Commission Regulation (EU) No 1321/2014Show full title

5. COMPLETION OF THE CERTIFICATE BY THE ORIGINATOR U.K.

Block 1 [F1 CAA/UK] U.K.

F2 ...

Textual Amendments

F2 Words in Annex 1 Appendix 2 para. 5 omitted (31.12.2020) by virtue of The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(i)(bb) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

Textual Amendments

F1 Word in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(i)(aa) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

Block 2 [F3 CAA Form 1] header U.K.

‘AUTHORISED RELEASE CERTIFICATE

[F3 CAA Form 1’]

Textual Amendments

F3 Words in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(ii) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

Block 3 Form Tracking Number U.K.

Enter the unique number established by the numbering system/procedure of the organisation identified in block 4; this may include alpha/numeric characters.

Block 4 Organisation Name and Address U.K.

Enter the full name and address of the approved organisation (refer to [F4 CAA Form 3]) releasing the work covered by this Certificate. Logos, etc., are permitted if the logo can be contained within the block.

Textual Amendments

F4 Words in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(iii) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

Block 5 Work Order/Contract/Invoice U.K.

To facilitate customer traceability of the item(s), enter the work order number, contract number, invoice number, or similar reference number.

Block 6 Item U.K.

Enter line item numbers when there is more than one line item. This block permits easy cross-referencing to the Remarks block 12.

Block 7 Description U.K.

Enter the name or description of the item. Preference should be given to the term used in the instructions for continued airworthiness or maintenance data (e.g. Illustrated Parts Catalogue, Aircraft Maintenance Manual, Service Bulletin, Component Maintenance Manual).

Block 8 Part Number U.K.

Enter the part number as it appears on the item or tag/packaging. In case of an engine or propeller the type designation may be used.

Block 9 Quantity U.K.

State the quantity of items.

Block 10 Serial Number U.K.

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 U.K.

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.

a Applicable standard means a manufacturing/design/maintenance/quality standard, method, technique or practice approved by or acceptable to the [F5 CAA]. The applicable standard shall be described in block 12.
(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 [F6 CAA]. 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 standarda.
(iii)	Inspected/Tested	.	Examination, measurement, etc. in accordance with an applicable standarda (e.g. visual inspection, functional testing, bench testing etc.).
(iv)	Modified	.	Alteration of an item to conform to an applicable standarda.

Textual Amendments

F5 Word in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(iv)(bb) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

F6 Word in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(iv)(aa) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

Block 12 Remarks U.K.

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 [F7 CAA Form 1]. Each statement must clearly identify which item(s) in Block 6 it relates to.

Textual Amendments

F7 Words in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(v) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

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.

(ix)

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

(x)

[F8 [X1 For maintenance organisations approved in accordance with Subpart F of Annex I (Part-M) or Annex Vd (Part-CAO), the component CRS statement referred to in point M.A.613 and CAO.A.070, as applicable:

‘ Certifies that, unless otherwise specified in this block, the work identified in block 11 and described in this block was accomplished in accordance with the requirements of Section A, Subpart F of Annex I (Part-M) or Annex Vd (Part-CAO) to Regulation (EU) No 1321/2014, 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 (EU) No 1321/2014. ’

If printing the data from an electronic [F7 CAA Form 1], any appropriate data not fit for other blocks should be entered in this block.]]

Editorial Information

X1 Substituted by Corrigendum to Commission Implementing Regulation (EU) 2019/1383 of 8 July 2019 amending and correcting Regulation (EU) No 1321/2014 as regards safety management systems in continuing airworthiness management organisations and alleviations for general aviation aircraft concerning maintenance and continuing airworthiness management (Official Journal of the European Union L 228 of 4 September 2019).

Textual Amendments

F8 Substituted by Commission Implementing Regulation (EU) 2019/1383 of 8 July 2019 amending and correcting Regulation (EU) No 1321/2014 as regards safety management systems in continuing airworthiness management organisations and alleviations for general aviation aircraft concerning maintenance and continuing airworthiness management (Text with EEA relevance).

Block 13a-13e U.K.

General Requirements for blocks 13a-13e: Not used for maintenance release. Shade, darken, or otherwise mark to preclude inadvertent or unauthorised use.

[F8 [X1 Block 14a U.K.

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 regulations 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.

For all maintenance carried out by maintenance organisations approved in accordance with Section A, Subpart F of Annex I (Part M) or Annex Vd (Part-CAO) to Regulation (EU) No 1321/2014, the box ‘ other regulation specified in block 12 ’ shall be ticked and the CRS statement be entered in block 12. In that case, the certification statement ‘ unless otherwise specified in this block ’ is intended to address the following cases:

(a)

where maintenance could not be completed;

(b)

where maintenance deviated from the standard required by Annex I (Part-M) or Annex Vd (Part-CAO);

(c)

where maintenance was carried out in accordance with a requirement other than that specified in Annex I (Part-M) or Annex Vd (Part-CAO); in this case, block 12 shall specify the particular national regulation.

For all maintenance carried out by maintenance organisations approved in accordance with Section A of Annex II (Part-145) to Regulation (EU) No 1321/2014, the certification statement ‘ unless otherwise specified in block 12 ’ is intended to address the following cases:

(a)

where maintenance could not be completed;

(b)

where maintenance deviated from the standard required by Annex II (Part-145);

(c)

where 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 U.K.

This space shall be completed with the signature of the authorised person. Only persons specifically authorised under the rules and policies of the [F9 CAA] are permitted to sign this block. To aid recognition, a unique number identifying the authorised person may be added.

Textual Amendments

F9 Word in Annex 1 Appendix 2 para. 5 substituted (31.12.2020) by The Aviation Safety (Amendment etc.) (EU Exit) Regulations 2019 (S.I. 2019/645), regs. 1, 262(3)(c)(vi) (with Sch. 3) (as amended by S.I. 2019/1098, regs. 1(3), 12); 2020 c. 1, Sch. 5 para. 1(1)

Block 14c Certificate/Approval Number U.K.

Enter the Certificate/Approval number/reference. This number or reference is issued by the [F9 CAA].

Block 14d Name U.K.

Enter the name of the person signing block 14b in a legible form.

Block 14e Date U.K.

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 U.K.

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 accompanied 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.’