Request for UAS Aerial Work Activity in Restricted Airspace

1. Activity

Activity

2. Work area and characteristics of the activity

Coordinates

Circular area within a radius of…

Maximum height above ground (AGL)

3. Company

Company name

Name of the pilot responsible for the operation

Address

Phone

Contact mobile during operation

Email:

4. Activity Dates

Period or day

Start Time (Indicate if it is Local time)

End Time (Indicate if it is Local time)

5. Aircraft (Add as many aircraft as necessary)

Aircraft

Record

6. Operator's Certificate of Conformity

I certify that the information contained in this form, as well as the attached documentation, is real, true and correct.

I certify that I have the necessary authorization to undertake the requested activity.

I certify that the personnel and/or material means used to carry out the activity comply with the requirements established by the General Directorate of Civil Aviation/AESA.

I certify that within a 2 km radius of the Ullastrell Heliport, I will maintain listening and coordinate with aircraft in flight on the 123.55Khz frequency.

7. Signature of the Operator's Representative

Full name

Place

Date

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