ED Decision 2012/020/R
The competent authority must receive an application for permit to fly in a form and manner established by that authority, e.g. on EASA Form 21 (see below) completed by the applicant.
Application for Part 21 Permit to Fly |
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1. Applicant: |
[Name of applicant] |
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2. Aircraft nationality and identification marks: |
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3. Aircraft owner: |
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4. Aircraft manufacturer/type |
5. Serial number |
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6. Purpose of flight [Use terminology of 21.A.701(a) and add any additional information for accurate description of the purpose, e.g. place, itinerary, duration…] [For an application due to a change of purpose (ref. 21.A.713): reference to initial request and description of new purpose] |
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7. Expected target date(s) for the flight(s) and duration |
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8. Aircraft configuration as relevant for the permit to fly 8.1 The above aircraft for which a permit to fly is requested is defined in [add reference to the document(s) identifying the configuration of the aircraft. Same as required in AMC 21.A.263(c)(6) or AMC 21.A.709(b) application approval form 18A or 18B, box 6] 8.2 The aircraft is in the following situation related to its maintenance schedule:
[Describe status] |
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9. Approval of flight conditions [if not available at the time of application, indicate reference of request for approval]
[Reference to: 1. EASA approval, if flight conditions are approved by EASA; or 2. DOA approval form (see AMC 21.A.263(c)(6)), if approved under DOA privilege; or 3. Competent authority approval. |
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10. Date:
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11. Name and signature:
[Authorised signatory]
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EASA Form 21
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