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Block 9 Quantity
.  State the quantity of items.
Block 10 Serial Number
.  If the item is required by regulations 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
.  The following describes the permissible entries for block 11. Enter only one of these terms – where more than one may be applicable, use the one that most accurately describes the majority of the work performed and/or the status of the article.
(i)  
Overhauled. Means a process that ensures the item is in complete conformity with all the applicable service tolerances specified in the type certificate holder’s, or equipment manufacturer’s instructions for continued airworthiness, or in the data which is approved or accepted by the Authority. The item will be at least disassembled, cleaned, inspected, repaired as necessary, reassembled and tested in accordance with the above specified data.

(ii)  
Repaired. Rectification of defect(s) using an applicable standard (*).

(iii) Inspected/Tested. Examination, measurement, etc. in accordance with an applica-ble standard (*) (e.g. visual inspection, functional testing, bench testing etc.).
(iv) Modified. Alteration of an item to conform to an applicable standard (*).
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 the main EASA Form 1. Each statement must clearly iden-tify which item(s) in Block 6 it relates to.
.  Examples of information to be entered in block 12 are:
(i)
Maintenance data used, including the revision status and reference.

(ii)
Compliance with airworthiness directives or service bulletins.

(iii) Repairs carried out.
(iv)
Modifications carried out.

(v)
Replacement parts installed.

(vi)
Life limited parts status.

(vii) Deviations from the customer work order.
(viii) Release statements to satisfy a foreign Civil Aviation Authority maintenance requirement.
*  Applicable standard means a manufacturing/design/maintenance/quality standard, method, technique or practice approved by or acceptable to the Competent Authority. The applicable standard shall be described in block 12
EU 127/2010
PART-M Appendices

(ix)  
Information needed to support shipment with shortages or re-assembly after delivery.

(x)  
For maintenance organisations approved in accordance with Subpart F of Annex I (Part-M), the component certificate of release to service statement referred to in point M.A.613:

“Certifies that, unless otherwise specified in this block, the work identified in block 11 and described in this block was accomplished in accordance to the requirements of Section A, Subpart F of Annex I (Part-M) to Regulation (EC) No 2042/2003 and in respect to that work the item is considered ready for release to service. THIS IS NOT A RELEASE UNDER ANNEX II (PART-145) TO REGULATION (EC) NO 2042/2003.”
If printing the data from an electronic EASA Form 1, any appropriate data not fit for other blocks should be entered in this block.
Block 13a-13e
General Requirements for blocks 13a-13e: Not used for maintenance release. Shade, darken, or otherwise mark to preclude inadvertent or unauthorised use.
Block 14a
Mark the appropriate box(es) indicating which regulations apply to the completed work. If the box “other regulations specified in block 12” is marked, then the regula-tions of the other airworthiness authority(ies) must be identified in block 12. At least one box must be marked, or both boxes may be marked, as appropriate.
　
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