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Licence No. [Handwritten, red ink] 104 (Provl.) [Provisional] 28/6/21.

(For Official use only.)

C.A. Form 1. a

[Stamped in purple ink 'AIR SERVICES' with handwritten reference number 'P22 [-] 4 [-] 43' written inside stamp.]

[Bold text:] DEPARTMENT OF DEFFENCE.

Air Navigation Regulations 1921.

[Main heading:] APPLICATION FOR PILOT'S LICENCE.

[Italicised:] (See conditions printed on the back of this form.)

[Box next to headings, titled 'For Official use only'.]

No. of Application[:] 43

Fee received [blank space for date.]

Class [blank space for response.]

Approved [blank space for date.]

Signed [blank space for signature.]

[End of box.]

[This portion of the record is in a question answer format. The questions are typed and answers are handwritten in faded black ink]

1. Full name of Applicant

(To be written in BLOCK CAPITALS.)

CHARLES EDWARD KINGSFORD-SMITH [surname underlined in red.]

2. Nationality

Australian

3. Nationality of Parents at their Birth

(Father)[:] Australian

(Mother)[:] Australian

4. Whether Applicant is married[:]

No

5. Postal Address[:]

"Kuranda" Arabella St. Longueville Sydney.

6. Whether qualified as an R.A.F., A.F.C., or A.A.F. Pilot[:]

R.A.F.

7. Whether Licence is for flying aircraft carrying passengers, or goods, for hire or reward[:]

Yes

8. Name and type of class, or classes, of machine for which licence is required [:]

two & three seaters such as AVRO., BRISTOL., DH419 etc.

also multi-engined [sic] machines — HANDLEY PAGE, BLACKBURN "KANGAROO" etc.

I hereby declare that the above particulars are true in every respect.

Signature of Applicant[:] [Handwritten signature:] E Kingsford Smith

Date of Application[:] 2nd June 1921. [Date handwritten.]

[Handwritten annotation in black ink:] Recd. [received] 30/6/21.

[Footer:] (This Form, when filled up and accompanied by documents, &c., set out on the back of this form, should addressed to—The Secretary, Air Council, Department of Defence, Melbourne.)

C.2530.

[A box along the right edge of the page, oriented landscape, with the following printed text:]

[Bold heading:] For Official use only.

License issued to [blank] by [blank] on [blank] 19 [blank].

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[Bold heading:] PILOT'S LICENCES FOR PASSENGER OR GOODS AIRCRAFT.

1. Persons applying for a pilot's licence to fly passenger or goods aircraft for hire or renewal will be required to—

(a) Pass a medical examination carried out under the control of the Minister for Defence;

(b) Produce a certificate of competency issued by a responsible authority duly authorized by the Minister for Defence to grant such certificates, or be qualified as R.A.F., A.F.C., or A.A.F. pilots;

(c) Submit proof of recent reasonable flying experience on the class of machine for which the licence is required, or, failing such proof, undergo a practical test.

N.B.—Applicants should complete this form and forward it with—

(1) Certificate of competency (b), if not qualified as an R.A.F., A.F.C., or A.A.F. pilot;

(2) Proof of recent flying on the class of machine for which the licence is required, and/or on any class of machine (e.g., certified copy of the last ten hours flying extracted from log-book, giving date, machine, course; number of passengers, if any, and time in air);

(3) Two unmounted photographs of applicant, not larger than 3 inches by 2 inches.

[Dividing line.]

[Bold heading:] PILOT'S PRIVATE LICENCES.

2. Persons applying for a pilot's licence to fly machine, other than passenger or goods aircraft for hire or reward, must either be qualified as R.A.F., A.F.C., or A.A.F. pilots, or produce a certificate of competency issued by a responsible authority duly authorized by the Minister for Defence.

N.B.—Applications must be accompanied by—

(1) Certificate of competency, if not qualified as an R.A.F., A.F.C, or A.A.F. pilot;

(2) Two unmounted photographs of applicant, not larger than 3 inches by 2 inches.