RMA F3
WITHDRAWAL OF APPROVAL TO OPERATE IN RVSM AIRSPACE
FOR USE BY APPROVAL ISSUING AUTHORITIES ONLY
This form must be completed and returned to the Regional Monitoring Agency to which the State is accredited. For a full list of State/RMA accreditations please see ICAO Doc. 9937. For States accredited to the EUR RMA please forward this form to the address below. (PLEASE USE BLOCK LETTERS.)
State of Registry.1
Name of Operator.2
3 Letter ICAO Operator Code.3
State ofOperator.4
Aircraft type.5
Aircraft series*.6
Manufacturer’s serial number.7
Registration mark.8
24 bit ICAO address (Mode S).9
Date of withdrawal of RVSM Approval.10
Reason for withdrawal of RVSM Approval.11
Additional Remarks
(Details of new registration, etc.)
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Approvals from States accredited to the EUR RMA should be sent to:
Fax+32 27 29 51 85
* Required if Aircraft type entry is ICAO Designator
INSTRUCTIONS FOR COMPLETING FORM RMA F2
1Enter the one or two letter ICAOState identifier as contained in ICAO Doc. 7910, or full name.
2Enter the full operator name as contained in ICAO Doc. 8585 or full legal name.
3Enter the operator 3 letter code as contained in ICAO Doc. 8585 or for General Aviation enter IGA.
4Enter the one or two letter ICAOState identifier as contained in ICAO Doc. 7910, or full name.
5Enter full manufacturer model, or as a minimum the ICAO designator as contained in ICAO Doc. 8643.
6Enter the aircraft series or manufacturer’s custom designator.
7Enter the manufacturer’s serial number.
8Enter the registration mark of the aircraft.
9Enter the 24 bit ICAO aircraft address (Mode S) allocated by the State. Use 6 digit hexadecimal format.
10Enter the date that the RVSM approval was officially withdrawn. Use UTC day/Month/Year format.
11Provide reason for withdrawal of approval (de-registration, airframe removed from service, non-compliance with technical or operational requirements, airframe modification, etc.)
12Enter the date that the RVSM approval expires (if appropriate). Use UTC day/Month/Year format.
13Enter the TC, TC amendment, SB or STC number which confirms compliance with RVSM aircraft airworthiness requirements.