Published date: 2 April 2010

General

Civil Aviation Authority Advisory Circulars contain information about standards, practices, and procedures that the Director has found to be an Acceptable Means of Compliance (AMC) with the associated rule.

An AMC is not intended to be the only means of compliance with a rule, and consideration will be given to other methods of compliance that may be presented to the Director.   When new standards, practices, or procedures are found to be acceptable they will be added to the appropriate Advisory Circular.

An Advisory Circular may also include guidance material(GM) to facilitate compliance with the rule requirements.   Guidance material must not be regarded as an acceptable means of compliance.

Purpose

This Advisory Circular provides methods acceptable to the Director for showing compliance with the maintenance and manufacturing rules set out in Parts 43, 145, 148, and the documentation for the installation of parts in accordance with Part 21.

The Advisory Circular includes material intended for persons responsible for manufacture of aircraft components and maintenance of aircraft and components, and provides acceptable techniques, methods, and practices in relation to CAA Form One– authorised release certificate.

Related Rules

This Advisory Circular relates specifically to Civil Aviation Rule Part 21- Certification of Products and Parts, Part 43- General Maintenance Rules, Part 145- Aircraft Maintenance Organisations-Certification, and Part 148- Aircraft Manufacturing Organisations-Certification.


Change Notice

Revision 1 removes the six month transition provisions allowing the use of the previous format of CAA Form One. All CAA Form One ( authorised release certificates) are now required to comply with the contents of this Advisory Circular.


Introduction

General

This advisory circular is intended as a general guide on the use of CAA Form One – authorised release certificate (hereafter referred to as authorised release certificate) in accordance with the requirements of Civil Aviation Rule Parts 21, 43, 145 and 148.

The main purposes of an authorised release certificate are as follows:

1.      Export of a part or appliance (rule 21.339(a)):

The authorised release certificate must only be used for the export of a part or appliance . The rule specifies the conditions to be met before the authorised release certificate is to be used in this instance. Amongst other conditions, the part or appliance is new, has been newly overhauled, or was last installed in an aircraft which possesses a valid standard or restricted category airworthiness certificate and the part or appliance is fit for release to service.  In addition, the authorised release certificate has been issued in accordance with the procedures of an aircraft maintenance organisation certificated under Part 145, or an aircraft manufacturing organisation certificated under Part 148.

An appliance is defined as – any instrument, mechanism, equipment, part, or accessory that is used, or is intended to be used, in operating or controlling an aircraft in flight, or is installed in or attached to the aircraft, that is not part of the airframe, engine, or propeller (CAR Part 1):

2.       Certify component for release to service (rule 43.105(b)(1):

If a component is not installed on, or allocated to an aircraft, the person certifying the component for release-to-service must certify the release-to-service on the authorised release certificate. The authorised release certificate is to be used if rule 43.54 requires the maintenance to be performed under a maintenance organisation certificate issued under Part 145, or the component is to be exported under Part 145 or an aircraft manufacturing organisation under Part 148.

A component means – any instrument, mechanism, equipment, part, or accessory, including an airframe, aircraft engine or propellor, that is used, or is intended to be used, in operating or controlling an aircraft in flight, or is installed in or attached to the aircraft, that has a part number or a serial number allocated by the manufacturer, unless the manufacturer has designated such an item as a standard part (CAR Part 1).

3.      M anufactured item conforms to type design and in condition for safe operation (rule 148.11(c)):

The authorised release certificate may be used for a manufactured item indicating that

the item conforms to the type design for the item and is in a condition for safe operation.


The uses of the authorised release certificate are illustrated in the figure below.

This Advisory Circular provides instructions for the completion of an authorised release certificate.

This Advisory Circular does not apply to standard parts, although it is recommended that such parts should be accompanied by a statement of conformity.

For the purposes of this Advisory Circular and international harmonisation, the terms:

· ‘item’ refers to a part, appliance, component, aircraft engine, propeller, or material (but excludes an aircraft)  ; and

· ‘production’ refers to manufacture.

An authorised release certificate is not required to be used for the transfer of an item within an organisation. In such cases a certification for release–to-service statement must be entered in the aircraft records when the component is installed on an aircraft.

If it is likely that an item will frequently be transferred outside a maintenance organisation then the organisation may choose to use an authorised release certificate for its internal record keeping. Should an item be transferred to an overseas operator, or the aircraft on which it is installed be transferred overseas, then the overseas authority may require an authorised release certificate as evidence of the airworthiness status of the item. This is particularly important where a spares pooling agreement exists.

An authorised release certificate, should accompany the item and correlation should be established between the certificate and the item. A copy of the authorised release certificate should be retained by the organisation that manufactured or maintained the item. Where the format and data for an authorised release certificate are entirely computer generated it is acceptable to retain the authorised release certificate format and data on a suitable electronic database.

Advisory Circulars AC43-1, AC145-1, and AC148-1 include considerations for the establishment of computerised records systems.

In the globalisation of the aviation industry and the increasing need for mutual recognition of authorised release certificates between the different regulatory authorities, the best option is to ensure common understanding of the use and meaning of the data provided by the authorised release certificate. This can best be achieved through introduction of harmonised instructions.

Since September 2004, a global manufacturing team composed of authorities from the Production and Airworthiness forum has been working on the format of the authorised release certificate and its instructions for completion.  The objective of the combined team was to harmonise the format and wording of the authorised release certificate and associated documents to improve mutual global acceptance of the certificate, solve current implementation problems, and provide for the electronic exchange of authorised release certificates.

This Advisory Circular reflects the output of the team’s work, and provides harmonised instructions for completing the CAA Form One – authorised release certificate. This Advisory Circular provides separate instructions for both the maintenance use of the CAA Form One and the production (manufacturing) use of the CAA Form One.

With the harmonised format for the authorised release certificate, there are a few changes from the previous CAA Form One detailed in AC43-3:

· The former block 9 (Eligibility) has been deleted and the remaining blocks renumbered. 

· The former blocks 14 to 19 have been regrouped into new blocks 13a to 13e for manufactured items, and;

· New blocks 14a to 14e for the maintenance release of items have also been added. 

· The format for the date format is also specified. 

These harmonised instructions along with the changes to the format of the CAA Form One represent an improvement that will facilitate more efficient use of the authorised release certificate among those countries with which New Zealand has technical arrangements. The changes are also intended to facilitate the worldwide introduction of electronic processing of the authorised release certificates.


Section One

AUTHORISED RELEASE CERTIFICATE:  MAINTENANCE INSTRUCTIONS

These instructions relate only to the use of the CAA Form One authorised release certificate for maintenance purposes and the completion of blocks 1 to 12 and blocks 14a to 14e. Attention is drawn to the production instructions in Section Two of this Advisory Circular which cover the use of the CAA Form One for production purposes.

1.           PURPOSE AND USE

A primary purpose of the authorised release certificate is to declare the airworthiness of maintenance work undertaken on an item (other than an aircraft), and to certify that the maintenance work has been performed in accordance with the prescribed regulatory requirements.

There must be a correlation between a completed authorised release certificate and the documented maintenance records, maintenance data used for Release-to-Service and the item(s) associated with the certificate. A Release-to-Service on the certificate is for maintenance performed; not the complete product. The originator must retain a copy of the completed authorised release certificate in a form that allows verification of the original data.

An authorised release certificate is acceptable to many airworthiness authorities, but may be dependent on technical arrangements or the policy of the airworthiness authority.

An authorised release certificate is not a delivery, or shipping note.

An authorised release certificate for items that have been subjected to maintenance work may only be issued by an aircraft maintenance organisation certificated in accordance with Part 145, and within the scope of the maintenance organisation certificate.

An aircraft may not be released-to-service using an authorised release certificate.

An authorised release certificate does not constitute an approval to install the item on a particular aircraft, engine, or propeller, but helps the end user determine the airworthiness approval status of the item.

An authorised release certificate may not be used for a mixture of production released items (blocks 13a to 13e) and maintenance released items (blocks 14a to 14e) on the same certificate.

2.           GENERAL FORMAT

An authorised release certificate must comply with the format shown at the end of this section including the block numbers and the location of each block. The size of each block may be varied to suit an individual’s use of the certificate, but not to the extent that would make the certificate unrecognisable.

An authorised release certificate is to be in ‘landscape’ format, but the overall size may be significantly increased or decreased if the certificate remains recognisable and legible. If in doubt, consult the CAA.

The User/Installer Responsibility statement may be placed on either side of the certificate. If placed on the front, the depth of the certificate may be reduced.

An authorised release certificate may be either a printed form, or an electronic computer generated form, but in either case the printing of lines and characters must be clear and legible and in accordance with the defined format.  If an electronic computer generated form is used, it is to be readily printable if required.

An authorised release certificate is to be in English, and if appropriate, one or more other languages.

The details to be entered on an authorised release certificate may be either machine/computer printed, or hand written using block letters and must permit ease of reading.

The use of abbreviations should be kept to a minimum.

The space remaining on the reverse side of an authorised release certificate may be used by the originator for any additional information, but must not include any certification statement. Any use of the reverse side of the authorised release certificate is to be referenced in the appropriate block on the front side of the certificate.

3.           COPIES

There is no restriction in the number of copies of an authorised release certificate that may be sent to a customer or retained by the originator.

4.           ERROR(S) ON A CERTIFICATE

If an end user finds an error on an authorised release certificate, the user should identify the error and notify the originator of the certificate in writing. The originator of an incorrect certificate may issue a new authorised release certificate if the correction can be verified by the originator.

A new corrected authorised release certificate is to have a new tracking number, signature, and date, and should refer to the previous certificate in block 12 with the following statement:

“This certificate corrects the error(s) in block(s) [ Enter block(s) corrected] of authorised release certificate [ Enter original tracking number] dated [ Enter original issuance date] and does not cover conformity/condition/release to service”

A new corrected authorised release certificate may be issued without re-verification of the condition of the item(s). It is not a statement of current condition of the item(s) associated with the certificate.  Both certificates should be retained according to the retention period associated with the original certificate.

5.           COMPLETION OF THE CERTIFICATE BY THE ORIGINATOR

The following information must be entered on a CAA Form One – authorised release certificate issued by an aircraft maintenance organisation certificated in accordance with Part 145.

Block 1.           Approving National Aviation Authority/Country

State:      CAA/New Zealand.

Block 2.           AUTHORISED RELEASE CERTIFICATE

                        “AUTHORISED RELEASE CERTIFICATE”

                                                CAA Form One

Block 3.           Form Tracking Number

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

Enter the full name and address of the certificated aircraft maintenance organisation covered by the Certificate. Logos etc. of the organisation are permitted if the logo can be contained within the block.


Block 5.           Work Order/Contract/Invoice

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

Block 6.           Item

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

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).

Block 8.           Part Number

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

State the quantity of items.

Block 10.         Serial Number

If the item is required to be identified with a serial number, enter it here. Additionally, any other serial number not required, may also be entered. If there is no serial number identified on the item, enter “N/A”.

Block 11.         Status/Work

The following table 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.

Entry

Meaning

Overhauled

Means a process that ensures the item is in conformity with 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.

Repaired

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

Inspected/Tested

Examination, measurement, etc. in accordance with an applicable standard* (e.g. visual inspection, functional testing, bench testing and operational checks). Describe or reference the results in block 12.

Modified

Alteration of an item to conform to an applicable standard. *

* Applicable standard means a manufacturing/design/maintenance/quality standard, method, technique or practice approved by or acceptable to the Director. The Applicable Standard must be described in block 12.

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 the item in relation to the work being certified. If necessary a separate sheet may be used and referenced from the main authorised release certificate. Each statement must be clearly identified as to which item in block 6 it relates.

Examples of statements in block 12 are:

· Maintenance data used, including the revision status and reference the maintenance documentation.

· Compliance with airworthiness directives or service bulletins.

· Repairs carried out.

· Modifications carried out.

· Replacement parts installed.

· Life limited parts status.

· Deviations from the customer work order.

· Release statements to satisfy the maintenance requirements of a foreign Civil Aviation Authority.

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

Other examples are:                 Block 11                                    Block 12

· NDT                         Inspected/Tested              Describe Process then Technical Data

· Welding                     Repaired or Modified       Describe Process then Technical Data

· Surface Treatment     Repaired or Modified      Describe Process then Technical Data

· Heat Treatment         Modified                       Describe Process then Technical Data

If printing the data from an electronic CAA Form One, any data not appropriate in other blocks should be entered in this block.

Blocks 13a-13e

General requirements for blocks 13a-13e:

Not used for maintenance release. Shade, darken, or otherwise cross out to preclude inadvertent or unauthorised use.


Block 14a

Mark the appropriate box(s) 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 must be identified in block 12. At least one box must be marked, or both boxes may be marked, as appropriate.

Block 14b.       Authorised Signature

Only persons who are specifically authorised by the aircraft maintenance organisation identified in block 4 are permitted to sign this block. To aid recognition, a unique number identifying the authorised person is to be included. Alternatives to a hand-written signature (e.g. a computer-generated signature) are only permitted if the organisation’s procedures for a computer generated signature are accepted by the Director.

Block 14c.       Certificate/Approval number

Enter the organisation certificate/approval number. This is the maintenance organisation’s certification number issued by the CAA.

Block 14d.       Name

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

Block 14e.       Date (dd/mmm/yyyy)

Enter the date on which block 14b is signed.

The date must be in the format dd/mmm/yyyy

(dd = 2 digit day, mmm = first 3 letters of the month, yyyy = 4 digit year).

User/Installer Responsibilities

Place the following statement on the authorised release certificate to notify the end user that the user is not relieved of his or her responsibilities concerning the installation and use of any item referenced by the authorised release certificate:

“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 block(s) 13a and 14a do not constitute installation certification. In all cases aircraft maintenance records are to contain an installation certification issued in accordance with national regulations of the user/installer before the aircraft may be flown.”


3.  Form Tracking Number

5.  Work order/Contract/Invoice

11.  Status/Work

12.  Remarks

14a.    CAR 43.105(b) Release to Service      Other regulation specified in block 12

Certifies that unless specified in block 12, the work identified in block 11 and described in block 12, was accomplished in accordance with Civil Aviation Rules Part 43 and in respect to that work the items are considered ready for release to service.

14c.  Certificate/Approval Number

14e.  Date (dd/mmm/yyyy)

2.                     AUTHORISED RELEASE CERTIFICATE

CAA Form One

4.  Organisation Name and Address:

10.  Serial Number

14b.  Authorised  Signature & Number

14d.  Name

9.  Qty

8.  Part Number

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

□   approved design data and are in a condition for safe operation

   non-approved design data specified in block 12

13c.  Certificate/Approval Number

13e.  Date (dd/mmm/yyyy)

1.  Approving Country

CAA/New Zealand

7.  Description

13b.  Authorised  Signature & Number

13d.  Name

6.  Items

USER/INSTALLER RESPONSIBILITIES

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 block(s) 13a and 14a do not constitute installation certification. In all cases aircraft maintenance records are to contain an installation certification issued in accordance with national regulations of the user/installer before the aircraft may be flown.



Section Two

AUTHORISED RELEASE CERTIFICATE:  PRODUCTION INSTRUCTIONS

These instructions relate only to the use of the CAA Form One authorised release certificate for production purposes and the completion of blocks 1 to 12 and blocks 13a to 13e. Attention is drawn to the maintenance instructions in Section One of this Advisory Circular which cover the use of the CAA Form One for maintenance purposes.

1.           PURPOSE AND USE

A primary purpose of the authorised release certificate is to declare the airworthiness of new aviation items (other than an aircraft), that are manufactured by an aircraft manufacturing organisation certificated in accordance with Part 148.

There must be a correlation between a completed authorised release certificate and the documented manufacturing records, design data and the item(s) associated with the certificate. The originator must retain a copy of the completed authorised release certificate in a form that allows verification of the original data.

An authorised release certificate is acceptable to many airworthiness authorities, but may be dependent on technical arrangements or the policy of the airworthiness authority. The ‘approved design data’ mentioned in an authorised release certificate for production means design data accepted by the airworthiness authority of the importing country.

An authorised release certificate is not a delivery, or shipping note.

An authorised release certificate for production items may only be issued by an aircraft manufacturing organisation certificated in accordance with Part 148, and within the scope of the manufacturing organisation certificate.

An aircraft may not to be released-to-service using an authorised release certificate.

An authorised release certificate does not constitute an approval to install the item on a particular aircraft, engine, or propeller, but helps the end user determine the airworthiness approval status of the item.

An authorised release certificate may not be used for a mixture of production released items (blocks 13a to 13e) and maintenance released items (blocks 14a to 14e) on the same certificate.

A mixture of items certified in conformity with ‘approved data’ and to ‘non-approved data’ is not permitted on the same authorised release certificate.

2.           GENERAL FORMAT

An authorised release certificate must comply with the format shown at the end of this section including the block numbers and the location of each block. The size of each block may be varied to suit an individual’s use of the certificate, but not to the extent that would make the certificate unrecognisable.

An authorised release certificate is to be in ‘landscape’ format, but the overall size may be significantly increased or decreased provided the certificate remains recognizable and legible. If in doubt, consult the CAA.

The user/installer responsibility statement may be placed on the reverse of the certificate or on the front by reducing the depth of the certificate.

An authorised release certificate may be either a printed form, or an electronic computer generated form, but in either case the printing of lines and characters must be clear and legible and in accordance with the defined format.  If an electronic computer generated form is used, it must be readily printable if required.

An authorised release certificate is to be in English, and if appropriate, one or more other languages.

The details to be entered on an authorised release certificate may be either machine/computer printed, or hand-written using block letters and must permit ease of reading.

The use of abbreviations should be kept to a minimum.

The space remaining on the reverse side of an authorised release certificate may be used by the originator for any additional information, but must not include any certification statement. Any use of the reverse side of the authorised release certificate is to be referenced in the appropriate block on the front side of the certificate.

3.           COPIES

There is no restriction in the number of copies of an authorised release certificate that may be sent to a customer, or retained by the originator.

4.           ERRORS(S) ON A CERTIFICATE

If an end user finds an error on an authorised release certificate, the user should identify the error and notify the originator of the certificate in writing. The originator of an incorrect certificate may issue a new authorised release certificate if the correction can be verified by the originator.

A new corrected authorised release certificate is to have a new tracking number, signature, and date, and should refer to the previous certificate in block 12 with the following statement:

“This Certificate corrects the error(s) in block(s) [ enter block(s) corrected] of authorised release certificate [e nter original tracking number] dated [ enter original issuance date] and does not cover conformity/condition/release to service”

A new corrected authorised release certificate may be issued without re-verification of the condition of the item(s). It is not a statement of current condition of the item(s) associated with the certificate. Both certificates should be retained according to the retention period associated with the original certificate.

5.           COMPLETION OF THE CERTIFICATE BY THE ORIGINATOR

The following information must be entered in a CAA Form One – authorised release certificate issued by an aircraft manufacturing organisation certificated in accordance with Part 148.

Block 1.           Approving National Aviation Authority/Country

State:      CAA/New Zealand.

Block 2.           AUTHORISED RELEASE CERTIFICATE

                        “AUTHORISED RELEASE CERTIFICATE”

                                                CAA Form One


Block 3.           Form Tracking Number

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

Enter the full name and address of the aircraft manufacturing organisation covered by the certificate. Logos, etc. of the organisation are permitted if they can be contained within the block.

Block 5.           Work Order/Contract/Invoice

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

Block 6.           Item

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

Block 7.           Description

Enter the name or description of the item from the applicable design data.

Block 8.           Part Number

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

State the quantity of the items.

Block 10.         Serial Number

If the item is required to be identified with a serial number, enter it here. Additionally, any other serial number not required, may also be entered. If there is no serial number identified on the item, enter “N/A”.

Block 11.         Status/Work

Enter either “Prototype” or “New”.

Enter “Prototype” for the production of a new item in conformity with non-approved design data.

Enter “New” for:

1. The production of a new item in conformity with the approved design data.

2. The re-certification of a new item by the organisation identified in block 4 of the original authorised release certificate for the item after alteration or rectification work on the item, (such as incorporation of a design change, correction of a defect, inspection or test, or renewal of shelf life), prior to entry into service.  Details of the original authorised release certificate and the alteration or rectification work are to be entered in block 12.

3. The re-certification of a prototype item from “Prototype” to “New” by the organisation identified in block 4 of the original authorised release certificate for the item, subsequent to the approval of the applicable design data, provided that the design data has not changed. The following statement must be entered in block 12: “RE-CERTIFICATION OF ITEM(S) FROM “PROTOTYPE” TO “NEW”: THIS DOCUMENT ONLY CERTIFIES THE APPROVAL OF THE DESIGN DATA TO WHICH THIS ITEM/THESE ITEMS WAS/WERE MANUFACTURED, BUT DOES NOT COVER CONFORMITY/CONDITION AFTER RELEASE OF THE ORIGINAL AUTHORISED RELEASE TO CERTIFICATE NUMBER ( Fill in the Certificate tracking number).

4. The examination of a previously released new item prior to entry into service:

· In accordance with customer-specified standard or specification, details of which, and of the original release, are to be entered in block 12.

· To establish airworthiness. An explanation of the basis of release and details of the original release are to be entered in block 12.

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 the item in relation to the work being certified. If necessary a separate sheet may be used and referenced from the main authorised release certificate. Each statement must be clearly identified as to which item in block 6 it relates.

Enter the justification for release to non-approved design data in block 12 (e.g. pending type-certificate, for test only, pending approved data).

Examples of conditions which would necessitate statements in block 12 are:

· Reference to the applicable design data including the revision status:

· When the certificate is used for prototype purposes the following statement must be entered at the beginning of block 12:

“NOT ELIGIBLE FOR INSTALLATION ON IN-SERVICE TYPE-CERTIFICATED AIRCRAFT”

· Re-certification of “Prototype” to “New” items once the applicable design data is approved. The following statement must be entered in block 12:

“RE-CERTIFICATION OF ITEMS FROM “PROTOTYPE” TO “NEW”: THIS DOCUMENT ONLY CERTIFIES THE APPROVAL OF THE DESIGN DATA TO WHICH THIS ITEM (THESE ITEMS) WAS/WERE MANUFACTURED, BUT DOES NOT COVER CONFORMITY/CONDITION AFTER RELEASE OF THE ORIGINAL AUTHORISED RELEASE CERTIFICATE NUMBER ( Fill in the Certificate tracking number)

· When a new Certificate is issued to correct an error the following statement must be entered in block 12:

“THIS CERTIFICATE CORRECTS THE ERROR(S) IN BLOCK(S) [ Enter block(s) corrected] OF AUTHORISED RELEASE CERTIFICATE [ Enter original tracking number] DATED[ Enter original issuance date] AND DOES NOT COVER CONFORMITY/CONDITION/RELEASE TO SERVICE”.

· For NZTSO articles, state the applicable NZTSO.

· Shelf life data.

· Shortages, or outstanding work, e.g. missing parts of an assembly, reassembly after shipment.

If printing the data from an electronic Form One, any data not appropriate in other blocks should be entered in this block.

Block 13a

Mark only one of the two boxes.

(1) Mark the “approved design data and are in a condition for safe operation” box if the item(s) were manufactured using approved design data and found to be in a condition for safe operation.

(2) Mark the “ non-approved design data specified in block 12” box if the item(s) were manufactured using applicable non-approved design data. Identify the data in block 12. (e.g. pending type certificate, for test only, pending approved data).

Mixtures of items released against approved and non-approved design data are not permitted on the same authorised release certificate.

Block 13b.       Authorised Signature

Only persons who are specifically authorised by the aircraft manufacturing organisation identified in block 4 are permitted to sign this block. To aid recognition, a unique number identifying the authorised person is to be to be included. Alternatives to a hand written signature (e.g. a computer generated signature) are only permitted if the organisation’s procedures for a computer generated signature are accepted by the Director.

Block 13c.       Certificate/Approval number

Enter the organisation certificate/approval number. This is the manufacturing organisation’s certification number issued by the CAA.

Block 13d.       Name

Enter the name of the person signing block 13b in a legible form.

Block 13e.       Date (dd/mmm/yyyy)

Enter the date on which block 13b is signed.

The date must be in the format dd/mmm/yyyy

(dd=2 digit day; mmm=first 3 letters of the month; yyyy=4 digit year.

Blocks 14a-14e

General Requirements for Blocks 14a-14e:

Not used for production release. Shade, darken, or cross out to preclude inadvertent or unauthorised use.


User/Installer Responsibilities

Place the following statement on the authorised release certificate to notify the end users that the user is not relieved of his or her responsibilities concerning the installation and use of any item referenced in the authorised release certificate:

“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 block(s) 13a and 14a do not constitute installation certification. In all cases aircraft maintenance records are to contain an installation certification issued in accordance with national regulations of the user/installer before the aircraft may be flown.”


3.  Form Tracking Number

5.  Work order/Contract/Invoice

11.  Status/Work

12.  Remarks

14a.    CAR 43.105(b) Release to Service      other regulation specified in block 12

  Certifies that unless specified in block 12, the work identified in block 11 and described in block 12, was accomplished in accordance with Civil Aviation Rules Part 43 and in respect to that work the items are considered ready for release to service.

14c.  Certificate/Approval Number

14e.  Date (dd/mmm/yyyy)

2.                            AUTHORISED RELEASE CERTIFICATE

CAA Form One

4.  Organisation Name and Address:

10.  Serial Number

14b.  Authorised Signature & Number

14d.  Name

9.  Qty

8.  Part Number

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

approved design data and are in a condition for safe operation

   non-approved design data specified in block 12

13c.  Certificate/Approval Number

 13e.  Date (dd/mmm/yyyy)

1.  Approving Country

CAA/New Zealand

7.  Description

13b.  Authorised Signature  & Number

13d.  Name

6.  Items

USER/INSTALLER RESPONSIBILITIES

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 block(s) 13a and 14a do not constitute installation certification. In all cases aircraft maintenance records are to contain an installation certification issued in accordance with national regulations of the user/installer before the aircraft may be flown.