(b)
Where the maintenance deviated from the standard required by Annex I (Part-M).
(c)
Where the maintenance was carried out in accordance with a requirement other than that specified in Annex I (Part-M). In this case block 12 shall specify the par-ticular national regulation.
For all maintenance carried out by maintenance organisations approved in accordance with Section A of Annex II (Part-145) to Regulation (EC) No 2042/2003, the certification statement “unless otherwise specified in block 12” is intended to address the following cases;
(a)
Where the maintenance could not be completed.
(b)
Where the maintenance deviated from the standard required by Annex II (Part-145).
(c)
Where the maintenance was carried out in accordance with a requirement other than that specified in Annex II (Part-145). In this case block 12 shall specify the particular national regulation.
Block 14b Authorised Signature
This space shall be completed with the signature of the authorised person. Only per-sons 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.
EU 127/2010
Block 14c Certificate/Approval Number
. Enter the Certificate/Approval number/reference. This number or reference is issued by the Competent Authority.
Block 14d Name
. Enter the name of the person signing block 14b in a legible form.
Block 14e Date
. Enter the date on which block 14b is signed, the date must be in the format dd = 2 digit day, mmm = first 3 letters of the month, yyyy = 4 digit year
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 accom-panied 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.”
EU 127/2010
PART-M Appendices
EU 127/2010
1. Approving Competent Authority / Country 2. AUTHORISED RELEASE CERTIFICATE EASA FORM 1 3. Form Tracking Number
4. Organisation Name and Address: 5. Work Order/Contract/Invoice
6. Item 7. Description 8. Part No. 9. Qty. 10. Serial No. 11. Status/Work
12. Remarks
13a. Certifies that the items identified above were manufactured in con-formity 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 12Certifies 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.
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