CPL CPL CPL CPL CPL
Registration Temp Id: P-T2022/5375 P-T2022/5375
APPLICATION FOR ALLOTMENT OF COMPUTER NUMBER FOR APPEARING DGCA INDIA CA-9
IN FLIGHT CREW LICENCE EXAMINATION
GOVERNMENT OF INDIA
DIRECTORATE GENERAL OF CIVIL AVIATION
CENTRAL EXAMINATION ORGANISATION
FOR OFFICE USE ONLY SIGN OF OFFICER
P-
1. PERSONAL DETAILS
1.1. Name MUDIT
1.2. Gender MALE
1.3. Date of Birth 19-03-2005
1.4. Mother's Name SUSHEEL RANI
1.5. Fathers Name RAKESH DAHIYA
1.6. Email ID mudit2724@[Link]
1.7. Nationality INDIA
1.8. Mobile Number XXXXXX9335
2. Study Details
Have you studied in Foreign University, situated in India NO
or Abroad?
Do you have AIU/ equivalent education qualification NO
certificate?
3. Address
Correspondence Address Permanent Address
House no 289 Sector 23 Sonipat Sonipat Haryana PIN- House no 289 Sector 23 Sonipat Sonipat Haryana PIN-
131001 India 131001 India
4. Education
Level Degree / Board / University Duration Year of Percentage
Diploma (In Year) Passing
10th 10th CBSE 1 2020 87.8
10+2 with PM 12th CBSE 1 2022 80.8
5. 10+2 Details
Subject Marks Maximum Board/ University
Obtained Marks
Physics 83 100 CBSE
Maths 63 100 CBSE
English 92 100 CBSE
Online Submission Date & Time : 25/08/2022 & [Link] Page No. 1
CPL CPL CPL CPL CPL
Registration Temp Id: P-T2022/5375 P-T2022/5375
6. Flight Crew Details
APPLYING FOR CPL
DEFENCE -
PILOT LICENCE TYPE -
PILOT LICENCE NO -
PILOT LICENCE ISSUE DATE -
PILOT LICENCE EXPIRY DATE -
LICENCE ISSUING AUTHORITY -
LICENCE ISSUING COUNTRY -
MULTI ENGINE ENDORSEMENT NO
COURSE COMPLETION CERTIFICATE NO -
AIRCRAFT TYPE -
AUW -
FIRST TRAINING FLIGHT -
TRAINING INSTITUTE -
TOTAL FLYING HOURS -
TOTAL HOURS PILOT IN COMMAND -
GROUND TRAINING INSTITUTE -
7. Documents Uploaded and to be enclosed
[Link]. [Link]. Document Name Tick Mark DGCA Remark
1 - Applicant Photograph
2 - Applicant Signature
3 - Date of Birth Proof
4 - Xth Marksheet
5 - Xth Pass Certificate
6 - Board Verification Certificate for Xth
Qualification
7 - XIIth / Equivalent Pass Certificate
8 - Board Verification Certificate for XIIth/
Equivalent Qualification
9 - XIIth / Equivalent Marksheet
10 - UID Aadhar Card
11 - Copy of Proof of Permanent Address
Online Submission Date & Time : 25/08/2022 & [Link] Page No. 2
CPL CPL CPL CPL CPL
Registration Temp Id: P-T2022/5375 P-T2022/5375
8. Declaration
I hereby certify that the above particulars/enteries made by me are true and correct in every respect to
❏ the best of my knowledge and belief and that nothing has been concealed or withheld by me. I
understand that if any of my particulars/enteries are found false or incorrect at any time, my
candidature will stand rejected and further action can be taken against me by DGCA as per the Rules.
Further, I have read the requirement for issue/ extension of Pilot Licence/Rating, as laid down in
Aircraft Rules / CARs amended from time to time.
I declare that I have read and understood the above declaration.
❏
DATE SIGNATURE
PLACE NAME
9. CERTIFICATION BY COMPETENT AUTHORITY
To be attested by CFI/PII/Gazetted Officer/Notary Public. In case of serving Defence Applicant should
personnel ,this may be attested by another serving Commissioned Officer paste recent color
passport size
This is to certify that all the above particulars furnished by MUDIT have been verified by photograph.
me and found to be correct.
*Signature in full of attesting authority.......................
Date
Place
* Signature & stamp shall partly cover this page and photograph.
Online Submission Date & Time : 25/08/2022 & [Link] Page No. 3
