(Registration Number)

Nomor Seri Pesawat Udara(Aircratt Serial Number)

Yang bertanda tangan dibawah ini menerangkan bahwa pesawat udara tersebut di atas telah didaftar dalam Daflar Pesawat Udara SipilRepublik Indonesia sesuai dengan Perjanjian Penerbangan SipilInternasionaHangqal 7 Desember 1944, Undang-Undang Republik IndonesiaNo.1 tahun 2009 tentang Penerbangan serta Peraturan Keselamatan Penerbangan Sipil (PKPS) yang berlaku.

/( is hereby certified that the above described aircraft has been registered in the Civil Aircraft Register ol the Republic of Indonesia inaccordance with the Convention on International Civil Aviation dated 7 December 1944, the Republic ol Indonesia Aviation Law. No. 1 Year2009and applicable CivilAviation SafelyRegulations (CASR).

Berlaku Sampai:(ValidUntil)

D«AO Form 47-02 |0B 09)

Tanggal Diterbitkan Jakarta,(Date of issuance)

u.b. Direktur Jenderal Perhubungan Udara(On behalfol the DirectorGeneralol CivilAviation)

Tanda tangan (Signature)

Ur,d3ng-Undang Republik Indonesia No. 1 Tahun 2009 tentang PenerbanganRepublic of Indonesia Aviation LawNo. 1 Year 2009

Pasal 404

Setiap oranc yang mencoperasikan pesawat udara yang tidak mempunyai tanda pendaftaran sebagaimana dimaksud dalam Pasal 24 dipidana denganpidana penjara paling lama 5(lima) tahun alau denda paling banyak Rp. 1000 000 000.00 (satu miliar aipiah).Anybody operatinn anaircraft without any reoistration identity as meant in Micle24shall becondemned with imprisonment fora maximum 5 (live) years ora fine of a maximum Rp 1,000,000,000.00(onebillion nipialis).

Pasal 405

Setiap orang yang niemberikan tanda-tanda alau mengubah pendaftaran sedemikian rupa sehingga mengaburkan tanda pendallaran, kebangsaan, clanbendera pada pesawat udara sebagaimana dimaksud dalam Pasal 28 dipidana dengan pidana penjara paling lama I (satu) tahun atau denda palingbanyak Rp 250 000000.00 (duaratus lima puluh |uta rupiah)Anybody giving signs orcnar.ging registration identity as such as todisguise the aircraft's registration marks, nationality, and Hag as meant in Article 28shallbe condemned with imprisommii lora maximum '.(one) year ora lineola maximum Rp 2oO,000.000.00 (tvio hundred fifty million tvpiahs).

APPENDIX 3 APP 3-1

v.

May 2011SI 47-01 Amdt. 1

Appendix 4 -Temporary Certificate of Registration, DAAO Form 47-14

^2iV.

^

REPUBLIK INDONESIARepublic of Indonesia

DEPARTEMEN PERHUBUNGANMinistry of Transportation

DIREKTORAT JENDERAL PERHUBUNGAN UDARADirectorate Generalof CivilAviation

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARADirectorate ofAirworthiness and Aircraft Operations

SERTIFIKAT PENDAFTARAN SEMENTARA(Temporary Certificate ofRegistration)

Penerbitan Sertitikat Pendaftaran Pesawat Udara dibawali Ini(Where as the issuance Registration Certificate ofthe lollowing aircraft)

Pembuat dan Model(Make andModel)Nomor Seri(Serial Number)Alokasi Tanda Pendaftaran(Allocated Registralion Marks)Nomor Pendaftaran(Reg.Number)Pemilik(Owned by)Dioperasikan oleh(Operated by)

ditunda menunggu penyerahan dokumen(ispostponed pending submission ol)

Ijin terbang pesawat udara untuk semenlara diberikan dengan kondisi dibawah ini :(Temporary permission to fly the said Aircraft is hereby granted under the lollowing conditions):\. Sertifikat Pendaftaran Sementara ini bukan untuk penerbangan komersil.

(This Temporary Certificate ofRegistration IS NOT tor revenue flight)'. Tanda Pendaftaran harus tetap pada posisi yang benar sesuai dengan peraturan yang berlaku.

(The Registralion Mark should be affixed on the proper position in accordance with applicable regulation).Tanggal Diterbitkan JakartaBerlaku Sampai:

(Valid Until) (Dale of Issuance)u b Oirektur Jenderal Perhubungan Udara(On behalf ofthe Director General ofCivil Aviation)

Tanda Tangan (Signature)DAAOForm 47-14(DSOSI

Undang-Undang Republik Indonesia No. 1Tahun 2009 tentang PenerbanganRepublicofIndonesiaAviation Law No. 1Year2009

Pasal404

Ssssss*rssttOSs&r** dimaksud dalam Pa5a'24 d,pidana den3an p,da"aSffiS,aStB!S^*^** 'M Sh3"be ••*••«**••«* 'o^maximum 5(five, yearsorafme o,

Pasal405

hSrf^i,''3"9 m6""*"kan landa-tanda alau mengubah idenlitas pendaftaran sedemikian rupa sehingga mengaburkan tanda pendaftaran kebanosaan danS mttfi£^£t*da,am Pasal 28 dip,dana dengan Plda,,a penjara Ala™' S3K^p*K rp™^J!'fn5J9"S " °"aT9 reS'stral,on «**y « such as to disguise the aircraft's registration marks nationality and flag as meant in Article 28 shall Dpcondemned with imprisonment tor amaximum tfotie) year or atine ol amaximum Rp. 250,000.000 00 {two hundred fifty million nipLs).

APPENDIX 4APP 4-1

b

May 2011 SI 47-01 Amdt. 1

Appendix 5 - Aircraft Detail Card, DAAO Form 47-2B

KEMENTERIAN PERHUBUNGANMINISTRY OF TRANSPORTATION

DIREKTORAT JENDERAL PERHUBUNGAN UDARADIRECTORATE GENERAL OFCIVIL AVIATION

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARADIRECTORATE OF AIRWORTHINESS AND AIRCRAFT OPERATIONS

KARTU PENDAFTARAN PESAWAT UDARAAIRCRAFT REGISTRATION CARD •

A. BAG IAN I (Section I)

I. PENERBITAN SERTIFIKAT PENDAFTARAN PERTAMA [ISSUE OF INITIAL CERTIFICATE OF REGISTRATION)SuratPersetujuan PengadaanAircraft Procwement Approval

TipePesawat Udara(Aiicratt Type):

Pesawat Udara:

Nama Pabrik PembuatfA.tantjf3rfu.ier!'

Nomor Seri Pesawat(Seiial Number).

Tahun Pembuatan(Daleol Manufacture):

Tanggal:Date

JmlPenumpang(Number of Seat):

Nomor Pendaftaran:Registration Number

Tanda Pendaftaran:Recistiation Mam

Tnd. Pendaftaran Lama(Pievious Reg Mark):

Kalegpri Pesawat Udara"Aircraft CategoryPemilik (Owner):

TransportTransport

NormalNorma!

KomulerCommuter

Alamat (Address)

Lain-Lain (tuliskan):Other (specify,

Bukti Kepemilikan (Evidence ofOwnership)Operator (Operator):

Dasar Penguasaan"Reference of Possesion

Perjanjian Sewa Guna Usaha-Lease Agreement

BeliPuichase

Perjanjian Pengik3tan Hak BersyaratTinfe Reservation AgreementNamaPenjual(Sella* IPemberiSewa iLe.Sato)! Lainnya (Order)-

Sewa Guna UsahaLeasing

IPenjual3ersyarat (CondKionaf

Tanggal (Dale)

Alamat(Address).

Pembelian BersyaratCcnrliltonai Sale

Alamat(Address):

Lain-Lain (tuliskan)Offier {specify,

Nama Per.be.'i [Sayn) ^erier.r-ia Se^a(tasne) PenK. Bersyarat (ConditionalBvve-),' Lainnya. (OtimT:

Alamat (Adiess).

ASURANSI (INSURANCE)

NamaPenanggungIrswer -s^j

Jenis TanggunganInsurance Coverage

KEPABEANAN CUSTOMS CLEAR

Nomor dan Tanggal PIBNumber of PIB

Nomor danTanggal SPPBNumhai and Date c: SPPB

Tanggal Diterbitkan Sertifikat PendaftaranSemeniaraTempoiaiy Ce.-t/fics.'ecffferj/s.'rafjbn issuing dateTanggal Diterbitkan Sertifikal PendaftaranPertamaInitial Certireete ofRegistration issuing date

IV. PENGGANTIAN KEPEMILIKAN (CHANGE OF OWNERSHIP)Pemilik (Omter)

Reference (Reference)

Tanggal Diterbitkan Sertitikat Pendaftaran PenggantiDale cfIssuance Certificate olRegistration ReptaevoMl

DAAO Form47-2B (04/11)

APPENDIX 5

Tanggal Berlaku Asuransi:Insurance Period

Jenis Impor":Importation Type

Berlaku sampai dengan:Validity

Berlaku sampaidengan:Validity

Alamat (Adams):

Tanggal (Ds.'e)

Beriaku sampai dengan:Validity

TetapPermanent

Semenlaia

Temporary

InspeklurInspector

InspeklurInspector

APP 5-1

May 2011 SI 47-01 Amdt. 1

V. CATATANPENJAMINAN (MORTGAGE RECORDJ

(Pencatatan penjaminan ini dilakukan berdasarkan permintaan daninformasi yang diberikan oleh pemohon terhadap adanya suatupenjaminan, dilengkapi dengan akta Hipotek danakta Perjanjian Pinjaman dansural keterangan tentang penjaminan dari para pihakyangterlibat)(Record ofMortgage ismade according lothe request and information submitted by applicant along w/tfi Mwtoage Deed and Loan Agreement andaknowledgement letter from eachpady)Nama dan Alamat Penerima Jaminan:NameandAddiessct Afortgagee Inspektur

InspectorNomor sural pencalatan penjaminan:Raterenced tellerol mortgagerecord

Tanggal:Dale

VI. PENGHAPUSAN PENJAMINAN (RELEASE ofMORTGAGE)InspekturInspector

Nomorsurat penghapusanpencatatanpenjaminan:Referenced letter olcancellation ofniolgage tecord

Tanggal:Date

VII. CATATAN IDERA (IDERA RECORD)

Nama Debitur:

Oeofor NameAlamal (Address)

InspekturInspector

NamaPihak yangdiberi Kuasaatau Orang yangDitunjuk secara San":Authorized Pailyof Certified Designee'

Alamal(Address):

Referensi Perjanjian:Agreement made as Releience

Tanggal Persetujuan dan Pencatatan DAAO Form47-03Date AgreedandLodaed ol DAAO Form47-03

VIII. PEMBATALAN IDERA (REVOCATION ol IDERA)InspekturInspector

Nomorsural pembatalan IDERA:Referenced letter of revocation of IDERA

Tanggal:Dale

IX. PENGHAPUSAN TANDA PENDAFTARAN PESAWAT UDARA (CANCELLATION OF REGISTRATION)Nomor PersetujuanPenghapusan TandaPendaftaran:Cancellation Registration Approval Number

Tanggal:Dale

Nomor Pemberitahuan PenghapusanTanda Pendallaran:Confirmation Cancellation Registration Number

Tanggal:Dale

TanggalPenghapusan Tanda PendaftaranCancellation Registration Dale

Inspekturinspector

AlasanPenghapusan:Reason tor Cancellation

Catalan (note) ' Coret yang tidak periu (Cross as required)" Pilih yangiSSuai | fie* cc; e»ae eat)

A. BAGIAN II(Secr.on II)

PERPANJANGAN SERTIFIKAT PENDAFTARAN PESAWAT UDARA

(RENEWAL of CERTIFICATE OF REGISTRATION)Tanggal

[Date}BerlakuSampai Dengan NamaInspektur

(Validity) (Inspector Nme)Tanda Tangan

(Signature)Keterangan(Remarks)

I

DAAO Form 47-2B (04/11)

APPENDIX 5 APP 5-2

May 2011 SI 47-01 Amdt. 1

BAGIANII(Secfionlf)

Lembar Lanjutan (continuationpage) : ' ->:.•

PERPANJANGAN SERTIFIKAT PENDAFTARAN PESAWAT UDARA(RENEWAL ofCERTIFICA TE OF REGISTRA TION)

Tanggal(Date)

Berlaku Sampai Dengan(Validity)

Nama Inspeklur(InspectorName)

Tanda Tangan(Signature)

Keterangan(Remark)

\ .

i

DAAO Form 47-2B (04/11)

APPENDIX 5 APP 5-3

May 2011 SI 47-01 Amdt. 1

Appendix 7 - Application for Cancellation of Aircraft Registration,DAAO Form 47-17

ta«&

KEMENTERIAN PERHUBUNGANMINISTRY OF TRANSPORTATION

DIREKTORAT JENDERAL PERHUBUNGAN UDARADIRECTORATE GENERAL OF CIVIL AVIATION

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARADIRECTORATE OF AIRWORTHINESSAND AIRCRAFT OPERATIONS

PERMOHONAN PENGHAPUSAN TANDA PENDAFTARAN PESAWAT UDARAApplication for Cancellation of Aircraft Registration

Tanda PendaftaranRegistation Mark

Nomor Pendaftaran

Registration NumberTipe Pesawat UdaraAircraft Type

Nomor SeriSerial Number

Nama OperatorName of Operator

Nama & Alamat PemilikNam & Address of Owner

Alasan Penghapusan"Reason for Cancellation

Selesai Perjanjian Sewa GunaUsaha

Expiration of lease agreement

Penghentian perjanjian yangdisepakati para pihakTerminating agreement as agreedupon each party

Rusak total akibat kecelakaanTotal loss during accident

Pergantian kepemilikanChance of Ownership

Akan didaftar di negara lainIntended tobe register to anothercountry

Tidak digunakan secarapermanen

Withdrawn from use

Sengaja dimsakIntentionally destroyed

i

Melampirkan referensi : perjanjian'bukti kepemilikan.'keterargan rusak*Attached reference: agreement/evidence ofownership /evidence ofreturn tocustody

Keterangan catatan penjaminan di DKUPPU**Record of Mortgage filed with DAAO

Nomor Surat Penjaminan DKUPPU:DAAO referenced letter

Ada

Yes

Tidak AdaNo

Melampirkan bukti selesai penjaminan (apabila ada) / pemyataan tidak dijaminkan (apabila tidak ada)*Attached settlement ofmortgage (for a recorded mortgage) / statement ofno mortgage (for no recorded mortgage)Melampirkan surat kuasa (apabila permohonan dilakukan oleh selain operator atau pemilik)Attached Power ofAttorney (for application made byother than operator or owner)

Tanggal Efektif PenghapusanEffective Cancellation Date

Dibuat Rangkap 2Made In2 copies

Coret yang tidak diperlukanCross as necessaryBeri tanda X pada kotak yang terkaitTickApplicable Box

DAAO Form 47-17 (04/11)

APPENDIX 7

Tempat:Place

Tanggal:date

Nama:

Name

Jabatan:

Title

Meterai

dan

Cap PerusahaanTanda TanganSignature

APP 7-1

May 2011 SI 47-01 Amdt. 1

Appendix 6 - Application for Renewal of Certificate of Registration,DAAO Form 47-13

KEMENTERIAN PERHUBUNGANMINISTRY OF TRANSPORTATION

DIREKTORAT JENDERAL PERHUBUNGAN UDARADIRECTORA TE GENERAL OF CIVIL A VIATION

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARADIRECTORA TE OF AIRWORTHINESS AND AIRCRAFT OPERATIONS

PERMOHONAN PERPANJANGAN SERTIFIKAT PENDAFTARAN

APPLICATION FOR RENEWAL OF CERTIFICATE OF REGISTRATIONA. DATA PESAWAT UDARA /AIRCRAFT DATA01. Tanda Pendaftaran Pesawat Udara:

Aircraft Registration MarkingMasa berlaku Sertifikat Pendaftaran:

Validity of Cof R

02. Nomor Pendaftaran Pesawat udara:

AircraftRegistration Number03. 04.

05. Nomordan Masa berlakuAsuransi Pesawat Udara (lampirkan)Number and Validityof Insurance (attach)

Masa berlaku Sertifikat Kelaikudaraan:Validity of CofA

B. DATA OPERATOR PESAWATUDARA/ AIRCRAFT OPERATOR DATA06 Nama Operator:

Operator's name

C DATA KEPEMILIKAN / OWNERSHIP DATA08

10,

Bukti Kepemilikan:Evidence of Ownership

Pemilik:

Owner

P. DASAR PENGUASAAN / TERM OFPOSSESSION'

07. Alamat Operator:Operator's Address

09. Tanggal :Dote

11. Alamat:

Address

12 Referensi:

ReferenceSewa Guna Usaha

LecsingPembelian BersyaratConditional Sole

13. Perjanjian Sewa Guna Usaha (tanggal dan masa sewa):Lease Agreement (date and leasing periods)

14. Perjanjian Pengikatan Hak Bersyarat (tanggal;Title Reservation Agreement (date)

I 15. Nama Penyewa Baru (Lessor) / Penjual Bersyarat(ConditionalSeller) / Lainnya (orrier)":

17. Marr.a Pemberi Sewa (lessee) / Pemoeli Bersvarat(ConditionalBuyer) / Lainnya (other)':

E. ALASAN PERPANJANGAN C OF R / REASON FORRENEWAL*

16. Alamat:

•~d~re ss

Aiara::

Address

19. Habis Masa Berlaku C of R

Expiration of Cof RPerubahan Pemilik/Pemberi sewa

Changes of Ownership/Lessor

Lain-lain (tuliskan):Other (specify)

Hilang/Rusak*Lost / destroyed

20. LampirkanReferensi Ccf R/ BuktiKspemifikan / PiAttachreferencefor c of R/ Evidence afOwnersh p ,;-

Keterangan k'ehilar.gan (atau Kerusakan)*. cgna of lost (c cestroyed.

Dalam halalasanperpanjangan adalah perubahan pen-,.k atau pe-rcerisewa, maka bagian CdanDdiisidata baruIn thecase reason for renewal ischangeof ownerorlessor, fill in column CandDwith thenew data

F, LAIN-LAIN / OTHERS "20. Kepabeanan

Customs Clearance

Catatan :

Note

Coret yang tidak perluCross as necessary

Pilih kotak yang sesuaiTick applicable box

DAAO Form 47-13 (04/11)

APPENDIX 6

Impor TelapPermanent Import

2r Sen-er'a^a

pc-ary .r-pzr.Lainnya (sebutkan)Other (specify)

Dibuat dengan sesungguhnya:/ certify chat clt information are true and correct

Tempat:

Place

Tanggal:Date

Nama

Name

Jabatan:

Title

Meleraidan Cap

Perusahaan

Tanda TanganSignature

APP 6-1

MaV2011 SI 47-01 Amdt. 1

Appendix 8 - Checklist Cancellation of Registration, DAAO Form 47-17

KEMENTRIAN PERHUBUNGANDIREKTORAT JENDERAL PERHUBUNGAN UDARA

DIREKTORAT KELAIKAN UDARA DANPENGOPERASIAN PESAWAT UDARA

JL. ME DAN MERDEKA BARAT NO. 8, JAKARTA PUSAT 10110 INDONESIATEL. : (62-21) 350.6664,350.6665 FAX.: (62-21) 350.6663

•• -:>•:•-•••:• ^s^^-v^'r^i^,-,-- P.O.BOX 3049, JAKARTA 10030. INDONESIACHECKLIST

CANCELLATION OF REGISTRATION

AircratType : Registration MarkSerial Number : Registration Number :

1. Application of Deregistration, DAAO Form 47-17* (check one applicable box)~\ a. Requested byOperator

Name •

• b. Requested by LessorMamo •Name

I Ic. Requested by Owner' ' Mama •Name :

| |d- Requested by authorised person* or certified designee* using IDERA (cross as applicable)certificate ofdesignation (asapplicable), please specify :Form of IDERA, DAAO Form 47-03, dated :

2. Application issigned by 'company authorised' person.Evidence :

3. Acknowledgement/Consent Letter to the Deregistration from parties other than applicant (not applicablewhen it is requested using IDERA' (check any applicaale box)

I [a. OperatorName & Address :

~lb. LessorName & Address :

I |c. Sub LessorName & Address :

id. Owner

Name & Address :

3. Power of Attorney (or other delegation form) when coresspondance made by attorney's of applicant •Name of Attorney in Fact:

4- Reason ofCencellation* (check oneapplicable bet)| |a. Termination of Lease Agreement

| |b- Default of contract (non performance) by lessee or debtor (IDERA)

| |c- Transfer ofownership dated :20November 2010

^d. Total loss of aircraft during accident

Js. Permanently withdrawn from use of aircraft

I |f- Intentionally scrapped or destroyed of aircraft

I |g. Intended to be registered into other country

I |h. Airworthiness can not be maintained for more than 3years continuously(when this condition occured, complete item 6, 7, 9, 10 only)

5. When item 4.d. ticked (total loss on accident), attached evidence of return to custody form KNKTReference :

DAAO Form 47-17A (04/1'

APPENDIX 8

-

Page 1 of 2

APP 8-1

May 2011 SI 47-01 Amdt. 1

6. Cancellation ofMortgage Record (for recorded mortgage)a. Name of Mortgagor :b. Name of Mortgagee:c. Date of Cancellation :

7. Statement of 'No liens against the aircraft or the aircraft is not under mortgage nor any liensf formoperator or owner.

8. Deregistration Permit from Director General :

9. Deregistration Letter number:

10. Issue 'Notification Letter' to importing country (check address of registration office)11. Entry information ofderegistration on DAAO Form 47-2B Kartu Pendaftaran12. Entry data on Deregistration Log Book

Data required for 'aircraft deregistration' has beenchecked andfound :

• SATISFACTORY •UNSATISFACTORY to meet the requirements.J Letter or e-mail' (cross one) regarding the required data has been delivered (applicable for

UNSATISFACTORY condition, as an interim process).

I I Deregistration statement is recommended to be issued.

| | Data returned to PM (when deregistration statement has been issued) for filing.

L JName of Inspector

NOTE:

This check list (when fully completed) will substantiate as a report toKasubdit and KasiCorrespondance letter or e-mail can be used asan evidence of processing the taskData (other than original form) is strongly recommenced nelectronic oopy

DAAO Form 47-17A (04/11)

APPENDIX 8

Page 2 of2

APP 8-2

May 2011SI 47-01 Amdt. 1

Appendix 9-Sample Confirmation Letter of Cancellation of Registration

*s& MINISTRY OF TRANSPORTATIONDIRECTORATE GENERAL OF CIVIL AVIATION

Jalan Medan Merdeka Barat No. 8Jakarta 10110PO BOX No : 1389Jakarta 1001.1

Phone: +62 21 3505136+ 62 21 3505137

Fax: + 62 21 3505135♦ 62 21 3505139+ 62 21 3507144

Our Ref.

Subject

To

Jakarta, (DD/MM/YYYY)

: Cancellation of Registration

:CAA

:::sthat the airc^^^(H^SSe9iStered fr°m lnd°neSia C,V" A'rCraft Re9is{er effective fromO^^rds^how no unreleased recorded liens against the aircraft.

Faithfully Yours,

lr. YURLIS HASIBUAN

Director of Airworthiness and Aircraft Operat,

APPENDIX 9

ions

APP 9-1