Personal Details
NAME _____________________________________________________________________________________________________________
CORRESPONDANCE ADDRESS: __________________________________________________________________________________________
___________________________________________________________________________________________
PERMANENT ADDRESS: ____________________________________________________________________________________________
____________________________________________________________________________________________
DOB: _____/_____/______
CONTACT DETAILS: _____________________,________________________
EMAIL ID: ______________________________________________________
LOG BOOK S/N __________________________________________________
PHOTO
Cat 1 [Basic] R☐ RPAS ☐ Auto ☐ N☐ Mi ☐ Sm ☐ Me ☐
(VLOS,
<400ft, H☐ RPAS ☐ Auto ☐ N☐ Mi ☐ Sm ☐ Me ☐
Day & Night,
Green Zone) A☐ RPAS ☐ Auto ☐ N☐ Mi ☐ Sm ☐ Me ☐
Cat 2 R☐ RPAS ☐ Auto ☐ N☐ Mi ☐ Sm ☐ Me ☐
[Special]
(BVLOS,
H☐ RPAS ☐ Auto ☐ N☐ Mi ☐ Sm ☐ Me ☐
<400ft,
Day & Night,
All Zones) A☐ RPAS ☐ Auto ☐ N☐ Mi ☐ Sm ☐ Me ☐
Cat 3 R☐ RPAS ☐ Auto ☐ Sm ☐ Me ☐ Sm ☐
[Advanced]
(BVLOS,
H☐ RPAS ☐ Auto ☐ Sm ☐ Me ☐ Sm ☐
<400ft,
Day & Night,
All Zones) A☐ RPAS ☐ Auto ☐ Sm ☐ Me ☐ Sm ☐
LICENCE DETAILS
UAS Category: R = Rotorcraft, H = Hybrid, A = Aeroplane
M: UAS DETAILS Name of UAV Name of UAV Route of Flight/Place Time of Operations
Duration
Y: Test Test of Operations
Pilot/ Pilot/
Engineer Engineer From–To Start End Duration
Date UIN/DAN Class Cat.
(Lat: Long) (UTC) (UTC) HH:MM
Brought Forward ───────────────────────────────────────────────────────────────────────────────
I hereby certify that entries in this log are true. Total this page
______________________________
Name of UAV Test Pilot/ Engineer ______________________________
Signature: ______________________________________________________________ Total till date
UAS Category: R = Rotorcraft, H = Hybrid, A = Aeroplane
UAS Class: N = Nano, Mi = Micro, Sm = Small, Me = Medium, La - Large
4
Instructional
Hours
Rotorcraft Hybrid Aeroplane Operational Condition Times
Night
Exercise/Remarks/
Performance (S/NS)
Dual RPIC Dual RPIC Dual RPIC CAT 1 CAT 2 CAT 3
(1) (2) (3) (4) (5) (6) Basic Special Advanced
S: Satisfactory / NS: Non – Satisfactory
CAT 1 [Basic] = (Small UAS, VLOS, < 400 ft, Day & Night, Green Zone)
CAT 2 [Special] = (Upto Medium UAS, BVLOS, > 400ft, Day & Night, All Zones)
CAT 3 [Advanced] = (Upto Large UAS, BVLOS, > 400ft, Day & Night, All Zones)