Regulation (EU) 2022/1358
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When the Forms of this Annex are issued in a language other than English they shall include an English translation. |
The EASA (‘European Union 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 24B Restricted certificate of airworthiness
Appendix II EASA Form 45B Restricted noise certificate
Appendix III EASA Form 52B Aircraft statement of conformity
Appendix IV EASA Form 53B Certificate of release to service
Appendix I — EASA Form 24B — Restricted certificate of airworthiness
Regulation (EU) 2022/1358
Appendix I
Restricted Certificate of Airworthiness — EASA Form 24B
Competent authority logo
RESTRICTED CERTIFICATE OF AIRWORTHINESS (DECLARED)
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[Member State of registry] [COMPETENT AUTHORITY OF THE MEMBER STATE] |
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1. Nationality and registration marks |
2. Manufacturer and manufacturer’s designation of aircraft |
3. Aircraft serial number |
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4. Categories |
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5. This restricted certificate of airworthiness is issued pursuant to Article 18(2)(a) of Regulation (EU) 2018/1139 in respect of the above-mentioned aircraft which is considered to be airworthy when maintained and operated in accordance with the foregoing and the pertinent operating limitations.
In addition to above, the following restriction applies: This restricted certificate of airworthiness is issued on the basis of a declaration of design compliance made in accordance with Regulation (EU) No 748/2012 and is valid and recognised in all EU Member States without further requirements or evaluation. This certificate does not comply with all of the applicable Standards of Annex 8 to the Convention on International Civil Aviation and therefore may not be valid for international air navigation over non-EU Member States, unless approved by the state(s) being overflown.
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Date of issue: |
Signature: |
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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. |
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EASA Form 24B — Issue 1
This certificate shall be carried on board during all flights.
Appendix II — EASA Form 45B — Restricted noise certificate
Regulation (EU) 2022/1358
Appendix II
Restricted noise certificate — EASA Form 45B
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For use by the Member State of registry |
1. Member State of registry |
3. Document No: |
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2. RESTRICTED NOISE CERTIFICATE (DECLARED) |
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4. Registration marks:
……………………………………………... |
5. Manufacturer and designation of aircraft:
…………………………………………… |
6. Aircraft serial No:
………………………………………….. |
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7. Designation of engine:
……………………………………………………………………... |
8. Designation of propeller:
…………………………………………………………………… |
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9. Maximum take-off mass (kg)
……………………………………………… |
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10. Additional modifications incorporated for the purpose of compliance with the applicable noise certification standards: ………………………………………………………………………………………………………………………………………………………… |
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11. Noise certification standard:
………………………………………………………… |
12. Take-off noise level:
………………………… |
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Remarks |
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13. This restricted noise certificate is issued pursuant to Article 9 of Regulation (EU) 2018/1139, in respect of the above-mentioned aircraft, which is declared by the declarant of a declaration of design compliance in accordance with Annex Ib (Part 21 Light) to Regulation (EU) No 748/2012 to comply with the indicated noise standard when maintained and operated in accordance with the relevant requirements and operating limitations.
14. Date of issue ………………………………………….15. Signature ………….……………………………………….. |
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EASA Form 45B — Issue 1
Appendix III —EASA Form 52B — Aircraft statement of conformity
Regulation (EU) 2022/1358
Appendix III
Aircraft statement of conformity — EASA Form 52B
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AIRCRAFT STATEMENT OF CONFORMITY |
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1. State of manufacture |
2. [MEMBER STATE] A Member of the European Union |
3. Statement Ref. No: |
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4. Organisation |
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5. Aircraft type |
6. Type certificate/Declaration of design compliance refs: |
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7. Aircraft registration or mark |
8. Production organisation identification No |
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9. Engine/propeller details 5 |
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10. Modifications and/or service bulletins 1 |
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11. Airworthiness directives |
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12. Concessions |
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13. Exemptions, waivers or derogations 1 |
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14. Remarks |
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15. Restricted/certificate of airworthiness |
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16. Additional requirements |
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17. Statement of conformity It is hereby certified that this aircraft conforms fully to the: □ type-certified design; or □ declared design data and to the items above in boxes 9, 10, 11, 12 and 13. The aircraft is in a condition for safe operation. The aircraft has been satisfactorily tested in flight. |
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18. Signed |
19. Name |
20. Date (d/m/y) |
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21. Declared or approved production organisation reference (if applicable) |
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EASA Form 52B — Issue 1
Instructions for the use of the ‘Aircraft statement of conformity — EASA Form 52B’
1. PURPOSE AND SCOPE
1.1. The purpose of the aircraft statement of conformity (EASA Form 52B) issued under Subpart G or Subpart R of Section A of Annex Ib (Part 21 Light) or under Subpart G of Section A of Annex I (Part 21) is to enable the production organisation to apply for an individual aircraft certificate of airworthiness or restricted certificate of airworthiness from the competent authority of the Member State of registry.
2. GENERAL
2.1. The statement of conformity must comply with the model format, 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 pre-printed or computer generated, but in either case, the printing of lines and characters must be clear and legible. Pre-printed 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 should 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 and its installed products are approved or the declaration of design compliance is registered with the Agency.
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 these individual items may be included in block 10 or in the approved type design or the declared aircraft 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 should be pre-printed 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 pre-printed 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 pre-printed. Logos, etc., are permitted if the logo, etc., can be contained within the block.
Block 5 The aircraft type in full as defined in the type certificate and its associated data sheet or the declared aircraft design as registered by the Agency
Block 6 The type-certificate reference numbers and issue for the subject aircraft or the registration number of the declaration of design compliance
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 defined in the relevant type certificate and its associated data sheet or the registered declaration of design compliance. Their production organisation identification/reference number and the associated location should also be stated.
Block 10 Approved or declared design changes to the aircraft definition
Block 11 A listing of all the applicable airworthiness directives (or equivalent) and a declaration of compliance with the airworthiness directives, together with a description of the method of compliance of the subject individual aircraft, including products and installed parts, appliances and equipment. Any future compliance requirement time should be stated.
Block 12 Approved or declared unintentional deviations from the approved type design or declared design, sometimes referred to as ‘concessions’, ‘divergences’ or ‘non-conformances’.
Block 13 Only agreed or declared 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 the certificate of airworthiness requested.
Block 16 Additional requirements such as those notified by an importing country should 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, should be kept on file by the production organisation. The report should 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 either:
1. point (b) of point 21L.A.124; or
2. point (f) of point 21L.A.273,
to ensure that the aircraft conforms to the applicable design data, and is in a condition for safe operation.
The listing of items provided (or made available) to satisfy the aspects of this statement that relate to the safe operation of the aircraft should be kept on file by the production organisation.
Block 18 The statement of conformity may be signed by the person that is authorised to do so by the production organisation in accordance with point (d) of point 21L.A.125 or point (b) of point 21L.A.273. A rubber stamp signature should not be used.
Block 19 The name of the person that signs the statement should be typed or printed in a legible form.
Block 20 The date on which the statement of conformity is signed should be given.
Block 21 The competent authority approval reference should be quoted.
Appendix IV — EASA Form 53B — Certificate of release to service
Regulation (EU) 2022/1358
Appendix IV
Certificate of release to service — EASA Form 53B
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CERTIFICATE OF RELEASE TO SERVICE
[PRODUCTION ORGANISATION NAME]
Production organisation reference:
Certificate of release to service in accordance with 21L.A.126(e) or 21L.A.273(8) of Annex Ib (Part 21 Light) to Regulation (EU) No 748/2012 (delete as appropriate).
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 21L.A.126(e) or 21L.A.273(8) of Annex Ib (Part 21 Light) to Regulation (EU) No 748/2012 (delete as appropriate) 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 53B — Issue 1
COMPLETION INSTRUCTIONS
The Block BRIEF DESCRIPTION OF WORK PERFORMED appearing in EASA FORM 53B should include a reference to the approved data used to perform the work.
The Block LOCATION appearing in EASA FORM 53B refers to the location where the maintenance has been performed, not to the location of the facilities of the organisation (if different).