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Section A - Personal Details
ID Card Number *
Title *
Name *
Surname *
Door Name, Door Number & Building Entry Point Name
Street *
Locality *
Postcode *
Mobile Number *
Email Address *
Section B
Please fill in this form if you...
Part A - Reason for application (select one)
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Part B - General Company Information
Company Name *
Trading Name
Type of Business
AEO Certification Number
Company Registration Number
VAT Number
Telephone Number *
Registered Office Address *
Nature of Business *
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Handling Agent
Airline
Part C - Security Manager Details
Please give details...
Name *
Surname *
National ID Card Number / Passport Number *
Telephone
Mobile *
Designation *
Nationality *
Email Address *
Father Name *
Father Surname *
Mother Name *
Mother Maiden Name *
The nominated person must hold...
Home Address *
State/s of residence (other than Malta) for a period longer than 6 months during any of the last five years
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Country
Police Conduct
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Part D - Employment History
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Company of Employment
Contact Person
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Employment History Document
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Declaration
Part E - Data Protection
Declaration Data Protection
- please tick here
Part F - Declaration of commitments
Declaration Commitments
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PDF Copy of Form
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For Office Use
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Additional Remarks
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