Annex FORM OF IRREVOCABLE DE-REGISTRATION AND EXPORT REQUEST AUTHORISATION
Annex referred to in Article XIII
To: [Insert Name of Registry Authority]
Re: Irrevocable De-Registration and Export Request Authorisation
The undersigned is the registered [operator] [owner]*1 of the [insert the airframe/helicopter manufacturer name and model number] bearing manufacturers serial number [insert manufacturer's serial number] and registration [number] [mark] [insert registration number/mark] (together with all installed, incorporated or attached accessories, parts and equipment, the "aircraft").
This instrument is an irrevocable de-registration and export request authorisation issued by the undersigned in favour of [insert name of creditor] ("the authorised party") under the authority of Article XIII of the Protocol to the Convention on International Interests in Mobile Equipment on Matters specific to Aircraft Equipment. In accordance with that Article, the undersigned hereby requests:
The rights in favour of the authorised party established by this instrument may not be revoked by the undersigned without the written consent of the authorised party.
Please acknowledge your agreement to this request and its terms by appropriate notation in the space provided below and lodging this instrument in [insert name of registry authority].
|[insert name of operator/owner]|
|Agreed to and lodged this||By: [insert name of signatory]|
|[insert date]||Its: [insert title of signatory]|
1 Select the term that reflects the relevant nationality registration criterion.
[insert relevant notational details]