Change Control Form

1. Define Change:
Change Title:

Implementation
Change Sponsor:
Date:
A – CEO Approval
Type Approval B – CMC Approval
Functional Area:
Required:
C – Head of the
relevant department
PLEASE READ INSTRUCTIONS ON LAST PAGE OF THIS FORM BEFORE COMPLETING

2. Change Process:
A. Description of Change:
CHANGE SPONSOR TO COMPLETE

Reason for Change:

Stakeholders:

Risk Profile Assessment:

B. (in consultation with GM
SSQA or delegate)

Extreme

High
CHANGE SPONSOR TO

Medium
COMPLETE

Low

Very Low

Risk Assessment Attachments:

Form PA/OF 7900 Issue 1.0 Page 1 of 1

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01 Jul 2020
 Pacific Airlines Change Control Form

C.
CHANGE SPONSOR
Overview of the Implementation Plan:

TO COMPLETE

3. Change Management Portfolio Documentation:

Other Attachments (as applicable): Attachment No.

Business Case/Project Plan

Risk Assessment

Draft Document Amendments

CAAV Certification

Compliance Statement/Impact Review

Other (please specify)

NAME and TO BE FORWARDED

SIGNATURE: ..............................................................................................................
TO MANAGER

Form PA/OF 7900 Issue 1.0 Page 2 of 2

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01 Jul 2020
 Pacific Airlines Change Control Form

4. Stakeholder Endorsement:
(CROSS OUT IF NOT APPLICABLE)

Endorsed By:
........................................................................................................................................................
General Manager Flight Operations and Chief Pilot (or delegate)

Endorsed By:
........................................................................................................................................................
General Manager of SSQA (or delegate)

Endorsed By:
........................................................................................................................................................
General Manager of Ground Operations (or delegate)

Endorsed By:
........................................................................................................................................................
Chief Commercial Officer (or delegate)

Endorsed By:
........................................................................................................................................................
Chief Accountant (or delegate)

Endorsed By:
........................................................................................................................................................
Chief Technical Officer (or delegate)

Endorsed By:
........................................................................................................................................................
Chief Operating Officer (or delegate)

Endorsed By:
........................................................................................................................................................

5. Approval:
Category C
Approved By: ........................................................................................................................................................

Category B
Approved By: ........................................................................................................................................................
Chair Change Management Committee

Category A
Approved By: ........................................................................................................................................................
Chief Executive Officer

Form PA/OF 7900 Issue 1.0 Page 3 of 3

Controlled form
01 Jul 2020
 Pacific Airlines Change Control Form

6. Regulatory Application/Notification:
(Applicable for Major or Moderate Changes identified in Safety Risk Endorsement) DATE

Prepared By:

Forwarded To:

Regulator Approval/Acceptance:

7. Document Control:
INITIALS DATE

Close change on Change Management Forum

Uploaded to FTL

Compliance Statement Updated

Master Risk Register updated

INSTRUCTIONS FOR COMPLETION

1. Change Sponsor to drive the Change Management process and complete Sections 1 and 2.
2. Change Sponsor to identify Change Management Portfolio documentation in Section 3. All attachments
to be compiled numbered and forwarded with submission to functional Manager for endorsement.
3. Upon gaining endorsement, Change Sponsor to forward submission to Safety Risk Group for
endorsement.

Form PA/OF 7900 Issue 1.0 Page 4 of 4

Controlled form
01 Jul 2020