Appendix IV -- EASA Form 20b -- Permit to Fly (issued by approval organisations)

• Regulation (EU) No 748/2012 found in: Initial Airworthiness and Environmental Protection (No 748/2012) Part-21 Part-21L (Jul 2024)

Appendix IV — EASA Form 20b — Permit to Fly (issued by approval organisations) Regulation (EU) No 748/2012 Appendix IV <table border="1" cellpadding="0" cellspacing="0" width="603"> <tr> <td valign="top" width="236"> <p>Member State of the Competent Authority having issued the organisation approval under which the permit to fly is issued; or</p> <p>‘EASA’ when approval issued by EASA</p> </td> <td colspan="2" valign="top" width="368"> <p>         PERMIT TO FLY</p> </td> </tr> <tr> <td valign="top" width="236"> </td> <td colspan="2" valign="top" width="368"> </td> </tr> <tr> <td colspan="2" valign="top" width="308"> <p>Name and Address of the organisation issuing the permit to fly</p> </td> <td valign="top" width="296"> <p><a href="#_ftn45">[45]</a></p> </td> </tr> <tr> <td colspan="2" valign="top" width="308"> <p>This permit to fly is issued pursuant to Regulation (EC) No 216/2008, Article 5(4)(a) and certifies that the aircraft is capable of safe flight for the purpose and within the conditions listed below and is valid in all Member States</p> <p>This permit is also valid for flight to and within non-Member States provided separate approval is obtained from the competent authorities of such States.</p> </td> <td valign="top" width="296"> <p>1.          Nationality and registration marks:</p> </td> </tr> <tr> <td colspan="2" valign="top" width="308"> <p>2.          Aircraft manufacturer/type:</p> </td> <td valign="top" width="296"> <p>3.          Serial No:</p> </td> </tr> <tr> <td colspan="3" valign="top" width="603"> <p>4.          The permit covers: [purpose in accordance with <a href="#_DxCrossRefBm1649097379">21.A.701(a)</a></p> </td> </tr> <tr> <td colspan="3" valign="top" width="603"> <p>5.          Holder: [Organisation issuing the permit to fly]</p> </td> </tr> <tr> <td colspan="3" valign="top" width="603"> <p>6.          Conditions/remarks:</p> </td> </tr> <tr> <td colspan="3" valign="top" width="603"> <p>7.          Validity period:</p> </td> </tr> <tr> <td colspan="2" valign="top" width="308"> <p>8.          Place and date of issue:</p> </td> <td valign="top" width="296"> <p>9.          Authorised signature:</p> <p>              Name:</p> <p>              Approval Reference No:</p> </td> </tr> <tr height="0"> </tr> </table> EASA Form 20b --- [[45]](#_ftnref45)    For use by Organisation Approval holder.