May 2011 SI Amdt. 1

V. CATATANPENJAMINAN (MORTGAGE RECORDJ

(Pencatatan penjaminan ini dilakukan berdasarkan permintaan daninformasi yang diberikan oleh pemohon terhadap adanya suatu penjaminan, dilengkapi dengan akta Hipotek danakta Perjanjian Pinjaman dansural keterangan tentang penjaminan dari para pihak yang terlibat)

(Record ofMortgage ismade according lothe request and information submitted by applicant along w/tfi Mwtoage Deed and Loan Agreement and aknowledgement letter from eachpady)

Nama dan Alamat Penerima Jaminan:

Name and Addiess ct Afortgagee Inspektur

Inspector

Nomor sural pencalatan penjaminan:

Raterenced tellerol mortgagerecord

Tanggal: Dale VI. PENGHAPUSAN PENJAMINAN (RELEASE ofMORTGAGE)

Inspektur

Inspector

Nomorsurat penghapusan pencatatan penjaminan:

Referenced letter ol cancellation ofniolgage tecord

Tanggal:

Date

VII. CATATAN IDERA (IDERA RECORD) Nama Debitur:

Oeofor Name

Alamal (Address)

Inspektur Inspector NamaPihak yangdiberi Kuasaatau Orang yang Ditunjuk secara San":

Authorized Pailyof Certified Designee'

Alamal(Address):

Referensi Perjanjian:

Agreement made as Releience

Tanggal Persetujuan dan Pencatatan DAAO Form47-03 Date AgreedandLodaed ol DAAO Form47-03

VIII. PEMBATALAN IDERA (REVOCATION ol IDERA)

Inspektur Inspector Nomorsural pembatalan IDERA:

Referenced letter of revocation of IDERA

Tanggal: Dale

IX. PENGHAPUSAN TANDA PENDAFTARAN PESAWAT UDARA (CANCELLATION OF REGISTRATION) Nomor Persetujuan Penghapusan Tanda Pendaftaran:

Cancellation Registration Approval Number Tanggal:Dale

Nomor Pemberitahuan Penghapusan Tanda Pendallaran:

Confirmation Cancellation Registration Number Tanggal:_Dale

Tanggal Penghapusan Tanda Pendaftaran

Cancellation Registration Dale

Inspektur

inspector AlasanPenghapusan:

Reason tor Cancellation

Catalan (note) ' Coret yang tidak periu (Cross as required)

" Pilih yangiSSuai | fie* cc; e»ae eat)

A. BAGIAN II(Secr.on II)

PERPANJANGAN SERTIFIKAT PENDAFTARAN PESAWAT UDARA

(RENEWAL of CERTIFICATE OF REGISTRATION)

Tanggal

[Date}

Berlaku Sampai Dengan Nama Inspektur

(Validity) (Inspector Nme)

Tanda Tangan (Signature) Keterangan (Remarks) I DAAO Form 47-2B (04/11)

May 2011

_{SI 47-01 Amdt. 1}

BAGIANII(Secfionlf)

Lembar Lanjutan (continuationpage) : ' ->:.•

PERPANJANGAN SERTIFIKAT PENDAFTARAN PESAWAT UDARA

(RENEWAL of CERTIFICA TE OF REGISTRA TION)

Tanggal

(Date)

Berlaku Sampai Dengan

(Validity) Nama Inspeklur (InspectorName) Tanda Tangan (Signature) Keterangan (Remark)

\

.

i

DAAO Form 47-2B (04/11)

Appendix 7 - Application for Cancellation of Aircraft Registration,

DAAO Form 47-17

ta«&

KEMENTERIAN PERHUBUNGAN

MINISTRY OF TRANSPORTATION

DIREKTORAT JENDERAL PERHUBUNGAN UDARA

DIRECTORATE GENERAL OF CIVIL AVIATION

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARA

DIRECTORATE OF AIRWORTHINESSAND AIRCRAFT OPERATIONS

PERMOHONAN PENGHAPUSAN TANDA PENDAFTARAN PESAWAT UDARA

Application for Cancellation of Aircraft Registration

Tanda Pendaftaran

Registation Mark

Nomor Pendaftaran

Registration Number

Tipe Pesawat Udara

Aircraft Type

Nomor Seri

Serial Number

Nama Operator

Name of Operator

Nama & Alamat Pemilik

Nam & Address of Owner

Alasan Penghapusan"

Reason for Cancellation

Selesai Perjanjian Sewa Guna

Usaha

Expiration of lease agreement

Penghentian perjanjian yang

disepakati para pihak

Terminating agreement as agreed

upon each party

Rusak total akibat kecelakaan

Total loss during accident

Pergantian kepemilikan

Chance of Ownership

Akan didaftar di negara lain

Intended tobe register to another country

Tidak digunakan secara

permanen

Withdrawn from use

Sengaja dimsak

Intentionally destroyed

i

Melampirkan referensi : perjanjian'bukti kepemilikan.'keterargan rusak*

Attached reference: agreement/evidence ofownership /evidence ofreturn tocustody

Keterangan catatan penjaminan di DKUPPU**

Record of Mortgage filed with DAAO

Nomor Surat Penjaminan DKUPPU:

DAAO referenced letter

Ada

Yes

Tidak Ada

No

Melampirkan bukti selesai penjaminan (apabila ada) / pemyataan tidak dijaminkan (apabila tidak ada)*

Attached settlement ofmortgage (for a recorded mortgage) / statement ofno mortgage (for no recorded mortgage)

Melampirkan surat kuasa (apabila permohonan dilakukan oleh selain operator atau pemilik)

Attached Power ofAttorney (for application made byother than operator or owner)

Tanggal Efektif Penghapusan

Effective Cancellation Date

Dibuat Rangkap 2

Made In 2 copies

Coret yang tidak diperlukan

Cross as necessary

Beri tanda X pada kotak yang terkait

TickApplicable Box

Tempat:

Place

Tanggal:

date Nama: Name Jabatan: Title Meterai dan Cap Perusahaan

Tanda Tangan

Signature

May 2011

_{SI 47-01 Amdt. 1}

Appendix 6 - Application for Renewal of Certificate of Registration,

DAAO Form 47-13

KEMENTERIAN PERHUBUNGAN

MINISTRY OF TRANSPORTATION

DIREKTORAT JENDERAL PERHUBUNGAN UDARA

DIRECTORA TE GENERAL OF CIVIL A VIA TION

DIREKTORAT KELAIKAN UDARA DAN PENGOPERASIAN PESAWAT UDARA

DIRECTORA TE OF AIRWORTHINESS AND AIRCRAFT OPERATIONS

PERMOHONAN PERPANJANGAN SERTIFIKAT PENDAFTARAN

APPLICATION FOR RENEWAL OF CERTIFICATE OF REGISTRATION

A. DATA PESAWAT UDARA /AIRCRAFT DATA 01. Tanda Pendaftaran Pesawat Udara:

Aircraft Registration Marking

Masa berlaku Sertifikat Pendaftaran:

Validity of Cof R

02. Nomor Pendaftaran Pesawat udara:

AircraftRegistration Number

03. _04.

05. Nomordan Masa berlakuAsuransi Pesawat Udara (lampirkan)

Number and Validityof Insurance (attach)

Masa berlaku Sertifikat Kelaikudaraan:

Validity of Cof A

B. DATA OPERATOR PESAWATUDARA/ AIRCRAFT OPERATOR DATA

06 Nama Operator:

Operator's name

C DATA KEPEMILIKAN / OWNERSHIP DATA 08 10, Bukti Kepemilikan: Evidence of Ownership Pemilik: Owner

P. DASAR PENGUASAAN / TERM OFPOSSESSION'

07. Alamat Operator: Operator's Address 09. Tanggal : Dote 11. Alamat: Address 12 Referensi: Reference

Sewa Guna Usaha

Lecsing

Pembelian Bersyarat Conditional Sole 13. Perjanjian Sewa Guna Usaha (tanggal dan masa sewa):

Lease Agreement (date and leasing periods)

14. Perjanjian Pengikatan Hak Bersyarat (tanggal;

Title Reservation Agreement (date)

I 15. Nama Penyewa Baru (Lessor) / Penjual Bersyarat

(ConditionalSeller) / Lainnya (orrier)":

17. Marr.a Pemberi Sewa (lessee) / Pemoeli Bersvarat

(ConditionalBuyer) / Lainnya (other)':

E. ALASAN PERPANJANGAN C OF R / REASON FORRENEWAL*

16. Alamat:

•~d~re ss

A i a r a : : Address

19. Habis Masa Berlaku C of R Expiration of Cof R

Perubahan Pemilik/Pemberi sewa

Changes of Ownership/Lessor Lain-lain (tuliskan): Other (specify) Hilang/Rusak* Lost / destroyed 20. LampirkanReferensi C cf R/ BuktiKspemifikan / Pi

Attachreferencefor c of R/ Evidence afOwnersh p

,;-Keterangan k'ehilar.gan (atau Kerusakan)* . cgna of lost (c cestroyed.

Dalam halalasan perpanjangan adalah perubahan pen-,.k atau pe-rcerisewa, maka bagian Cdan Ddiisidata baru

In thecase reason for renewal is changeof owneror lessor, fill in column CandDwith thenew data

F, LAIN-LAIN / OTHERS " 20. Kepabeanan

Customs Clearance

Catatan :

Note

Coret yang tidak perlu Cross as necessary Pilih kotak yang sesuai

Tick applicable box

DAAO Form 47-13 (04/11) Impor Telap Permanent Import 2r Sen-er'a^a pc-ary .r-pzr. Lainnya (sebutkan) Other (specify)

Dibuat dengan sesungguhnya:

/ certify chat clt information are true and correct Tempat: Place Tanggal: Date Nama Name Jabatan: Title Melerai dan Cap Perusahaan Tanda Tangan Signature

Appendix 8 - Checklist Cancellation of Registration, DAAO Form 47-17

KEMENTRIAN PERHUBUNGAN

DIREKTORAT JENDERAL PERHUBUNGAN UDARA

DIREKTORAT KELAIKAN UDARA DAN

PENGOPERASIAN PESAWAT UDARA

JL. ME DAN MERDEKA BARAT NO. 8, JAKARTA PUSAT 10110 INDONESIA

TEL. : (62-21) 350.6664,350.6665 FAX.: (62-21) 350.6663

•• -:>•:•-•••:•

^s^^-v^'r^i^,-,--

P.O.BOX 3049, JAKARTA 10030. INDONESIA

CHECKLIST

CANCELLATION OF REGISTRATION

AircratType

:

Registration Mark

Serial Number :

Registration Number

:

1. Application of Deregistration, DAAO Form 47-17* (check one applicable box)

~\ a.

Requested by Operator

Name •

•

b.

Requested by Lessor

Mamo •

Name

I

Ic.

Requested by Owner

' ' Mama •_{Name :}

|

|d- Requested by authorised person* or certified designee* using IDERA (cross as applicable)

certificate ofdesignation (as applicable), please specify :

Form of IDERA, DAAO Form 47-03, dated :

2. Application issigned by 'company authorised' person.

Evidence :

3. Acknowledgement/Consent Letter to the Deregistration from parties other than applicant (not applicable

when it is requested using IDERA' (check any applicaale box)

I

[a. Operator

Name & Address : ~lb. Lessor

Name & Address :

I

|c. Sub Lessor

Name & Address :

id. Owner

Name & Address :

3. Power of Attorney (or other delegation form) when coresspondance made by attorney's of applicant •

Name of Attorney in Fact:

4- Reason of Cencellation* (check oneapplicable bet)

|

|a. Termination of Lease Agreement

|

|b- Default of contract (non performance) by lessee or debtor (IDERA)

|

|c- Transfer ofownership dated : 20 November 2010

^d. Total loss of aircraft during accident

Js. Permanently withdrawn from use of aircraft

I

|f-

Intentionally scrapped or destroyed of aircraft

I |g. Intended to be registered into other country

I |h. Airworthiness can not be maintained for more than 3years continuously

(when this condition occured, complete item 6, 7, 9, 10 only)

5. When item 4.d. ticked (total loss on accident), attached evidence of return to custody form KNKT

Reference :

DAAO Form 47-17A (04/1'

-May 2011

SI 47-01 Amdt. 1

6. Cancellation ofMortgage Record (for recorded mortgage)

a. Name of Mortgagor :

b.

Name of Mortgagee:

c. Date of Cancellation :

7. Statement of 'No liens against the aircraft or the aircraft is not under mortgage nor any liensf form

operator or owner.

8.

Deregistration Permit from Director General :

9. Deregistration Letter number:

10. Issue 'Notification Letter' to importing country (check address of registration office)

11. Entry information of deregistration on DAAO Form 47-2B Kartu Pendaftaran

12. Entry data on Deregistration Log Book

Data required for 'aircraft deregistration' has been checked and found :

•

SATISFACTORY

•UNSATISFACTORY

to meet the requirements.

J Letter or e-mail' (cross one) regarding the required data has been delivered (applicable for

UNSATISFACTORY condition, as an interim process).

I

I Deregistration statement is recommended to be issued.

|

| Data returned to PM (when deregistration statement has been issued) for filing.

L J

Name of Inspector

NOTE:

This check list (when fully completed) will substantiate as a report toKasubdit and Kasi

Correspondance letter or e-mail can be used as an evidence of processing the task

Data (other than original form) is strongly recommenced nelectronic oopy

DAAO Form 47-17A (04/11)