Section/division AIRWORTHINESS: AIRCRAFT INSPECTION & REGISTRATION Form Number: CA 44-01

Telephone number: 011-545-1000 Fax Number: [email protected]

Physical address Ikhaya Lokundiza, 16 Treur Close, Waterfall Park, Bekker Street, Midrand, Gauteng
Postal address: Private Bag X73, Halfway House 1685 Website: www.caa.co.za

ANNUAL MAINTENANCE REVIEW REPORT

NON-TYPE CERTIFIED AIRCRAFT (NTCA)
FIXED WINGS AND ROTOR CRAFT
1. AIRCRAFT Airframe
Z -
serial number
REGISTRATION
2. Make/model of Aircraft
3. Make/model of Engine(s)
4. Make/model of Propeller(s)
5. Current Airframe
Current Airframe hours cycles

Hours accumulated in
Current Hobbs
the past 12 months
6. Aircraft
Aeroplane Helicopter
Classification
Glider Microlight Other
7. Hours
Engine serial Hours operated Cycles Cycles since Date of overhaul
operated
numbers(s) since overhaul since new overhaul or manufacture
since new
i DD-MM-CCYY

ii DD-MM-CCYY

iii DD-MM-CCYY

iv DD-MM-CCYY

8. ENGINE TBO DETAILS

9. Propeller serial Date newly Date of O/H Time since
Time since new
number(s) installed midlife inspection overhaul
i DD-MM-CCYY DD-MM-CCYY

ii DD-MM-CCYY DD-MM-CCYY

iii DD-MM-CCYY DD-MM-CCYY

iv DD-MM-CCYY DD-MM-CCYY

10. PROPELLER TBO DETAILS

Time since
11. Gearboxes Serial Numbers Date newly installed Time since new
overhaul
i Main rotor

ii Intermediate

iii Tail

iv Combiner

12. GEARBOX TBO DETAILS

Hours by which inspection was
13. Date of last flight DD-MM-CCYY
over flown
CA 44-01 04 August 2025 Page 1 of 2
 Flight Folio Copies Attached
14.
(most recent page)
15. Type of Annual Schedule maintenance as per
inspection Inspection AMS
16. CAA accepted Aircraft
Maintenance Schedule Issue/amendment
reference
17. Since the last ATF renewal/ issue, the following were complied with or carried out (attach logbook
copies):
i. Record showing details of major maintenance checks carried out YES NO
ii. Major component changes (Serialized life limited components as
YES NO
per OEM Chapter 5 or equivalent) (if applicable, attach copy)
iii. Airworthiness Directive numbers (if applicable, attach copy) YES NO
iv. Manufacturer’s recommendations (e.g. SB’s, SI’s, SL’s etc.)
YES NO
numbers (if applicable, attach copy)
v. Modification Records (if applicable, attach copy) YES NO
vi. Pitot Static check (attach copy) YES NO
vii.Transponder Check (attach copy) YES NO

18. Date of last compass swing DD-MM-CCYY

Radio station license (proof of application) available and
19. YES NO
current
20. Aircraft flight manual available and current YES NO
21. Date of last weighing DD-MM-CCYY
Is mass and balance data available / amended to date (if the
22. YES NO
aircraft has been reweighed attach copy of the weigh report)
23. Is the equipment list available / amended to date? YES NO
Are the engine and propeller models installed, the correct
24. models as required by the aircraft Type Certificate Data YES NO
Sheet or Type Approval Data Sheet?
Does the radio equipment comply with the original aircraft
25. equipment list, or are modification/STC approvals available YES NO
for any non-standard equipment installed?
Are the relevant approved documents to be carried in the
26. YES NO
aircraft available as per Part 91 and 94 of the CARs?
Is the aircraft fitted with a 406 MHZ Emergency Locating
27. YES NO
Transmitter?
28. Enter beacon ID Hex code
(If answered yes)
29. Authority to Fly expiry date DD-MM-CCYY
COMPLIANCE STATEMENT
30. I, the undersigned, hereby certify that I have completed the and
annual maintenance review on aircraft
Z -
that
i. All mandatory overhauls, modifications and special inspections due in accordance with the
accepted maintenance schedule (AMS) have been done and are recorded in the applicable
logbooks.
ii. This aircraft is airworthy, and a maintenance certificate of release is available and current.
iii. The information given on this form is true in every respect to the best of my knowledge and
belief.

DD-MM-CCYY

SIGNATURE OF AIRCRAFT
NAME IN BLOCK
MAINTENANCE ENGINEER DATE
LETTERS
(AME) /APPROVED PERSON (AP)
AME/AMO/AP licence number

CA 44-01 04 August 2025 Page 2 of 2