Application for Loss of Licence Cover The following application is for cover under the Australian Air Pilots Mutual Benefit Fund (the Fund or MBF) Rules, in accordance with the Product Disclosure Statement in place at the date your cover commences.

1. Proof of Australian citizenship (Australian passport/birth certificate or certificate of citizenship), OR, if NOT an Australian citizen, foreign passport and proof of Australian residency (visa documents, driver licence or utilities bill with Australian address)
2. Australian Class 1 Medical Certificate
3. Proof of employment (e.g. recent payslip)
4. Any medical reports for conditions declared in the Health Declaration
5. Payment

DO NOT PROCEED IF YOU DO NOT HAVE THE ABOVE READY FOR PROCESSING

You must meet the following eligibility criteria as set out in Rule 2 (see link below).

• I am a full financial member of AFAP
• I hold a current Commercial Pilot Licence or higher
• I derive my principal source of income from piloting activities
• I hold a current Australian Class 1 Medical Certificate
• I am aged less than 56 years
• I am an Australian citizen, or an Australian resident

For the cost of your cover and benefit options, please use our MBF Quote.

By proceeding, you are acknowledging that you have read the PDS and MBF Rules to ensure this is the right product for you.

• Current MBF Rules
• Current MBF PDS