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CK CAPITALS using black or dark blue ink. Unique No. (to be completed by CAA) Please read attached Guidance Notes before completing this form. FALSE REPRESENTATION STATEMENT It is an offence under Article 231 of the Air Navigation Order 2009 to make, with intent to deceive, any false representation for the purpose of procuring the grant, issue, renewal or variation of any certificate, licence, approval, permission or other document. This offence is punishable on summary conviction by a fine up t.

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