Appendix 6

Form A
CA 40/CA 41
DGCA India
Page 1 of 2
License/Type Rating Skill Test/IR PPC Form
for Commercial Aeroplanes with AUW Rev 3 01 Jan 17
exceeding 5700 kgs
SIMULATOR LEVEL__
OPERATOR:
_______
TEST ON:
AEROPLANE/
DG/D TEST DATE TEST/FLIGHT
TIME DURATION:
TYPE OF TEST:
SKILL TEST ☐
Go Airlines IR ☐
SIMULATOR LOCATION:
(India) Ltd
AEROPLANE DAY/ NIGHT
_______
AEROPLANE/SIMULATOR D M YY ON/TAKE OFF
PPC ☐
OFF/LANDING
TYPE: REGISTRATION: D M
A320
PILOT UNDER CHECK: LICENSE NUMBER: ______
DE/EXAMINER: AUTHORISATION/LICENSE
NUMBER:
ATPL / CPL

CREW STATUS: SEAT OCCUPIED: Note: For assessment enter "S" (Satisfactory) , "U" (Unsatisfactory) OR NA (Not
TRAINEE/LICENSED applicable). Items marked "#" to be completed only on Simulator. “M” is mandatory for
skill test/PPC. “IR” is mandatory for instrument rating. Any engine-out exercises or
PIC/CO-PILOT LHS/RHS items marked # conducted on aeroplane are to be simulated only through touch drills.

EXERCISE S/U/NA
1 FLIGHT PREPARATION
1.1 Performance calculation
1.2 Aeroplane external visual inspection; location of each item and purpose of inspection NA
1.3 Cockpit inspection
1.4 M Use of checklists prior to starting engines, starting procedures, radio and navigation
1.5 Taxying in compliance with ATC or instructions of Examiner
1.6 M Pre-flight checks
2 TAKE-OFF(s)
2.1 Normal take offs with different flap settings. NA
2.2 IR Instrument take off; transition to instrument flight during rotation or immediately after airborne
2.3 ____________
Cross wind take-off (aeroplane, if practicable)
2.4 Take-off at maximum take-off AUW (actual or simulated maximum take-off AUW) NA
2.5 IR Simulated engine failure after V2
2.5.1 M IR # Simulated engine failure between V1 and V2
2.5.2 M # Rejected take-off at a reasonable speed before reaching V1
3 FLIGHT MANOEUVRES AND PROCEDURES
3.1 Turns with and without spoilers (as applicable) NA
3.2 # Tuck under and Mach buffets and other specific flight characteristics of the Aeroplane (e.g. Dutch Roll) NA
3.3 Normal operation of systems and control
3.4 Normal and abnormal operations of following systems (minimum of 3 M items shall be selected from
3.4 to 3.5 inclusive
____
3.4.0 M Engine (if___________
necessary propeller)
3.4.1 M Pressurisation and air- conditioning
3.4.2 M Pitot/static system
3.4.3 M Fuel system NA
3.4.4 M Electrical system NA
3.4.5 M Hydraulic system NA
3.4.6 M Flight control and Trim- system NA
3.4.7 M Anti- and de-icing system, Glare shield heating NA
3.4.8 M Autopilot/Flight director NA
3.4.9 M Stall warning devices or stall avoidance devices, and stability augmentation devices. NA
3.4.10 M Ground Proximity Warning System, Weather radar, Radio altimeter, Transponder.
NA
3.4.11 M Radios, Navigation equipment, Instruments, Flight Management System.
NA
3.4.12 M Landing gear and brake- system. NA

22
Rev 4 01st January 2017
 CA 40/CA 41
DGCA India
Page 2 of 2
License/Type Rating Skill Test/IR PPC
Form for Commercial Aeroplanes with Rev 4 29 Oct 18
AUW exceeding 5700 kgs
3.4.13 M Slat and flap system. NA
3.4.14 M Auxiliary Power Unit. NA
3.5 M # _____
ACAS/TCAS
3.6 Abnormal and emergency procedures (minimum of 3 M items shall be selected from 3.6.1 to 3.6.8 ____
Inclusive).
3.6.1 M # Fire drills e.g. Engine, APU, Cabin, Cargo compartment, Flight deck, Electrical Fires
including Evacuation.
3.6.2 M # Smoke control and removal. NA
3.6.3 M #
______
Engine failures, shut-down and restart, fuel jettison
3.6.4 M Recognition and Management of Threat and Error( For Issuance of ATPL/IR) NA
3.6.5 M # Windshear at Take Off and Landing.
3.6.6 M Cabin pressure failure/Emergency descent. NA
3.6.7 M Incapacitation of flight crew member.
3.6.8 Other emergency procedures as outlined in the appropriate Aeroplane Flight Manual. NA
3.7 Steep turns with 45° bank, 180° to 360° left and right. NA
3.8 # Early recognition and counter measures on approaching stall (up to activation of stall warning device) NA
3.8.1# Recovery from full stall or after activation of stall warning device in climb, cruise and approach
NA
3.9
configuration.
Instrument flight procedures: ____
3.9.1 M IR Adherence to departure and arrival routes and ATC instructions.
3.9.2 IR Holding procedures.
3.9.3 M IR ILS-approaches down to a decision height (DH) not less than 60 m (200 ft):
3.9.3.1 M IR manually, without flight director.
3.9.3.2 M IR manually, with flight director. (any one of 3.9.3.2 or 3.9.3.3) NA
3.9.3.3 M IR automatically, with Autopilot (see above)
3.9.3.4 M IR manually, with one engine simulated inoperative
3.9.4 M IR
___
NDB or VOR /LOC or RNAV approach down to the MDH/A.
NA
____
3.9.5 M IR Circling approach (if applicable) to a runway at least 90° off centerline from final approach
4 MISSED APPROACH PROCEDURES
4.1 IR Go-around with all engines operating after an ILS approach on reaching decision height.
4.2 IR Go – around with one engine simulated inoperative after an ILS approach on reaching DH (see also
3.9.3.4).

____
4.3 M IR Rejected landing at (50 ft) above runway threshold and go-around.
5 LANDING(s)
5.1 IR Normal landings also after an ILS approach with transition to visual flight on reaching DH.
5.2 # Landing with simulated jammed horizontal stabiliser in an any out-of-trim position.
5.3 ____________
Cross wind landings (aeroplane, if practicable).
5.4 Traffic pattern and landing without extended or with partly extended flaps and slats. NA
5.5 M Landing with critical engine simulated inoperative.
5.6 M # Landing with two engines simulated inoperative (for 3 and 4 engine aeroplanes) NA
6 LOW VISIBILITY OPERATIONS INCLUDING CAT II/III(if applicable)
6.1 M IR # RTO at minimum authorized RVR at a reasonable speed before reaching V1
6.2 M IR ILS approach using flight guidance system (checking for SOP, task sharing, standard calls etc)
6.3 M IR Go around - manual/automatic from DH/AH (due reduced RVR, ground/aircraft equipment failure etc)
6.4 M IR Landing(s) – manual/automatic from DH/AH with visual reference established
6.5 M # Take off in minimum T/O RVR <150m

OVERALL ASSESSMENT: SKILL TEST / IR PPC - PASS/FAIL (separate sheet for remarks in case of fail)
(Limitations: - Height ± 100' > 15 Sec, Direction ± 10°, Speed ± 10 kts except in approach phase when it would be +10 / -0 kts)

Pilot under Check _____

Rev 5 29th October 2018