...... ……………......

(date of submission of the Application to PPL)

......

(city) (date)

......

………......

......

(name and address of the air carrier)

Polish Airports

Commercial Department

Aeronautical Services Sales Division

Zwirki i Wigury 1

00-906 Warszawa, Poland

e-mail:

APPLICATION

FOR THE NEW ROUTE DISCOUNTS

Referring to point 4.2. of the “Airport charges tariff at Warsaw Chopin Airport’ (hereinafter referred to as the Tariff) we apply for thenew scheduled routesdiscounts[1] as specified below:

Route WAW -………...... ……………………………………….……

(IATA code of destination airport)(arrival and departure flight numbers)

Flight no / Type and version of aircraft /
MTOM
(tonnes) / Number
of seats on aircraft / Arrival at WAW
(local time) / Departure from WAW
(local time) / Operations – days of the week / Schedule validity period from ... to ...

Route WAW - ………...... ……………………………………….……

(IATA code of destination airport)(arrival and departure flight numbers)

Flight no / Type and version of aircraft /
MTOM
(tonnes) / Number
of seats on aircraft / Arrival at WAW
(local time) / Departure from WAW
(local time) / Operations – days of the week / Schedule validity period from ... to ...

Furthermore, we declare that in accordance with point 4.1.3. of the Tariff, we will offer for sale to the public a monthly average of at least 50% of seats on each of the new routes specified above and that during the schedule season at least 50% of passengers will be carried based on the ticket offered for sale to the public on these routes. We understand that if we fail to satisfy either of these conditions, we will be obliged to return the discount received. Also, we are aware that PPL will suspend the discounts should we fail to settle the payments arising from airport charges at Warsaw Chopin Airport in a timely manner, referred to in 4.7.3. of the Tariff.

We also enclose a document confirming the right to perform the regular air transport on the a/m route(s) (permission/authorization)[2][3] and the decision of the Polish Civil Aviation Office approving the flight schedule for the first season with respect to the route(s) specified in the Application.

………………………………………………………………………

(signature and position of an authorised person)

[1] If more than one, fill in for all routes for which the discounts are applied for the first two schedule seasons

[2]Delete as appropriate

[3]Applies for routes outside the European Economic Area