As per ANO-66 AMC.66. A.20. (b)(2) /CAR-66 AMC.66. A.20.

(b)(2)

CERTIFYING STAFF EXPERIENCE LOG BOOK

NT-QA-022
ISSUE NO. 01, REV.NO. 04, DATE: 11/01/22

NAME:

EMPLOYEE ID:

DESIGNATION / SECTION:

AMEL NUMBER:

CERTIFICATION AUTHORIZATION NO.:

CONTACT NO.:

EMAIL ADDRESS:
 CERTIFYING STAFF EXPERIENCE LOG BOOK
NT-QA-022
REV.NO. 00, DATE: 01/10/19

Information recorded by the individual Certifying Staff in this Experience Log Book shall be linked to the qualification and scope of authorization. Experience should be recorded
systematically and in a manner which shall verify individual’s experience continuity both in maintenance experience and aircraft type experience.

A duly completed Experience Log Book is required to be submitted along with the application for Certification Authorization issuance/renewal/extension. This Experience Log book
shall be filled by the Certifying Staff working in Maintenance areas or company shop(s).
[[[[[[

This Experience Log Book must be filled progressively without discontinuity. The Record should be in a manner so that experience on all applicable aircraft would be confirmed as per
scope of certification authorization.

Column # 1: Date Date of the task / maintenance activity performed.

Column # 2: Equipment Aircraft Type e.g. A320 or Engine/APU Type e.g. CFM56 or Components e.g. Wheels / Battery etc.

Column # 3: Aircraft Registration Aircraft Registration Number for maintenance areas or component Nomenclature.

Column # 4: Category used/Rating Category e.g. A, B1 & B2

Column # 5: Operation Performed Operation(s) performed e.g. Transit, Daily, Weekly and ‘A’ checks, removal/installation of components,
servicing, troubleshooting, AD compliance etc.

Column # 6: Type of Activity Supervision/Release: Work supervised e.g. maintenance performed and certified. (Sign where applicable).
OJT: when maintenance activity observed or performed for obtaining of a certification authorization.

Column # 7: Validation Signature Signature and authority number of certifying staff (required only in the case of OJT).

Validation (Bottom of the page) Signature, name, date and stamp of the Manager (Concerned) signed when the page is completed.

The experience log book shall be filled by hand and in capital letters with the use of Permanent Ink. Details shall be legible and comprehensible. The abbreviations should be limited to
a minimum.

Note: Photo copy or Print of Experience Log book can be used for filling.
CERTIFYING STAFF EXPERIENCE LOG BOOK
NT-QA-022
REV.NO. 00, DATE: 01/10/19
 CERTIFYING STAFF EXPERIENCE LOG BOOK
NT-QA-022
REV.NO.03, DATE: 01/12/20

TYPE OF ACTIVITY VALIDATION

AIRCRAFT CATEGORY

SUPERVISION
SIGNATURE/

/ RELEASE
DATE EQUIPMENT REGISTRATION USED/ OPERATION PERFORMED
AUTHORITY NO.

OJT
(For Maintenance) RATING
(Only In Case Of OJT)

VALIDATION (SIGNATURE & DATE)

MAINTENANCE MANAGER: ________________________________ MANAGER SAFETY & QUALITY: ____________________________________

CERTIFYING STAFF EXPERIENCE LOG BOOK
NT-QA-022
REV.NO.03, DATE: 01/12/20