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Appendix VIII -- EASA Form 52-- Aircraft statement of conformity

Available versions for ERULES-1963177438-4101

Regulation (EU) 2022/201 found in: Initial Airworthiness and Environmental Protection (No 748/2012) Part-21 Part-21L (Jul 2024)

Version Text

Appendix VIII — EASA Form 52— Aircraft statement of conformity

Regulation
(EU) 2022/201

Appendix VIII

Aircraft statement of
conformity — EASA Form 52

<table border="0" cellpadding="0" cellspacing="0" width="603">
<tr>
<td colspan="5" valign="top" width="603">
AIRCRAFT STATEMENT OF CONFORMITY
</td>
</tr>
<tr>
<td valign="top" width="154">
1.          State of
 manufacture
</td>
<td colspan="3" valign="top" width="298">
2.          [MEMBER STATE]<a href="#_ftn50">[50]</a> A Member of the
 European Union<a href="#_ftn51">[51]</a>
</td>
<td valign="top" width="152">
3.          Statement ref.
 no:
</td>
</tr>
<tr>
<td colspan="5" width="603">
4.          Organisation
</td>
</tr>
<tr>
<td colspan="2" width="310">
5.          Aircraft type
</td>
<td colspan="3" width="294">
6.          Type-certificate
 ref. nos:
</td>
</tr>
<tr>
<td colspan="2" width="310">
7.          Aircraft
 registration or mark
</td>
<td colspan="3" width="294">
8.          Production
 organisation identification no:
</td>
</tr>
<tr>
<td colspan="5" width="603">
9.          Engine/propeller
 details<a href="#_ftn52">[52]</a>
</td>
</tr>
<tr>
<td colspan="5" width="603">
10.        Modifications
 and/or service bulletins<a href="#_ftn53">[53]</a>
</td>
</tr>
<tr>
<td colspan="5" width="603">
11.        Airworthiness
 directives
</td>
</tr>
<tr>
<td colspan="5" width="603">
12.        Concessions
</td>
</tr>
<tr>
<td colspan="5" width="603">
13.        Exemptions,
 waivers or derogations<a href="#_ftn54">[54]</a>
</td>
</tr>
<tr>
<td colspan="5" width="603">
14.        Remarks
</td>
</tr>
<tr>
<td colspan="5" width="603">
15.        Certificate of airworthiness
</td>
</tr>
<tr>
<td colspan="5" width="603">
16.        Additional requirements
</td>
</tr>
<tr>
<td colspan="5" valign="top" width="603">
17.        Statement of conformity
              It is hereby
 certified that the aircraft conforms fully to the type‑certificated design
 and to the items in blocks 9, 10, 11, 12 and 13.
              The aircraft
 is in a condition for safe operation.
              The aircraft
 has been satisfactorily tested in flight.
</td>
</tr>
<tr>
<td width="154">
18.        Signed
</td>
<td colspan="2" width="298">
19.        Name
</td>
<td colspan="2" width="152">
20.        Date (d/m/y)
</td>
</tr>
<tr>
<td colspan="5" width="603">
21.        Production organisation
 approval reference
</td>
</tr>
<tr height="0">
</tr>
</table>

EASA Form 52 - Issue 3

Instructions for the use of the “Aircraft
statement of conformity – EASA Form 52"

1.       PURPOSE
AND SCOPE

1.1.    The use of the
aircraft statement of conformity issued by a production organisation that
produces under Part 21 Section A Subpart F is described in
point [21.A.130](#_DxCrossRefBm1649096912) and in the related
acceptable means of compliance (AMC).

1.2.    The purpose of the
aircraft statement of conformity (EASA Form 52) issued under
Part 21 Section A Subpart G is to enable the holder of an appropriate
production organisation approval certificate to exercise the privilege to
obtain an individual aircraft certificate of airworthiness and, if requested,
a certificate of noise from the competent authority of the Member State of
registry.

2.       GENERAL

2.1.    The statement of
conformity must comply with the model, including the block numbers and the
location of each block. The size of each block may, however, be varied to suit
the individual application, but not to the extent that would render the
statement of conformity unrecognisable. If in doubt, consult the competent
authority.

2.2.    The statement of
conformity must be either preprinted or computer generated, but in either
case, the printing of lines and characters must be clear and legible.
Preprinted wording is permitted in accordance with the attached model, but no
other certification statements are permitted.

2.3.    The completion of the
statement may be either machine/computer printed or handwritten, using block
letters to allow for easy reading. English, and where relevant, one or more of
the official language(s) of the issuing Member State, are acceptable.

2.4.    A copy of the
statement and all the referenced attachments are to be retained by the
approved production organisation.

3.       COMPLETION OF THE
STATEMENT OF CONFORMITY BY THE ORIGINATOR

3.1.    There must be an entry
in all blocks to render the document a valid statement.

3.2.    A statement of
conformity may not be issued to the competent authority of the Member State of
registry unless the design of the aircraft and its installed products are
approved.

3.3.    The information
required in blocks 9, 10, 11, 12, 13 and 14 may be by reference to
separate identified documents held on file by the production organisation,
unless the competent authority agrees otherwise.

3.4.    This statement of
conformity is not intended to include those items of equipment that may be
required to be fitted in order to satisfy the applicable operational rules.
However, some of those individual items may be included in block 10 or in
the approved type design. Operators are therefore reminded of their
responsibility to ensure compliance with the applicable operational rules for
their own particular operations.

Block 1        Enter the name of the State of
manufacture.

Block 2        The competent authority that issues the
statement of conformity under its authority.

Block
3        A
unique serial number must be preprinted in this block for statement control
and traceability purposes. An exception is in the case of a computer-generated
document: the number need not be preprinted where the computer is programmed
to produce and print a unique number.

Block
4        The
full name and the address of the location of the organisation that issues the
statement. This block may be preprinted. Logos, etc., are permitted if the
logo, etc., can be contained within the block.

Block 5        The aircraft type in full as specified
in the type-certificate and its associated data sheet.

Block 6        The type-certificate reference numbers
and issue for the subject aircraft.

Block
7        If
the aircraft is registered, then this mark will be the registration mark. If
the aircraft is not registered, then this will be the mark that is accepted by
the competent authority of the Member State and, if applicable, by the
competent authority of a third country.

Block
8        The
identification number assigned by the production organisation for control and
traceability and product support purposes. This is sometimes referred to as a
“production organisation serial number” or “constructor’s number”.

Block
9        The
engine type and the propeller type(s) in full as specified in the relevant
type-certificate and its associated data sheet. Their production organisation
identification number and the associated location must also be stated.

Block 10      Approved design changes to the aircraft
definition.

Block
11      A
listing of all the applicable airworthiness directives (or equivalent) and a
declaration of compliance, together with a description of the method of
compliance of the subject individual aircraft, including products and
installed parts, appliances and equipment. Any future compliance requirement
time must be stated.

Block
12      Approved
unintentional deviations from the approved type design, sometimes referred to
as “concessions”, “divergences” or “non-conformances”.

Block 13      Only agreed exemptions, waivers or
derogations may be included here.

Block
14      Remarks.
Any statement, information, particular data or limitation which may affect the
airworthiness of the subject aircraft. If there is no such information or
data, state “NONE”.

Block
15      Enter
“certificate of airworthiness”, or “restricted certificate of airworthiness”,
as requested.

Block
16      Additional
requirements such as those notified by an importing country must be noted in
this block.

Block
17      The
validity of the statement of conformity is subject to the full completion of
all the blocks on the form. A copy of the flight test report, together with
any recorded defects and rectification details, must be kept on file by the
production organisation approval certificate holder. The report must be signed
as satisfactory by the appropriate certifying staff and a flight crew member,
e.g. the test pilot or the flight test engineer. The flight tests performed
are those defined under the control of the quality management element of the
production system, as established by point [21.A.139](#_DxCrossRefBm1649096881), in particular point 21.A.139(d)(1)(vi),
to ensure that the aircraft conforms to the applicable design data, and is in
condition for safe operation.

The listing of items provided (or made available) to satisfy the
aspects of this statement that relate to the safe operation of the aircraft
must be kept on file by the production organisation approval certificate
holder.

Block
18      The
statement of conformity may be signed by the person that is authorised to do
so by the production approval holder in accordance with point [21.A.145(d)](#_DxCrossRefBm1649096920). A rubber stamp
signature must not be used.

Block
19      The
name of the person that signs the statement must be typed or printed in a
legible form.

Block 20      The date on which the statement of
conformity is signed must be given.

Block 21      The competent authority approval
reference must be quoted.

---

[[50]](#_ftnref50)           Or “EASA”, if EASA
is the competent authority.

[[51]](#_ftnref51)           Delete for non-EU
Member States or EASA.

[[52]](#_ftnref52)           Delete as
applicable.

[[53]](#_ftnref53)           Delete as
applicable.

[[54]](#_ftnref54)           Delete as
applicable.