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Appendix X -- EASA Form 55 -- Production organisation approval certificate

Available versions for ERULES-1963177438-4103

Regulation (EU) 2022/201 found in: Initial Airworthiness and Environmental Protection (748/2012) Part-21 Part-21L (Jul 2024)
Regulation (EU) 2024/1108 found in: Initial Airworthiness and Environmental Protection (748/2012) (Nov 2025)

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Appendix X — EASA Form 55 — Production organisation approval certificate

Regulation
(EU) 2022/201

Appendix X

Production
organisation approval certificate — EASA Form 55

Production
organisation approval certificates referred to in Subpart G of Annex I (Part 21)

<table border="1" cellpadding="0" cellspacing="0" width="603">
<tr>
<td valign="top" width="603">
[MEMBER STATE]<a href="#_ftn55">[55]</a>
A Member of the European Union<a href="#_ftn56">[56]</a>
PRODUCTION
 ORGANISATION APPROVAL CERTIFICATE
Reference: [MEMBER STATE CODE<a href="#_ftn57">[57]</a>].21G.XXXX
Pursuant to Regulation
 (EU) 2018/1139 of the European Parliament and of the Council and to
 Commission Regulation (EU) No 748/2012, for the time being in
 force and subject to the conditions specified below, the [COMPETENT
 AUTHORITY OF THE MEMBER STATE] hereby certifies:
[COMPANY NAME AND ADDRESS]
as a production organisation in
 compliance with Annex I (Part 21) Section A of Regulation
 (EU) No 748/2012, is approved to produce products, parts and
 appliances listed in the attached approval schedule and issue the related
 certificates using the above references.
CONDITIONS:
1.          This
 approval is limited to that specified in the enclosed terms of approval.
2.          This
 approval is subject to compliance with the procedures specified in the
 approved production organisation exposition.
3.          This
 approval is valid while the approved production organisation remains in
 compliance with Annex I (Part 21) to Regulation (EU) No 748/2012].
4.          Subject
 to compliance with the foregoing conditions, this approval shall remain
 valid for an unlimited period of time unless it has previously been
 surrendered, superseded, suspended or revoked.
Date of original issue:
 ………………………………………………………………………………………………………………………………
Date of this revision:
 ………………………………………………………………………………………………………………………………..
Revision No:
 …………………………………………………………………………………………………………………………………………….
Signed: …………………………………………………………………………………………………………………………………………………….
For the competent authority:
 [COMPETENTAUTHORITY IDENTIFICATION<a href="#_ftn58">[58]</a>]
</td>
</tr>
</table>

EASA Form 55a - Issue 3

<table border="1" cellpadding="0" cellspacing="0" width="604">
<tr>
<td width="208">
[MEMBER STATE]<a href="#_ftn59">[59]</a>
A Member of the European Union<a href="#_ftn60">[60]</a>
</td>
<td colspan="2" width="195">
Terms of Approval
</td>
<td width="202">
TA: [MEMBER STATE CODE<a href="#_ftn61">[61]</a>].21G.XXXX
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="604">
This document is part of production organisation
 approval number [MEMBER STATE CODE<a href="#_ftn62">[62]</a>].21G.XXXX
 issued to:
Company name:
</td>
</tr>
<tr>
<td colspan="4" width="604">
Section 1. SCOPE OF
 WORK:
</td>
</tr>
<tr>
<td colspan="2" width="302">
PRODUCTION OF
</td>
<td colspan="2" width="302">
PRODUCTS/CATEGORIES
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
</td>
<td colspan="2" valign="top" width="302">
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
</td>
<td colspan="2" valign="top" width="302">
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
</td>
<td colspan="2" valign="top" width="302">
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
</td>
<td colspan="2" valign="top" width="302">
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
</td>
<td colspan="2" valign="top" width="302">
</td>
</tr>
<tr>
<td colspan="4" width="604">
For details and limitations, refer to
 the Production Organisation Exposition, Section xxx
</td>
</tr>
<tr>
<td colspan="4" width="604">
Section 2. LOCATIONS:
</td>
</tr>
<tr>
<td colspan="4" width="604">
Section 3. PRIVILEGES:
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="604">
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="604">
The production organisation is
 entitled to exercise, within its terms of approval and in accordance with
 the procedures of its Production Organisation Exposition, the privileges
 laid down in point 21.A.163, subject to the following:
</td>
</tr>
<tr>
<td colspan="4" valign="top" width="604">
[keep only applicable text]
</td>
</tr>
<tr>
<td colspan="4" width="604">
Prior to the approval of the design of
 the product, the EASA Form 1 may be issued only for conformity
 purposes.
</td>
</tr>
<tr>
<td colspan="4" width="604">
A statement of conformity may not be
 issued for a non-approved aircraft.
</td>
</tr>
<tr>
<td colspan="4" width="604">
Maintenance may be performed, until
 compliance with the maintenance regulations is required, in accordance with
 the Production Organisation Exposition Section xxx
</td>
</tr>
<tr>
<td colspan="4" width="604">
Permits to fly may be issued in
 accordance with the Production Organisation Exposition Section yyy
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
Date of original issue:
</td>
<td colspan="2" valign="top" width="302">
Signed:
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
Date of this revision:
</td>
<td colspan="2" valign="top" width="302">
</td>
</tr>
<tr>
<td colspan="2" valign="top" width="302">
Revision No.:
</td>
<td colspan="2" valign="top" width="302">
For [COMPETENT AUTHORITY
 IDENTIFICATION<a href="#_ftn63">[63]</a>]
</td>
</tr>
<tr height="0">
</tr>
</table>

EASA Form 55b - Issue 3

---

[[56]](#_ftnref56)           Delete for non-EU
Member States.

[[57]](#_ftnref57)           Or “EASA”, if EASA
is the competent authority.

[[58]](#_ftnref58)           Or “EASA”, if EASA
is the competent authority.

[[60]](#_ftnref60)           Delete for non-EU
Member States.

[[61]](#_ftnref61)           Or “EASA”, if EASA
is the competent authority.

[[62]](#_ftnref62)           Or “EASA”, if EASA
is the competent authority.

[[63]](#_ftnref63)           Or “EASA”, if EASA
is the competent authority.

#### Appendix X — EASA Form 55 — Production organisation approval certificate

*Regulation (EU) 2024/1108*

*Appendix X*

**Production
organisation approval certificate — EASA Form 55**

Production organisation approval certificates referred to in
Subpart G of Annex I (Part 21)

<table cellpadding="7" cellspacing="0">
<col/>
<tr>
<td valign="top">
[MEMBER
			STATE] (*)

 


A
			Member of the European Union (**)

 


PRODUCTION
			ORGANISATION APPROVAL CERTIFICATE

 


Reference:
			[MEMBER STATE CODE (*)].21G.XXXX

 


Pursuant
			to Regulation (EU) 2018/1139 of the European Parliament and
			of the Council and to Commission Regulation (EU) No 748/2012,
			for the time being in force and subject to the conditions
			specified below, the [COMPETENT AUTHORITY OF THE MEMBER STATE]
			hereby certifies:

 


[COMPANY
			NAME AND ADDRESS]

 


as
			a production organisation in compliance with Section A of
			Annex I (Part 21) to Commission Regulation
			(EU) No 748/2012, is approved to produce products,
			parts, appliances, control and monitoring units and control and
			monitoring unit components listed in the attached approval
			schedule and issue the related certificates using the above
			references.

 


CONDITIONS:

 


1.	This
			approval is limited to what is specified in the enclosed terms of
			approval.

2.	This
			approval is subject to compliance with the procedures specified in
			the approved production organisation exposition.

3.	This
			approval is valid for as long as the approved production
			organisation remains in compliance with Annex I (Part 21)
			to Commission Regulation (EU) No 748/2012.

4.	Subject
			to compliance with the foregoing conditions, this approval shall
			remain valid for an unlimited period of time unless it has
			previously been surrendered, superseded, suspended or revoked.

 


Date
			of original issue:
			………………………………………………………………………………………………………………………………

Date
			of this revision:
			………………………………………………………………………………………………………………………………..

Revision
			No: …………………………………………………………………………………………………………………………………………….

Signed:
			…………………………………………………………………………………………………………………………………………………….
For
			the competent authority: [COMPETENTAUTHORITY IDENTIFICATION(**)]
</td>
</tr>
<tr>
<td valign="top">
EASA
			Form 55a — Issue 4

(*)
			Or ‘EASA’, if EASA is the competent authority.
(**)
			Or ‘EASA’, if EASA is the competent authority.
</td>
</tr>
</table>

<table cellpadding="7" cellspacing="0">
<col/>
<col/>
<col/>
<col/>
<tr>
<td>
[MEMBER
			STATE]<a href="#_ftn49" name="_ftnref49">[49]</a>
A
			Member of the European Union<a href="#_ftn50" name="_ftnref50">[50]</a>
</td>
<td colspan="2">
Terms
			of Approval
</td>
<td>
TA:
			[MEMBER STATE CODE<a href="#_ftn51" name="_ftnref51">[51]</a>].21G.XXXX
</td>
</tr>
<tr>
<td colspan="4" valign="top">
This
			document is part of production organisation approval number
			[MEMBER STATE CODE<a href="#_ftn52" name="_ftnref52">[52]</a>].21G.XXXX
			issued to:
Company
			name:
</td>
</tr>
<tr>
<td colspan="4">
Section
			1. SCOPE
			OF WORK:
</td>
</tr>
<tr>
<td colspan="2">
PRODUCTION
			OF
</td>
<td colspan="2">
PRODUCTS/CATEGORIES
</td>
</tr>
<tr valign="top">
<td colspan="2">
 

</td>
<td colspan="2">
 

</td>
</tr>
<tr valign="top">
<td colspan="2">
 

</td>
<td colspan="2">
 

</td>
</tr>
<tr valign="top">
<td colspan="2">
 

</td>
<td colspan="2">
 

</td>
</tr>
<tr valign="top">
<td colspan="2">
 

</td>
<td colspan="2">
 

</td>
</tr>
<tr valign="top">
<td colspan="2">
 

</td>
<td colspan="2">
 

</td>
</tr>
<tr>
<td colspan="4">
For
			details and limitations, refer to the Production Organisation
			Exposition, Section xxx
</td>
</tr>
<tr>
<td colspan="4">
Section
			2.
			LOCATIONS:
</td>
</tr>
<tr>
<td colspan="4">
Section
			3. PRIVILEGES:
</td>
</tr>
<tr>
<td colspan="4" valign="top">
 

</td>
</tr>
<tr>
<td colspan="4" valign="top">
The
			production organisation is entitled to exercise, within its terms
			of approval and in accordance with the procedures of its
			Production Organisation Exposition, the privileges laid down in
			point 21.A.163, subject to the following:
</td>
</tr>
<tr>
<td colspan="4" valign="top">
[keep
			only applicable text]
</td>
</tr>
<tr>
<td colspan="4">
Prior
			to the approval of the design of the product, the EASA Form 1
			may be issued only for conformity purposes.
</td>
</tr>
<tr>
<td colspan="4">
A
			statement of conformity may not be issued for a non-approved
			aircraft.
</td>
</tr>
<tr>
<td colspan="4">
Maintenance
			may be performed, until compliance with the maintenance
			regulations is required, in accordance with the Production
			Organisation Exposition Section xxx
</td>
</tr>
<tr>
<td colspan="4">
Permits
			to fly may be issued in accordance with the Production
			Organisation Exposition Section yyy
</td>
</tr>
<tr valign="top">
<td colspan="2">
Date
			of original issue:
</td>
<td colspan="2">
Signed:
</td>
</tr>
<tr valign="top">
<td colspan="2">
Date
			of this revision:
</td>
<td colspan="2">
 

</td>
</tr>
<tr valign="top">
<td colspan="2">
Revision
			No.:
</td>
<td colspan="2">
For
			[COMPETENT AUTHORITY IDENTIFICATION<a href="#_ftn53" name="_ftnref53">[53]</a>]
</td>
</tr>
</table>

**EASA Form 55b - Issue 3**

---

[[49]](#_ftnref49) Or
“EASA”, if EASA is the competent authority.

[[50]](#_ftnref50) Delete
for non-EU Member States.

[[51]](#_ftnref51) Or
“EASA”, if EASA is the competent authority.

[[52]](#_ftnref52) Or
“EASA”, if EASA is the competent authority.

[[53]](#_ftnref53) Or
“EASA”, if EASA is the competent authority.

Compare / EASA/ Incorporated Amendments/ Compare & Highlight Differences

Appendix X -- EASA Form 55 -- Production organisation approval certificate

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