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Appendix XI - EASA Form 65 - Letter of Agreement for production without a production organisation approval

Available versions for ERULES-1963177438-4105

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 XI – EASA Form 65 – Letter of Agreement for production without
a production organisation approval

Regulation
(EU) 2022/201

Appendix XI

Letter of agreement
for production without a production organisation approval — EASA Form 65

Letter of agreement referred to in Subpart F
of [Annex I](#_DxCrossRefBm1649096856)
(Part 21)

<table border="1" cellpadding="0" cellspacing="0" width="610">
<tr>
<td valign="top" width="610">
[MEMBER STATE]<a href="#_ftn64">[64]</a>
A Member of the European Union<a href="#_ftn65">[65]</a>
LETTER OF AGREEMENT FOR
 PRODUCTION WITHOUT PRODUCTION ORGANISATION APPROVAL
[NAME OF THE APPLICANT]
[TRADE NAME (if different from the name
 of the applicant)]
[FULL POSTAL ADDRESS OF THE APPLICANT]
Date (Day, Month, Year)
Reference: [MEMBER STATE CODE<a href="#_ftn66">[66]</a>].21F.XXXX
Dear Mr/Ms [Name of the Applicant],
Your production inspection system has
 been evaluated and found to be in compliance with Section A,
 Subpart A and Subpart F of Annex I (Part 21) to
 Commission Regulation (EU) No 748/2012.
Therefore, subject to the conditions
 specified below, we agree that the showing of conformity of the products,
 parts and appliances mentioned below may be done under Section A,
 Subpart F of Annex I (Part 21) to Regulation (EU) No 748/2012.
         No of Units           P/N             S/N
AIRCRAFT
PARTS
The following conditions are applicable
 to this letter of agreement:
(1)     It
 is valid while [Company Name] remains in compliance with Section A,
 Subpart A and Subpart F of Annex I (Part 21) to
 Regulation (EU) No 748/2012.
(2)     It
 requires compliance with the procedures specified in [Company Name] manual
 ref./issue date........................
(3)     It
 terminates on ……………………………..
(4)     The
 statement of conformity issued by [Company Name] under point <a href="#_DxCrossRefBm1649096912">21.A.130</a> of Regulation
 (EU) No 748/2012 shall be validated by the issuing authority of
 this letter of agreement in accordance with the procedure................ of
 the referenced manual.
(5)     [Company
 Name] shall notify the issuing authority of this letter of agreement
 immediately of any changes to the production inspection system that may
 affect the inspection, conformity or airworthiness of the products and parts
 listed in this letter.
For the competent authority: [COMPETENT
 AUTHORITY IDENTIFICATION<a href="#_ftn67">[67]</a> <a href="#_ftn68">[68]</a>]
Date and Signature
</td>
</tr>
</table>

EASA Form 65 – Issue 3

---

[[65]](#_ftnref65)           Delete for non-EU
Member States.

[[66]](#_ftnref66)           Delete for non-EU
Member States.

[[67]](#_ftnref67)           Or “EASA”, if EASA is the competent
authority.

[[68]](#_ftnref68)           Delete for non-EU Member States.

#### Appendix XI – EASA Form 65 – Letter of Agreement for production without a production organisation approval

*Regulation (EU) 2024/1108*

*Appendix XI*

**Letter
of agreement for production without a production organisation
approval — EASA Form 65**

Letter of agreement referred to in Subpart F of [Annex I](#_DxCrossRefBm485230346)
(Part 21)

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

A
			Member of the European Union (**)

LETTER
			OF AGREEMENT FOR PRODUCTION WITHOUT A PRODUCTION ORGANISATION
			APPROVAL

 
 


[NAME
			OF THE APPLICANT]

[TRADE
			NAME (if different from the name of the applicant)]

[FULL
			POSTAL ADDRESS OF THE APPLICANT]

Date
			(day, month, year)

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

 
 


Dear
			Mr/Ms [name of the applicant],

your
			production inspection system has been evaluated and found to be in
			compliance with Section A, Subpart A and Subpart F
			of Annex I (Part 21) to Commission Regulation
			(EU) No 748/2012.

 
 


Therefore,
			subject to the conditions specified below, we agree that the
			showing of conformity of the products, parts, appliances, control
			and monitoring units and control and monitoring unit components
			mentioned below may be performed according to Section A of
			Subpart F of Annex I (Part 21) to Commission
			Regulation (EU) No 748/2012.

 
 


	No
			of Units		P/N		S/N

 
 


AIRCRAFT

PARTS

The
			following conditions are applicable to this letter of agreement:

(1)	It
			is valid while [company name] remains in compliance with Section A
			Subpart A and Subpart F of Annex I (Part 21)
			to Commission Regulation (EU) No 748/2012.

(2)	It
			requires compliance with the procedures specified in [company
			name] manual reference/issue
			date.........................................................................................................................

(3)	It
			terminates on ………………………………………………………………………………………………………………..

(4)	The
			statement of conformity issued by [company name] under
			point <a href="#_DxCrossRefBm485230403">21.A.130</a>
			of Commission Regulation (EU) No 748/2012 shall be
			validated by the issuing authority of this letter of agreement in
			accordance with the procedure...... of the referenced manual.

(5)	[company
			name] shall immediately notify the issuing authority of this
			letter of agreement of any changes to the production inspection
			system that may affect the inspection, conformity or airworthiness
			of the products, parts, control and monitoring units and control
			and monitoring unit components listed in this letter of agreement.

For
			the competent authority: [COMPETENT AUTHORITY IDENTIFICATION (*)
			(**)]

Date
			and Signature
 

</td>
</tr>
<tr>
<td valign="top">
EASA
			Form 65 – Issue 4

(*)
			Or 'EASA', if EASA is the competent authority.
(**)
			Delete for third countries.
</td>
</tr>
</table>

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Appendix XI - EASA Form 65 - Letter of Agreement for production without a production organisation approval

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