Flight Examiner Notification of Test Form

This is for use by Flight Examiners conducting Skill Tests, Proficiency Checks or Assessments of Competence on pilots holding a licence issued by the IAA.

Please review the IAA's National Administrative Procedures before completing the Notification of Test Form:

Pilot Examiner Standardisation Briefing Document (PLAM004)

Please review the IAA Personnel Licensing Advisory Memoranda (PLAM) as may be applicable to the test or check you are conducting:

PLAM

Please note:

Examiners certified by a Third Country (except where such examiner holds a valid examiner certificate issued i.a.w. FCL.1000(c) by an EASA Member State) may not carry out any licencing activity relating to an IAA issued Part FCL licence.
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Examiner Details

First Name

Surname

EU Examiner Certificate No

State of Licence Issue

Email Address

Phone Number

Candidate Details

First Name

Surname

IAA Pilot Licence Number

Email Address

Phone Number

Test Details

Type of Test

Purpose of Test

Category of Aircraft

Aircraft ICAO Type Designator

Is Test in Aircraft or Simulator

Aircraft Reg. or Sim approval no.(if known)

ATO/AOC Operator name if applicable to test

Planned Test Location (City, Country)

Airfield Name or Sim Location

Planned Date

Planned Time

Declaration

I declare that I have received information from the applicant regarding his/her experience and instruction, and have found that experience and instruction complies with the applicable requirements in Part-FCL

Agreed

I declare that I have reviewed and applied the IAA's current National Administrative Procedures

Agreed