ED 2010/002/R
229
Appendix III
Airworthiness Review Certificate – EASA Form 15
[MEMBER STATE]
A Member of the European Union (*)
AIRWORTHINESS REVIEW CERTIFICATE
ARC reference: ………..
Pursuant to Regulation (EC) No 216/2008 of the European Parliament and of the Council for the time being into force, the following continuing airworthiness management organisation, approved in accordance with Section A, Subpart G of Annex I (Part M) to Commission Regulation (EC) No 2042/2003
[NAME OF ORGANISATION APPROVED AND ADDRESS] Approval reference: [MEMBER STATE CODE].MG[NNNN]
has performed an airworthiness review in accordance with point M.A.710 of Annex I to Commission Regulation (EC) No 2042/2003 on the following aircraft :
Aircraft manufacturer: ..............................................................................................................
Manufacturer’s designation: ...................................................................................................
Aircraft registration: .................................................................................................................
Aircraft serial number: .............................................................................................................
and this aircraft is considered airworthy at the time of the review.
Date of issue: .................................................... Date of expiry: ............................................
Signed: ............................................................... Authorisation No: .......................................
1st Extension: The aircraft has remained in a controlled environment in accordance with
point M.A.901 of Annex I to Commission Regulation (EC) No 2042/2003 for the last year.
The aircraft is considered to be airworthy at the time of the issue.
Date of issue: .................................................... Date of expiry: .............................................
Signed: ................................................................ Authorisation No: .......................................
Company Name: ................................................ Approval reference: ...................................
2nd Extension: The aircraft has remained in a controlled environment in accordance with
point M.A.901 of Annex I to Commission Regulation (EC) No 2042/2003 for the last year.
The aircraft is considered to be airworthy at the time of the issue.
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