Easa Form 1 - Authorised Release Certificate printable pdf download

1. Approving Competent Authority / Country

3. Form Tracking Number

AUTHORISED RELEASE CERTIFICATE

B527

EASA FORM 1

4. Organisation Name and Address

1731 KETTNER BLVD

Telephone:

619-702-3112

5. Work Order/Contract/Invoice

SAN DIEGO

JB527

DEMO COMPANY USA

Fax:

619-702-3522

Work Order No:

CA92101

E-mail:

6. Item

7. Description

8. Part No

9. Qty

10. Serial/Batch No.

11. Status/Work

RECORDER UNIT VOIC

A100

12. Remarks

D U P L I C A T E

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

14a.

Part 145A.50 Release to Service

Other regulation specified in block 12

Certifies that unless otherwise specified in block 12, the work identified in

approved design data and are in condition for safe operation

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

non-approved design data specified in block 12

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)

JOHN DOE

EASA Form 1 - Issue 2

USER/INSTALLER RESPONSIBILITIES

This certificate does not automatically constitute authority to install.

This Certificate does not automatically constitute authority to install.

Where working in accordance with the national regulations of an Airworthiness Authority different than the Airworthiness Authority of the country

Where the user/installer performs work in accordance with regulations of an airworthiness authority different than the airworthiness authority specified in

specified in block 1, the user/installer shall ensure that their Airworthiness Authority accepts items from the Airworthiness Authority of the country

block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts items from the airworthiness authority specified in block

specified in block 1.

Statements in block(s) 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.