Commission Regulation (EU) No 748/2012 of 3 August 2012 laying down implementing rules for the airworthiness and environmental certification of aircraft and related products, parts and appliances, as well as for the certification of design and production organisations (recast) Text with EEA relevance

• (d) With regard to the certification and oversight of the organisation’s compliance with point 21.A.239A of this Annex, in addition to complying with points (a) to (c) of this point, the competent authority shall review any approval granted under point IS.D.OR.200(e) of the Annex to Delegated Regulation (EU) 2022/1645 following the applicable oversight audit cycle and whenever changes are implemented in the scope of work of the organisation.

21.B.432   Oversight programme

• (a) The competent authority shall establish and maintain an oversight programme covering the oversight activities required to comply with point 21.B.431(a).

• (b) The oversight programme shall take into account the specific nature of the organisation, the complexity of its activities, the results of past certification or oversight activities, or both, and it shall be based on the assessment of the associated risks. It shall include, within each oversight planning cycle:
• 1. assessments, audits and inspections, including, where appropriate:
• (i) management system assessments and process audits;
• (ii) product, UAS and CMU audits of a relevant sample of the design and certification of the products, parts, appliances, UAS, CMUs and CMU components that are within the scope of work of the organisation;
• (iii) sampling of the work performed;
• (iv) unannounced inspections;
• 1. meetings convened between the head of the design organisation and the competent authority to ensure that both parties remain informed of all significant issues.

• (c) The oversight planning cycle shall not exceed 24 months.

• (d) Notwithstanding point (c), the oversight planning cycle may be extended to 36 months if the competent authority has established that during the previous 24 months:
• 1. the organisation has demonstrated that it can effectively identify aviation safety hazards and manage the associated risks;
• 1. the organisation has continuously demonstrated compliance with point 21.A.247 and has full control over all changes to the design management system;
• 1. no level 1 findings have been issued;
• 1. all corrective actions have been implemented within the time period that was accepted or extended by the competent authority as provided for in point 21.B.433(d). Notwithstanding point (c), the oversight planning cycle may be further extended to a maximum of 48 months if, in addition to the conditions laid down in points (d)(1) to (d)(4), the organisation has established, and the competent authority has approved, an effective continuous system for reporting to the competent authority on the safety performance and regulatory compliance of the organisation itself.

• (e) The oversight planning cycle may be reduced if there is evidence that the safety performance of the organisation has decreased.

• (f) The oversight programme shall include records of the dates when assessments, audits, inspections and meetings are due, and when assessments, audits, inspections and meetings have been effectively carried out.

• (g) At the completion of each oversight planning cycle, the competent authority shall issue a recommendation report on the continuation of the approval, reflecting the results of the oversight.

21.B.433   Findings and corrective actions; observations

• (a) The competent authority shall have a system in place to analyse findings for their safety significance.

• (b) A level 1 finding shall be issued by the competent authority when a non-compliance is detected with the applicable requirements of Regulation (EU) 2018/1139 and its delegated and implementing acts, with the organisation’s procedures and manuals, or with the design organisation’s certificate including the terms of approval, which may lead to uncontrolled non-compliances and to a potential unsafe condition. The level 1 findings shall also include:
• 1. any failure to grant the competent authority access to the organisation’s facilities referred to in point 21.A.9 during normal operating hours and after two written requests;
• 1. obtaining the design organisation approval or maintaining its validity by falsification of the submitted documentary evidence;
• 1. any evidence of malpractice or fraudulent use of the design organisation approval;
• 1. failure to appoint a head of the design organisation pursuant to point 21.A.245(a).

• (c) A level 2 finding shall be issued by the competent authority when any non-compliance is detected with the applicable requirements of Regulation (EU) 2018/1139 and its delegated and implementing acts, with the organisation’s procedures and manuals, or with the certificate including the terms of approval, which is not classified as a level 1 finding.

• (d) When a finding is detected during oversight or by any other means, the competent authority shall, without prejudice to any additional action required by Regulation (EU) 2018/1139 and its delegated and implementing acts, communicate in writing the finding to the organisation and request corrective action to address the non-compliance(s) identified. Where a level 1 finding directly relates to a product, the competent authority shall inform the competent authority of the Member State in which the aircraft is registered.
• 1. If there are any level 1 findings, the competent authority shall:
• (i) grant the organisation a corrective action implementation period that is appropriate to the nature of the finding and that in any case shall not be more than 21 working days. That period shall commence from the date of the written communication of the finding to the organisation requesting corrective action to address the non-compliance(s) identified;
• (ii) assess the corrective action plan and implementation plan proposed by the organisation, and if it concludes that they are sufficient to address the non-compliance(s), accept them;
• (iii) if the organisation fails to submit an acceptable corrective action plan, or fails to perform the corrective action within the time period accepted by the competent authority, take immediate and appropriate action to prohibit or limit the activities of the organisation involved and, if appropriate, take action to revoke the design organisation approval or to limit or suspend it in whole or in part, depending upon the extent of the level 1 finding, until successful corrective action has been taken by the organisation.
• 1. If there are any level 2 findings, the competent authority shall:
• (i) grant the organisation a corrective action implementation period that is appropriate to the nature of the finding, and that in any case shall initially not be more than 3 months. That period shall commence from the date of the written communication of the finding requesting corrective action. At the end of this period, and subject to the nature of the finding, the competent authority may extend the 3-month period provided that a corrective action plan has been agreed by the competent authority;
• (ii) assess the corrective action and the implementation plan proposed by the organisation, and if it concludes that they are sufficient to address the non-compliance(s), accept them;
• (iii) if the organisation fails to submit an acceptable corrective action plan, or fails to perform the corrective action within the time period accepted or extended by the competent authority, the finding shall be raised to level 1 and action shall be taken as laid down in point (d)(1).

• (e) The competent authority may issue observations for any of the following cases not requiring level 1 or level 2 findings:
• 1. for any item whose performance has been assessed to be ineffective;
• 1. when it has been identified that an item has the potential to cause a non-compliance under points (b) or (c);
• 1. when suggestions or improvements are of interest for the overall safety performance of the organisation. The observations issued under this point shall be communicated in writing to the organisation and recorded by the competent authority.

21.B.435   Changes in the design management system

• (a) Upon receiving an application for a significant change to the design management system, the competent authority shall verify the organisation’s compliance with the applicable requirements of Regulation (EU) 2018/1139 and its delegated and implementing acts, before issuing the approval.

• (b) The competent authority shall establish the conditions under which the organisation may operate during the change unless the competent authority determines that the design organisation approval needs to be suspended.

• (c) When it is satisfied that the organisation complies with the applicable requirements of Regulation (EU) 2018/1139 and its delegated and implementing acts, the competent authority shall approve the change.

• (d) Without prejudice to any additional enforcement measures, if the organisation implements a significant change to the design management system without having received the approval of the competent authority pursuant to point (c), the competent authority shall consider the need to suspend, limit or revoke the organisation’s certificate.

• (e) For non-significant changes to the design management system, the competent authority shall include the review of such changes in its continuing oversight in accordance with the principles set forth in point 21.B.431. If any non-compliance is found, the competent authority shall notify the organisation, request further changes and act in accordance with point 21.B.433.

21.B.435A   Changes to the information security management system

• (a) For changes managed and notified to the competent authority in accordance with the procedure set out in point IS.D.OR.255(a) of the Annex (Part-IS.D.OR) to Delegated Regulation (EU) 2022/1645, the competent authority shall include the review of such changes in its continuing oversight in accordance with the principles laid down in point 21.B.431. If any non-compliance is found, the competent authority shall notify the organisation thereof, request further changes and act in accordance with point 21.B.433.

• (b) For other changes requiring an application for approval in accordance with point IS.D.OR.255(b) of the Annex (Part-IS.D.OR) to Delegated Regulation (EU) 2022/1645:
• (1) upon receiving the application for the change, the competent authority shall check the organisation’s compliance with the applicable requirements before issuing the approval;
• (2) the competent authority shall establish the conditions under which the organisation may operate during the implementation of the change;
• (3) if it is satisfied that the organisation complies with the applicable requirements, the competent authority shall approve the change.

SUBPART K —   PARTS, APPLIANCES, AND CONTROL AND MONITORING UNIT (CMU) COMPONENTS

Administrative procedures established by the Agency shall apply.

(SUBPART L — NOT APPLICABLE)

SUBPART M —   REPAIRS

21.B.450   Amendments to the type-certification basis for a repair design approval

The Agency shall designate any amendments to the type-certification basis incorporated by reference in, as applicable, either the type-certificate, the supplemental type-certificate or the APU ETSO authorisation, which the Agency considers necessary for maintaining a level of safety equal to that previously established and notify them to the applicant for a repair design.

21.B.453   Issuance of a repair design approval

• (a) The Agency shall issue an approval of a major repair design, provided that:
• 1. the applicant has demonstrated its capability in accordance with point 21.A.432B;
• 1. the applicant has complied with point 21.A.433;
• 1. the Agency, through its verification of the demonstration of compliance in accordance with the level of involvement established pursuant to point 21.B.100(a), has not found any non-compliance with the type-certification basis and the applicable environmental protection requirements; and
• 1. no feature or characteristic has been identified that may make the product, the UAS or the CMU unsafe for the use for which certification is requested.

• (b) The Agency shall issue an approval of a minor repair design, provided that the applicant has complied with points 2 and 4 of point (a) and provided that the Agency, through its verification of the demonstration of compliance in accordance with the level of involvement pursuant to point 21.B.100(b), has not found any non-compliance with the type-certification basis and the applicable environmental protection requirements.

(SUBPART N — NOT APPLICABLE)

SUBPART O —   EUROPEAN TECHNICAL STANDARD ORDER AUTHORISATIONS

21.B.480   Issuance of an ETSO authorisation

The Agency shall issue an ETSO authorisation, provided that:

• (a) the applicant has complied with point 21.A.606;

• (b) the Agency, through its verifications of the demonstration of compliance in accordance with the level of involvement pursuant to point 21.B.100(b), has not found any non-compliance with the technical conditions of the applicable ETSO or with deviations therefrom approved in accordance with point 21.A.610, if any; and

• (c) no feature or characteristic has been identified that may make the article unsafe for the uses for which certification is requested.

SUBPART P —   PERMIT TO FLY

21.B.520   Investigation

• (a)The competent authority shall perform sufficient investigation activities to justify the issuance, or revocation of the permit to fly.

• (b)The competent authority shall prepare evaluation procedures covering at least the following elements:

• 1. evaluation of the eligibility of the applicant;

• 1. evaluation of the eligibility of the application;

• 1. evaluation of the documentation received with the application;

• 1. inspection of the aircraft and for unmanned aircraft, of the CMU;

• 1. approval of the flight conditions in accordance with point 21.A.710(b).

21.B.525   Issuance of a permit to fly

The competent authority shall issue a permit to fly (EASA Form 20a, see Appendix III) without undue delay:

• (a) upon presentation of the data required by point 21.A.707; and

• (b) when the flight conditions referred to in point 21.A.708 have been approved in accordance with point 21.A.710; and

• (c) when the competent authority, through its own investigations, which may include inspections, or through procedures agreed with the applicant, is satisfied that the aircraft conforms to the design defined under point 21.A.708 before flight.

SUBPART Q —   IDENTIFICATION OF PRODUCTS, PARTS, APPLIANCES, CONTROL AND MONITORING UNITS (CMUs) AND CMU COMPONENTS

Administrative procedures established by the Agency shall apply.

Appendices

EASA FORMS

When the Forms of this Annex are issued in a language other than English they shall include an English translation.

The EASA (‘European Aviation Safety Agency’) Forms referred to in the appendices to this Part shall have the following obligatory features. Member States shall ensure that the EASA Forms they issue are recognisable and shall be responsible for having those Forms printed.

Appendix I — EASA Form 1 Authorised release Certificate

Appendix II — Reserved

Appendix III — EASA Form 20a Permit to Fly

Appendix IV — EASA Form 20b Permit to Fly (issued by approved organisations)

Appendix V — EASA Form 24 Restricted Certificate of Airworthiness

Appendix VI — EASA Form 25 Certificate of Airworthiness

Appendix VII —  —————

Appendix VIII — EASA Form 52 Aircraft/Unmanned Aircraft System Statement of Conformity

Appendix IX — EASA Form 53 Certificate of Release to Service

Appendix X — EASA Form 55 Production Organisation Approval Certificate

Appendix XI — EASA Form 65 Letter of Agreement for production without production organisation approval

Appendix XII — Categories of flight test and associated flight test crew qualifications

Appendix I

Authorised Release Certificate — EASA Form 1 referred to in Annex I (Part 21)

Image omitted; see official source

Text of image

EASA FORM 1

13a. Certifies that the items identified above were manufactured in conformity to:

approved design data and are in a condition for safe operation

non-approved design data specified in block 12

14a.

Part 145.A.50 Release to Service

Other regulation specified in block 12

Certifies that unless otherwise specified in block 12, the work identified in block 11 and described in block 12, was accomplished in accordance with Part 145 and in respect to that work the items are considered ready for release to service.

13b. Authorised Signature

13c. Approval/ Authorisation Number

14b. Authorised Signature

14c. Certificate/Approval Ref. No

13d. Name

13e. Date (dd mmm yyyy)

14d. Name

14e. Date (dd mmm yyyy)

USER/INSTALLER RESPONSIBILITIES

This certificate does not automatically constitute authority to install the item(s).

Where the user/installer performs work in accordance with regulations of an airworthiness authority different than the airworthiness authority specified in block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts items from the airworthiness authority specified in block 1.

Statements in blocks 13a and 14a do not constitute installation certification. In all cases aircraft maintenance records must contain an installation certification issued in accordance with the national regulations by the user/installer before the aircraft may be flown.

EASA Form 1-21 Issue 2.

Instructions for the use of EASA Form 1

These instructions relate only to the use of the EASA Form 1 for production purposes. Attention is drawn to Appendix II to Annex I (Part-M) to Regulation (EU) No 1321/2014 and to Appendix III to Annex I (Part-ML.UAS) to Delegated Regulation (EU) 2024/1107 which cover the use of the EASA Form 1 for maintenance purposes.

1. PURPOSE AND USE

• 1.1.The primary purpose of the certificate is to declare the airworthiness of new aviation engines, propellers, parts, appliances, CMUs and CMU components (‘the item(s)’).

• 1.2.Correlation must be established between the certificate and the item(s). The originator must retain a certificate in a form that allows verification of the original data.

• 1.3.The certificate is acceptable to many airworthiness authorities, but this may be dependent on bilateral agreements and/or the policy of the airworthiness authority.

• 1.4.The certificate is not a delivery or shipping note.

• 1.5.Aircraft are not to be released using the certificate.

• 1.6.The certificate does not constitute an approval to install the item in a particular aircraft, engine, propeller, or in a particular CMU in case of CMU components, but helps the end user determine its airworthiness approval status.

• 1.7.A mixture of production released and maintenance released items is not permitted on the same certificate.

• 1.8.A mixture of items certified in conformity with ‘approved data’ and to ‘non-approved data’ is not permitted on the same certificate.

2. GENERAL FORMAT

• 2.1.The certificate must comply with the format attached including block numbers and the location of each block. The size of each block may however be varied to suit the individual application, but not to the extent that would make the certificate unrecognisable.

• 2.2.The certificate must be in ‘landscape’ format, but the overall size may be significantly increased or decreased so long as the certificate remains recognisable and legible. If in doubt, consult the competent authority.

• 2.3.The user/installer responsibility statement can be placed on either side of the form.

• 2.4.All printing must be clear and legible to permit easy reading.

• 2.5.The certificate may either be pre-printed or computer generated but in either case the printing of lines and characters must be clear and legible and in accordance with the defined format.

• 2.6.The certificate should be in English, and if appropriate, in one or more other languages.

• 2.7.The details to be entered on the certificate may be either machine/computer printed or hand-written using block letters and must permit easy reading.

• 2.8.Limit the use of abbreviations to a minimum, to aid clarity.

• 2.9.The space remaining on the reverse side of the certificate may be used by the originator for any additional information but must not include any certification statement. Any use of the reverse side of the certificate must be referenced in the appropriate block on the front side of the certificate.

3. COPIES

• 3.1.There is no restriction in the number of copies of the certificate sent to the customer or retained by the originator.

4. ERROR(S) ON A CERTIFICATE

• 4.1.If an end user finds an error(s) on a certificate, they must identify it (them) in writing to the originator. The originator may issue a new certificate if they can verify and correct the error(s).

• 4.2.The new certificate must have a new tracking number, signature and date.

• 4.3.The request for a new certificate may be honoured without re-verification of the item(s) condition. The new certificate is not a statement of current condition and should refer to the previous certificate in block 12 by the following statement: ‘This certificate corrects the error(s) in block(s) [enter block(s) corrected] of the certificate [enter original tracking number] dated [enter original issuance date] and does not cover conformity/condition/release to service’. Both certificates should be retained according to the retention period associated with the first.

5. COMPLETION OF THE CERTIFICATE BY THE ORIGINATOR

• Block 1 Approving competent authority/Country State the name and country of the competent authority under whose jurisdiction this certificate is issued. When the competent authority is the Agency, only ‘EASA’ must be stated.

• Block 2 EASA Form 1 header ‘AUTHORISED RELEASE CERTIFICATE EASA FORM 1’

• Block 3 Form Tracking Number Enter the unique number established by the numbering system/procedure of the organisation identified in block 4; this may include alpha/numeric characters.

• Block 4 Organisation Name and Address Enter the full name and address of the production organisation (refer to EASA Form 55 Sheet A) or natural or legal persons releasing the item(s) covered by this certificate. Logos, etc. of the organisation are permitted if they can be contained within the block.

• Block 5 Work Order/Contract/Invoice To facilitate customer traceability of the item(s), enter the work order number, contract number, invoice number, or similar reference number.

• Block 6 Item Enter line item numbers when there is more than one line item. This block permits easy cross-referencing to the Remarks in block 12.

• Block 7 Description Enter the name or description of the item. Preference should be given to the term used in the instructions for continued airworthiness or maintenance data (e.g. Illustrated Parts Catalogue, Aircraft Maintenance Manual, Service Bulletin, Component Maintenance Manual).

• Block 8 Part Number Enter the part number as it appears on the item or tag/packaging. In case of an engine, propeller or CMU, the type designation may be used.

• Block 9 Quantity State the quantity of items.

• Block 10 Serial Number If the item is required by regulation to be identified with a serial number, enter it here. Additionally, any other serial number not required by regulation may also be entered. If there is no serial number identified on the item, enter ‘N/A’.

• Block 11 Status/Work Enter either ‘PROTOTYPE’ or ‘NEW’. Enter ‘PROTOTYPE’ for:
• (i) the production of a new item in conformity with non-approved design data;
• (ii) the production of a new item in conformity with design data that has not yet been declared by a declarant in accordance with Subpart C, F or N of Section A of Annex Ib (Part 21 Light);
• (iii) re-certification by the organisation identified in block 4 of the previous certificate after alteration or rectification work on an item, prior to entry into service, (e.g. after incorporation of a design change, correction of a defect, inspection or test, or renewal of shelf life). Details of the original release and the alteration or rectification work are to be entered in block 12; Enter ‘NEW’ for:
• (i) the production of a new item in conformity with the approved design data;
• (ii) the production of a new item in conformity with design data declared by the declarant in accordance with Subpart C, F or N of Section A of Annex Ib (Part 21 Light);
• (iii) re-certification by the organisation identified in block 4 of the previous certificate after alteration or rectification work on an item, prior to entry into service, (e.g. after incorporation of a design change, correction of a defect, inspection or test, or renewal of shelf-life). Details of the original release and the alteration or rectification work are to be entered in block 12;
• (iv) re-certification by the product manufacturer or the organisation identified in block 4 of the previous certificate of items from ‘prototype’ (conformity only to non-approved data) to ‘new’ (conformity to approved data and in a condition for safe operation), subsequent to approval of the applicable design data, provided that the design data has not changed. For certified products, the following statement must be entered in block 12: ‘RE-CERTIFICATION OF ITEMS FROM “PROTOTYPE” TO “NEW”: THIS DOCUMENT CERTIFIES THE APPROVAL OF THE DESIGN DATA [INSERT TC/STC NUMBER, REVISION LEVEL], DATED [INSERT DATE IF NECESSARY FOR IDENTIFICATION OF REVISION STATUS], TO WHICH THIS ITEM (THESE ITEMS) WAS (WERE) MANUFACTURED.’ The box ‘approved design data and are in a condition for safe operation’ should be marked in block 13a; For aircraft subject to a declaration of design compliance in accordance with Subpart C of Section A of Annex Ib (Part 21 Light), the following statement must be entered in block 12: ‘RE-CERTIFICATION OF ITEMS FROM “PROTOTYPE” TO “NEW”: THIS DOCUMENT CERTIFIES THE DECLARATION OF THE DESIGN DATA [INSERT DECLARATION REFERENCE, REVISION LEVEL], DATED [INSERT DATE IF NECESSARY FOR IDENTIFICATION OF REVISION STATUS], TO WHICH THIS ITEM (THESE ITEMS) WAS (WERE) MANUFACTURED.’
• (v) the examination of a previously released new item prior to entry into service in accordance with a customer-specified standard or specification (details of which and of the original release are to be entered in block 12) or to establish airworthiness (an explanation of the basis of release and details of the original release are to be entered in block 12).

• Block 12 Remarks Describe the work identified in block 11, either directly or by reference to supporting documentation, necessary for the user or installer to determine the airworthiness of item(s) in relation to the work being certified. If necessary, a separate sheet may be used and referenced from EASA Form 1. Each statement must clearly identify which item(s) in block 6 it relates to. If there is no statement, state ‘None’. Enter the justification for release to non-approved design data in block 12 (e.g. pending type certificate, for test only, pending approved data). If the item has been produced in accordance with design data that has not yet been declared by the declarant in accordance with Subpart C, F or N of Section A of Annex Ib (Part 21 Light), then the following statement shall be included in Block 12: ‘PENDING DECLARATION OF DESIGN COMPLIANCE IN ACCORDANCE WITH SUBPART C, F OR N of Section A of Annex Ib (Part 21 Light)’ If the item has been produced in accordance with design data that has been declared by the declarant in accordance with Subpart C, F or N of Section A of Annex Ib (Part 21 Light), then the following statement shall be included in Block 12: ‘PRODUCED IN CONFORMITY WITH THE DESIGN DATA OF A DECLARATION OF DESIGN COMPLIANCE IN ACCORDANCE WITH SUBPART C, F OR N of Section A of Annex Ib (Part 21 Light)’ If printing the data from an electronic EASA Form 1, any data not appropriate in other blocks should be entered in this block.

• Block 13a Mark only one of the two boxes:
• 1. Mark the ‘approved design data and are in a condition for safe operation’ box if the item(s) was (were) manufactured using approved design data and found to be in a condition for safe operation.
• 1. Mark the ‘non-approved design data specified in block 12’ box if the item(s) was (were) manufactured using applicable non-approved design data. This box shall also be marked when the item has been produced in conformity with design data that has been declared in accordance with Subpart C, F and N of Section A of Annex Ib (Part 21 Light). Identify the data in block 12 (e.g. pending type certificate, for test only, pending approved data, conformity to design data from a declaration of design compliance in accordance with Subpart C, F or N of Section A of Annex Ib (Part 21 Light). Mixtures of items released against approved and non-approved design data are not permitted on the same certificate.

• Block 13b Authorised Signature This space shall be completed with the signature of the authorised person. Only persons specifically authorised under the rules and policies of the competent authority are permitted to sign this block. To aid recognition, a unique number identifying the authorised person may be added.

• Block 13c Approval/Authorisation Number Enter the approval/authorisation number/reference. This number or reference is issued by the competent authority for approved or declared production organisations (for parts produced under Annex Ib (Part 21 Light). If the organisation has produced a part that conforms to design data declared by a declarant in accordance with Subpart C, F or N of Section A of Annex Ib (Part 21 Light) and the organisation is not an approved or a declared production organisation, then they should enter the following statement: ‘PRODUCED UNDER SUBPART R of Section A of Annex Ib (Part 21 Light)’

• Block 13d Name Enter the name of the person signing block 13b in a legible form.

• Block 13e Date Enter the date on which block 13b is signed, the date must be in the format dd = 2 digit day, mmm = first 3 letters of the month, yyyy = 4 digit year.

• Block 14a-14e General Requirements for blocks 14a-14e: Not used for production release. Shade, darken, or otherwise mark to preclude inadvertent or unauthorised use. User/Installer Responsibilities Place the following statement on the certificate to notify end users that they are not relieved of their responsibilities concerning installation and use of any item accompanied by the form: ‘THIS CERTIFICATE DOES NOT AUTOMATICALLY CONSTITUTE AUTHORITY TO INSTALL. WHERE THE USER/INSTALLER PERFORMS WORK IN ACCORDANCE WITH REGULATIONS OF AN AIRWORTHINESS AUTHORITY DIFFERENT THAN THE AIRWORTHINESS AUTHORITY SPECIFIED IN BLOCK 1, IT IS ESSENTIAL THAT THE USER/INSTALLER ENSURES THAT HIS/HER AIRWORTHINESS AUTHORITY ACCEPTS ITEMS FROM THE AIRWORTHINESS AUTHORITY SPECIFIED IN BLOCK 1. STATEMENTS IN BLOCKS 13A AND 14A DO NOT CONSTITUTE INSTALLATION CERTIFICATION. IN ALL CASES AIRCRAFT MAINTENANCE RECORDS MUST CONTAIN AN INSTALLATION CERTIFICATION ISSUED IN ACCORDANCE WITH THE NATIONAL REGULATIONS BY THE USER/INSTALLER BEFORE THE AIRCRAFT MAY BE FLOWN.’

Appendix III

Permit to Fly — EASA Form 20a

Competent authority logo	PERMIT TO FLY	PERMIT TO FLY
[^E0014]	[^E0014]
This permit to fly is issued pursuant to Regulation (EU) 2018/1139 and certifies that the aircraft is capable of safe flight for the purpose and within the conditions listed below, and is valid in all Member States. This permit to fly is also valid for flights to and within nonMember States provided a separate approval is obtained from the competent authorities of those States:	This permit to fly is issued pursuant to Regulation (EU) 2018/1139 and certifies that the aircraft is capable of safe flight for the purpose and within the conditions listed below, and is valid in all Member States. This permit to fly is also valid for flights to and within nonMember States provided a separate approval is obtained from the competent authorities of those States:	1. Nationality and registration marks:
2. Aircraft manufacturer/type: [for unmanned aircraft, please insert control and monitoring unit model and designation]	2. Aircraft manufacturer/type: [for unmanned aircraft, please insert control and monitoring unit model and designation]	3. Serial No:
4. The permit to fly covers: [purpose in accordance with point 21.A.701(a)]	4. The permit to fly covers: [purpose in accordance with point 21.A.701(a)]	4. The permit to fly covers: [purpose in accordance with point 21.A.701(a)]
5. Holder: [in case of a permit to fly issued for the purpose of point 21.A.701(a)(15), this should state: ‘the registered owner]	5. Holder: [in case of a permit to fly issued for the purpose of point 21.A.701(a)(15), this should state: ‘the registered owner]	5. Holder: [in case of a permit to fly issued for the purpose of point 21.A.701(a)(15), this should state: ‘the registered owner]
6. Conditions/remarks:	6. Conditions/remarks:	6. Conditions/remarks:
7. Validity period:	7. Validity period:	7. Validity period:
8. Place and date of issue:	8. Place and date of issue:	9. Signature of the competent authority representative:
EASA Form 20a – Issue 2	EASA Form 20a – Issue 2	EASA Form 20a – Issue 2

For use by the State of registry.

Appendix IV

Permit to Fly (issued by approved organisations) – EASA Form 20b

The Member State of the competent authority that has issued the organisation approval under which the permit to fly is issued; or ‘EASA’ when the approval is issued by EASA.	PERMIT TO FLY	PERMIT TO FLY
Name and address of the organisation that issues the permit to fly.	Name and address of the organisation that issues the permit to fly.	[^E0015]
This permit to fly is issued pursuant to Regulation (EU) 2018/1139 and certifies that the aircraft is capable of safe flight for the purpose and within the conditions listed below, and is valid in all Member States. This permit to fly is also valid for flights to and within non-Member Statesthird countries provided a separate approval is obtained from the competent authorities of those States.	This permit to fly is issued pursuant to Regulation (EU) 2018/1139 and certifies that the aircraft is capable of safe flight for the purpose and within the conditions listed below, and is valid in all Member States. This permit to fly is also valid for flights to and within non-Member Statesthird countries provided a separate approval is obtained from the competent authorities of those States.	1. Nationality and registration marks:
2. Aircraft manufacturer/type: [for unmanned aircraft, please insert control and monitoring unit model and designation]	2. Aircraft manufacturer/type: [for unmanned aircraft, please insert control and monitoring unit model and designation]	3. Serial No:
4. The permit to fly covers: [purpose in accordance with point 21.A.701(a)]	4. The permit to fly covers: [purpose in accordance with point 21.A.701(a)]	4. The permit to fly covers: [purpose in accordance with point 21.A.701(a)]
5. Holder: [organisation that issues the permit to fly]	5. Holder: [organisation that issues the permit to fly]	5. Holder: [organisation that issues the permit to fly]
6. Conditions/remarks:	6. Conditions/remarks:	6. Conditions/remarks:
7. Validity period:	7. Validity period:	7. Validity period:
8. Place and date of issue:	8. Place and date of issue:	9. Authorised signature: Name: Approval Reference No:
EASA Form 20b – Issue 2	EASA Form 20b – Issue 2	EASA Form 20b – Issue 2

For use by the organisation approval holder.

Appendix V

Restricted Certificate of Airworthiness — EASA Form 24

Competent authority LOGO

RESTRICTED CERTIFICATE OF AIRWORTHINESS

[^E0016]	[Member State of registry] [COMPETENT AUTHORITY OF THE MEMBER STATE]	[Member State of registry] [COMPETENT AUTHORITY OF THE MEMBER STATE]	[^E0016]
1. Nationality and registration marks	2. Manufacturer and manufacturer’s designation of aircraft	2. Manufacturer and manufacturer’s designation of aircraft	3. Aircraft serial number
4. Categories	4. Categories	4. Categories	4. Categories
5. This restricted certificate of airworthiness is issued pursuant to [^E0017] [the Convention on International Civil Aviation dated 7 December [1944] and [Regulation (EU) 2018/1139 of the European Parliament and of the Council] in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. In addition to the above, the following restrictions apply: (5) (8) [The aircraft may be used in international navigation notwithstanding the above-mentioned restrictions]. Remarks: [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This restricted certificate of airworthiness is issued pursuant to [^E0017] [the Convention on International Civil Aviation dated 7 December [1944] and [Regulation (EU) 2018/1139 of the European Parliament and of the Council] in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. In addition to the above, the following restrictions apply: (5) (8) [The aircraft may be used in international navigation notwithstanding the above-mentioned restrictions]. Remarks: [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This restricted certificate of airworthiness is issued pursuant to [^E0017] [the Convention on International Civil Aviation dated 7 December [1944] and [Regulation (EU) 2018/1139 of the European Parliament and of the Council] in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. In addition to the above, the following restrictions apply: (5) (8) [The aircraft may be used in international navigation notwithstanding the above-mentioned restrictions]. Remarks: [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This restricted certificate of airworthiness is issued pursuant to [^E0017] [the Convention on International Civil Aviation dated 7 December [1944] and [Regulation (EU) 2018/1139 of the European Parliament and of the Council] in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. In addition to the above, the following restrictions apply: (5) (8) [The aircraft may be used in international navigation notwithstanding the above-mentioned restrictions]. Remarks: [for unmanned aircraft, please insert control and monitoring unit model and designation]
Date of issue:	Date of issue:	Signature:	Signature:
6. This restricted certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This restricted certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This restricted certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This restricted certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.
EASA Form 24 — Issue 3	EASA Form 24 — Issue 3	EASA Form 24 — Issue 3	EASA Form 24 — Issue 3

For use by the State of registry.

Delete as applicable.

This restricted certificate of airworthiness shall be carried on board during all flights.

Appendix VI

Certificate of Airworthiness — EASA Form 25

Competent authority LOGO

CERTIFICATE OF AIRWORTHINESS

[^E0018]	[Member State of registry] [COMPETENT AUTHORITY OF THE MEMBER STATE]	[Member State of registry] [COMPETENT AUTHORITY OF THE MEMBER STATE]	[Member State of registry] [COMPETENT AUTHORITY OF THE MEMBER STATE]	[^E0018]
1. Nationality and registration marks	2. Manufacturer and manufacturer’s designation of aircraft	2. Manufacturer and manufacturer’s designation of aircraft	2. Manufacturer and manufacturer’s designation of aircraft	3. Aircraft serial number
4. Categories	4. Categories	4. Categories	4. Categories	4. Categories
5. This certificate of airworthiness is issued pursuant to the Convention on International Civil Aviation dated 7 December 1944 and Regulation (EU) 2018/1139 of the European Parliament and of the Council in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. Limitations/Remarks: (7) [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This certificate of airworthiness is issued pursuant to the Convention on International Civil Aviation dated 7 December 1944 and Regulation (EU) 2018/1139 of the European Parliament and of the Council in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. Limitations/Remarks: (7) [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This certificate of airworthiness is issued pursuant to the Convention on International Civil Aviation dated 7 December 1944 and Regulation (EU) 2018/1139 of the European Parliament and of the Council in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. Limitations/Remarks: (7) [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This certificate of airworthiness is issued pursuant to the Convention on International Civil Aviation dated 7 December 1944 and Regulation (EU) 2018/1139 of the European Parliament and of the Council in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. Limitations/Remarks: (7) [for unmanned aircraft, please insert control and monitoring unit model and designation]	5. This certificate of airworthiness is issued pursuant to the Convention on International Civil Aviation dated 7 December 1944 and Regulation (EU) 2018/1139 of the European Parliament and of the Council in respect of the above-mentioned aircraft which is considered airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations. Limitations/Remarks: (7) [for unmanned aircraft, please insert control and monitoring unit model and designation]
Date of issue:	Date of issue:	Signature:
6. This certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.	6. This certificate of airworthiness is valid unless revoked by the competent authority of the Member State of registry. A current airworthiness review certificate shall be attached to this certificate.
EASA Form 25 — Issue 3	EASA Form 25 — Issue 3	EASA Form 25 — Issue 3	EASA Form 25 — Issue 3	EASA Form 25 — Issue 3

For use by the State of registry.

This certificate of airworthiness shall be carried on board during all flights.

Appendix VII

For use by State of registry	For use by State of registry	For use by State of registry	1. State of registry	1. State of registry	1. State of registry	1. State of registry	1. State of registry	1. State of registry	3. Document No:	3. Document No:
2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE	2. NOISE CERTIFICATE
4. Registration marks:	4. Registration marks:	5. Manufacturer and manufacturer’s designation of the aircraft:	5. Manufacturer and manufacturer’s designation of the aircraft:	5. Manufacturer and manufacturer’s designation of the aircraft:	5. Manufacturer and manufacturer’s designation of the aircraft:	5. Manufacturer and manufacturer’s designation of the aircraft:	5. Manufacturer and manufacturer’s designation of the aircraft:	6. Aircraft serial No:	6. Aircraft serial No:	6. Aircraft serial No:
…	…	…	…	…	…	…	…	…	…	…
7. Manufacturer and manufacturer’s designation of the engine(s):	7. Manufacturer and manufacturer’s designation of the engine(s):	7. Manufacturer and manufacturer’s designation of the engine(s):	7. Manufacturer and manufacturer’s designation of the engine(s):	7. Manufacturer and manufacturer’s designation of the engine(s):	7. Manufacturer and manufacturer’s designation of the engine(s):	8. Manufacturer and manufacturer’s designation of the propeller(s) [^E0019]:	8. Manufacturer and manufacturer’s designation of the propeller(s) [^E0019]:	8. Manufacturer and manufacturer’s designation of the propeller(s) [^E0019]:	8. Manufacturer and manufacturer’s designation of the propeller(s) [^E0019]:	8. Manufacturer and manufacturer’s designation of the propeller(s) [^E0019]:
…	…	…	…	…	…	…	…	…	…	…
9. Maximum take-off mass (kg):	9. Maximum take-off mass (kg):	10. Maximum landing mass (kg) [^E0019]:	10. Maximum landing mass (kg) [^E0019]:	10. Maximum landing mass (kg) [^E0019]:	10. Maximum landing mass (kg) [^E0019]:	10. Maximum landing mass (kg) [^E0019]:	10. Maximum landing mass (kg) [^E0019]:	11. Noise certification standard:	11. Noise certification standard:	11. Noise certification standard:
…	…	…	…	…	…	…	…	…	…	…
12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …	12. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: …
13. Lateral/full-power noise level [^E0019] :	14. Approach noise level [^E0019]:	14. Approach noise level [^E0019]:	14. Approach noise level [^E0019]:	15. Flyover noise level [^E0019]:	15. Flyover noise level [^E0019]:	15. Flyover noise level [^E0019]:	16. Overflight noise level [^E0019]:	16. Overflight noise level [^E0019]:	16. Overflight noise level [^E0019]:	17. Take-off noise level [^E0019]:
…	…	…	…	…	…	…	…	…	…	…
Remarks:	Remarks:	Remarks:	Remarks:	Remarks:	Remarks:	Remarks:	Remarks:	Remarks:	Remarks:	Remarks:
18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.	18. This noise certificate is issued pursuant to Annex 16, Volume I to the Convention on International Civil Aviation, signed in Chicago on 7 December 1944, and Article 14(1) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft, which is considered to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.
19. Date of issue: …	19. Date of issue: …	19. Date of issue: …	19. Date of issue: …	19. Date of issue: …	20. Signature: …	20. Signature: …	20. Signature: …	20. Signature: …	20. Signature: …	20. Signature: …

These boxes may be omitted depending on the noise certification standard.

EASA Form 45 – Issue 2

Appendix VIII

Aircraft/Unmanned Aircraft System statement of conformity – EASA Form 52

AIRCRAFT/UNMANNED AIRCRAFT SYSTEM STATEMENT OF CONFORMITY	AIRCRAFT/UNMANNED AIRCRAFT SYSTEM STATEMENT OF CONFORMITY	AIRCRAFT/UNMANNED AIRCRAFT SYSTEM STATEMENT OF CONFORMITY	AIRCRAFT/UNMANNED AIRCRAFT SYSTEM STATEMENT OF CONFORMITY
1. State of manufacture	2. [MEMBER STATE] [^E0020] A Member of the European Union [^E0021]	2. [MEMBER STATE] [^E0020] A Member of the European Union [^E0021]	3. Statement reference No:
4. Organisation	4. Organisation	4. Organisation	4. Organisation
5. Aircraft type	5. Aircraft type	6. Type-certificate reference No:	6. Type-certificate reference No:
7. Aircraft registration or mark	7. Aircraft registration or mark	8. Production organisation identification No:	8. Production organisation identification No:
9. Engine/propeller/control and monitoring unit details [^E0022]	9. Engine/propeller/control and monitoring unit details [^E0022]	9. Engine/propeller/control and monitoring unit details [^E0022]	9. Engine/propeller/control and monitoring unit details [^E0022]
10. Modifications and/or service bulletins [^E0022]	10. Modifications and/or service bulletins [^E0022]	10. Modifications and/or service bulletins [^E0022]	10. Modifications and/or service bulletins [^E0022]
11. Airworthiness directives	11. Airworthiness directives	11. Airworthiness directives	11. Airworthiness directives
12. Concessions	12. Concessions	12. Concessions	12. Concessions
13. Exemptions, waivers or derogations [^E0022]	13. Exemptions, waivers or derogations [^E0022]	13. Exemptions, waivers or derogations [^E0022]	13. Exemptions, waivers or derogations [^E0022]
14. Remarks	14. Remarks	14. Remarks	14. Remarks
15. Certificate of airworthiness	15. Certificate of airworthiness	15. Certificate of airworthiness	15. Certificate of airworthiness
16. Additional requirements	16. Additional requirements	16. Additional requirements	16. Additional requirements
17. Statement of conformity It is hereby certified that the aircraft/unmanned aircraft system fully conforms to the type-certified design and to the items in Blocks 9, 10, 11, 12 and 13. The aircraft is in a condition for safe operation. The aircraft has been satisfactorily tested in flight.	17. Statement of conformity It is hereby certified that the aircraft/unmanned aircraft system fully conforms to the type-certified design and to the items in Blocks 9, 10, 11, 12 and 13. The aircraft is in a condition for safe operation. The aircraft has been satisfactorily tested in flight.	17. Statement of conformity It is hereby certified that the aircraft/unmanned aircraft system fully conforms to the type-certified design and to the items in Blocks 9, 10, 11, 12 and 13. The aircraft is in a condition for safe operation. The aircraft has been satisfactorily tested in flight.	17. Statement of conformity It is hereby certified that the aircraft/unmanned aircraft system fully conforms to the type-certified design and to the items in Blocks 9, 10, 11, 12 and 13. The aircraft is in a condition for safe operation. The aircraft has been satisfactorily tested in flight.
18. Signed	19. Name	19. Name	20. Date (dd/mm/yyyy)
21. Production organisation approval reference	21. Production organisation approval reference	21. Production organisation approval reference	21. Production organisation approval reference
EASA Form 52 — Issue 4	EASA Form 52 — Issue 4	EASA Form 52 — Issue 4	EASA Form 52 — Issue 4

Or ‘EASA’, if EASA is the competent authority.

Delete for non-EU Member States or EASA.

Delete as applicable.

Instructions for the use of the aircraft/unmanned aircraft system statement of conformity – EASA Form 52

1. PURPOSE AND SCOPE

• 1.1.The use of the aircraft/unmanned aircraft system statement of conformity issued by a production organisation that produces under Part 21 Section A Subpart F is described in point 21.A.130 and in the related acceptable means of compliance (AMC).

• 1.2.The purpose of the aircraft/unmanned aircraft system statement of conformity (EASA Form 52) issued under Part 21 Section A Subpart G is to enable the holder of an appropriate production organisation approval certificate to exercise the privilege to obtain an individual aircraft certificate of airworthiness and, if requested, a certificate of noise from the competent authority of the Member State of registry.

2. GENERAL

• 2.1.The statement of conformity must comply with the model, including the block numbers and the location of each block. The size of each block may, however, be varied to suit the individual application, but not to the extent that would render the statement of conformity unrecognisable. If in doubt, consult the competent authority.

• 2.2.The statement of conformity must be either preprinted or computer generated, but in either case, the printing of lines and characters must be clear and legible. Preprinted wording is permitted in accordance with the attached model, but no other certification statements are permitted.

• 2.3.The completion of the statement may be either machine/computer printed or handwritten, using block letters to allow for easy reading. English, and where relevant, one or more of the official language(s) of the issuing Member State, are acceptable.

• 2.4.A copy of the statement and all the referenced attachments are to be retained by the approved production organisation.

3. COMPLETION OF THE STATEMENT OF CONFORMITY BY THE ORIGINATOR

• 3.1.There must be an entry in all blocks to render the document a valid statement.

• 3.2.A statement of conformity may not be issued to the competent authority of the Member State of registry unless the design of the aircraft/unmanned aircraft system, its installed products, and for unmanned aircraft systems, the CMU, are approved.

• 3.3.The information required in blocks 9, 10, 11, 12, 13 and 14 may be by reference to separate identified documents held on file by the production organisation, unless the competent authority agrees otherwise.

• 3.4.This statement of conformity is not intended to include those items of equipment that may be required to be fitted in order to satisfy the applicable operational rules. However, some of those individual items may be included in Block 10 or in the approved type design. Operators are, therefore, reminded of their responsibility to ensure compliance with the applicable operational rules for their own particular operations.

Block 1	Enter the name of the State of manufacture.
Block 2	The competent authority that issues the statement of conformity under its authority.
Block 3	A unique serial number must be preprinted in this block for statement control and traceability purposes. An exception is in the case of a computer-generated document: the number need not be preprinted where the computer is programmed to produce and print a unique number.
Block 4	The full name and the address of the location of the organisation that issues the statement. This block may be preprinted. Logos, etc., are permitted if the logo, etc., can be contained within the block.
Block 5	The aircraft type in full as specified in the type-certificate and its associated data sheet.
Block 6	The type-certificate reference numbers and issue for the subject aircraft.
Block 7	If the aircraft is registered, then this mark will be the registration mark. If the aircraft is not registered, then this will be the mark that is accepted by the competent authority of the Member State and, if applicable, by the competent authority of a third country.
Block 8	The identification number assigned by the production organisation for control and traceability and product support purposes. This is sometimes referred to as a ‘production organisation serial number’ or ‘constructor’s number’.
Block 9	The engine type and the propeller type(s) in full, as specified in the relevant type certificate and its associated data sheet. Their production organisation identification number and the associated location must also be stated. For unmanned aircraft systems, the CMU type in full, as specified in the relevant type-certificate, its associated data sheet, and its production organisation identification number.
Block 10	Approved design changes to the aircraft definition.
Block 11	A listing of all the applicable airworthiness directives (or equivalent) and a declaration of compliance, together with a description of the method of compliance of the subject individual aircraft or unmanned aircraft system, including products and installed parts, appliances and equipment and, for unmanned aircraft systems, CMUs and CMU components. Any future compliance requirement time must be stated.
Block 12	Approved unintentional deviations from the approved type design, sometimes referred to as ‘concessions’, ‘divergences’ or ‘non-conformances’.
Block 13	Only agreed exemptions, waivers or derogations may be included here.
Block 14	Remarks. Any statement, information, particular data or limitation which may affect the airworthiness of the subject aircraft. If there is no such information or data, state ‘NONE’.
Block 15	Enter ‘certificate of airworthiness’, or ‘restricted certificate of airworthiness’, as requested.
Block 16	Additional requirements such as those notified by an importing country must be noted in this block.
Block 17	The validity of the statement of conformity is subject to the full completion of all the blocks on the form. A copy of the flight test report, together with any recorded defects and rectification details, must be kept on file by the production organisation approval holder. The report must be signed as satisfactory by the appropriate certifying staff and a flight crew member, e.g. the test pilot or the flight test engineer. The flight tests performed are those defined under the control of the quality management element of the production system, as established by point 21.A.139, in particular point (d)(2)(vi), to ensure that the aircraft conforms to the applicable design data, and is in a condition for safe operation. The listing of the items provided (or made available) to satisfy the aspects of this statement that relate to the safe operation of the aircraft must be kept on file by the production organisation approval certificate holder.
Block 18	The statement of conformity may be signed by the person that is authorised to do so by the production approval holder in accordance with point 21.A.145(d). A rubber stamp signature must not be used.
Block 19	The name of the person that signs the statement must be typed or printed in a legible form.
Block 20	The date on which the statement of conformity is signed must be given.
Block 21	The competent authority approval reference must be quoted.

Appendix IX

Image omitted; see official source

Text of image

CERTIFICATE OF RELEASE TO SERVICE

[APPROVED PRODUCTION ORGANISATION NAME]

Production organisation approval Reference:

Certificate of release to service in accordance with 21A.163(d).

Aircraft: …

Type: …

Constructor No/Registration: …

has been maintained as specified in Work Order: …

Brief description of work performed:

Certifies that the work specified was carried out in accordance with 21A.163(d) and in respect to that work the aircraft is considered ready for release to service and therefore is in a condition for safe operation.

Certifying Staff (name):

(signature):

Location:

Date: . . - . . - . . . . (day, month, year).

EASA Form 53

CERTIFICATE OF RELEASE TO SERVICE — EASA FORM 53

COMPLETION INSTRUCTIONS

The Block BRIEF DESCRIPTION OF WORK PERFORMED appearing in EASA FORM 53 should include reference to the approved data used to perform the work.

The Block LOCATION appearing in EASA FORM 53 refers to the location where the maintenance has been performed, not to the location of the facilities of the organisation (if different).

Appendix X

Production organisation approval certificate – EASA Form 55

Production organisation approval certificates referred to in Subpart G of Annex I (Part 21)

[MEMBER STATE] [^E0023] A Member of the European Union [^E0024] PRODUCTION ORGANISATION APPROVAL CERTIFICATE Reference: [MEMBER STATE CODE [^E0023] ].21G.XXXX Pursuant to Regulation (EU) 2018/1139 of the European Parliament and of the Council and to Commission Regulation (EU) No 748/2012, for the time being in force and subject to the conditions specified below, the [COMPETENT AUTHORITY OF THE MEMBER STATE] hereby certifies: [COMPANY NAME AND ADDRESS] as a production organisation in compliance with Section A of Annex I (Part 21) to Commission Regulation (EU) No 748/2012, is approved to produce products, parts, appliances, control and monitoring units and control and monitoring unit components listed in the attached approval schedule and issue the related certificates using the above references. CONDITIONS: 1. This approval is limited to what is specified in the enclosed terms of approval. 2. This approval is subject to compliance with the procedures specified in the approved production organisation exposition. 3. This approval is valid for as long as the approved production organisation remains in compliance with Annex I (Part 21) to Commission Regulation (EU) No 748/2012. 4. Subject to compliance with the foregoing conditions, this approval shall remain valid for an unlimited period of time unless it has previously been surrendered, superseded, suspended or revoked. Date of original issue: … Date of this revision: … Revision No: … Signed: … For the competent authority: [COMPETENT AUTHORITY IDENTIFICATION [^E0024]]
EASA Form 55a – Issue 4

Or ‘EASA’, if EASA is the competent authority.

Or ‘EASA’, if EASA is the competent authority.