Certificate for single common information service provider referred to in Article 14(3)

Implementing Regulation (EU) 2021/664

LOGO EASA or NAA as applicable

CERTIFICATE FOR SINGLE COMMON INFORMATION SERVICE PROVIDER

[CERTIFICATE NUMBER/ISSUE No]

Pursuant to Regulation (EU) …/…. (and to Regulation (EU) …/....), the [competent authority] hereby certifies

[NAME OF THE SINGLE COMMON INFORMATION SERVICE PROVIDER]

[ADDRESS OF THE SINGLE COMMON INFORMATION SERVICE PROVIDER]

as a single common information service provider.

This certificate is valid whilst the certified single common information service provider remains in compliance with Regulation (EU) …/… and the other applicable regulations and, when relevant, with the procedures in the singles common information service provider’s documentation as required by Regulation (EU)  …/…, Part-….

Subject to compliance with the foregoing conditions, this certificate shall remain valid unless it has been surrendered, limited, suspended or revoked.

Date of issue:

Signed:

[Competent authority]