AMC No 1 to 21.A.130(b) Statement of conformity for complete aircraft    

CAA ORS9 Decision No. 1

1. PURPOSE AND SCOPE

The description under this AMC refers only to the use of the aircraft Statement of Conformity issued under Part 21 Section A Subpart F. Statement of Conformity under Part 21 Subpart F for products other than complete aircraft, and for parts and appliances is described in AMC No 2 to 21.A.130(b).

Use of the aircraft Statement of Conformity issued by an approved production organisation is described in 21.A.163(b) under Part 21 Section A Subpart G and the completion instructions are to be found in the Appendices to Part 21.

The purpose of the aircraft Statement of Conformity (CAA Form 52) issued under Part 21 Section A Subpart F is to present to the CAA a complete aircraft. The CAA only validates the Statement of Conformity if it finds, as described in 21.A.130 and its associated GM, that the aircraft conforms with the type design and is in condition for safe operation.

2. GENERAL

The Statement of Conformity must comply with the format attached including 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 make the Statement of Conformity unrecognisable. If in doubt consult the CAA.

The Statement of Conformity must either be pre-printed or computer generated but in either case the printing of lines and characters must be clear and legible. Pre-printed wording is permitted in accordance with the attached model but no other certification statements are permitted.

Statements of Conformity must be issued in one or more of the official language(s) of the issuing CAA with translations in English shown below, if required. Completion may be either machine/computer printed or hand-written using block letters to permit easy reading.

A copy of the Statement of Conformity and all referenced attachments are to be retained by the manufacturer. A copy of the validated Statement of Conformity is to be retained by the CAA.

3. COMPLETION OF THE AIRCRAFT STATEMENT OF CONFORMITY BY THE ORIGINATOR

There must be an entry in all Blocks to make the document a valid Statement.

A Statement of Conformity must not be issued for validation by the CAA, unless the design of the aircraft and its installed products are approved.

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 manufacturer, unless the CAA agrees otherwise.

This Statement of Conformity is not intended to provide for the complete equipment fit required by the applicable operational rules. However, some of these 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 operation.

Block 1 Enter name of the State of manufacture.

Block 2 The competent authority under which authority the Statement of Conformity is  issued.

Block 3   A unique serial number should be pre-printed in this Block for Statement control   and traceability purposes. Except that in the case of a computer generated document the number need not be pre-printed where the computer is programmed to produce and print a unique number.

Block 4 The full name and location address of the manufacturer issuing the statement. This Block may be pre-printed. Logos, etc., are permitted if the logo can be contained within the Block.

Block 5  The aircraft type in full as defined 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 such a mark that is accepted by the CAA and, if applicable, by the competent authority of a third country.

Block 8 The identification number assigned  by  the  manufacturer  for  control  and traceability and product support. This is sometimes referred to as a Manufacturers Serial No or Constructors No.

Block 9 The engine and propeller type(s) in full as defined in the relevant type-certificate  and its associated data sheet. Their manufacturer identification No and associated location should also be shown.

Block 10 Approved design changes to the Aircraft Definition.

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

Block 12 Approved unintentional deviation to 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 aircraft. If there is no such information or data, state: ‘NONE’. If the CAA has endorsed a CO₂ emissions production cut-off exemption, make the following record: ‘Aeroplane exempted from the applicability of paragraph 2.1.1 [x] as referenced in the 1st Edition of Annex 16, Volume III, Part II, Chapter 2 (July 2017).’

Block 15 Enter ‘Certificate of Airworthiness’ or ‘Restricted Certificate of Airworthiness’ for  the Certificate of Airworthiness requested.

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

Block 17 Validity of the Statement of Conformity is dependent on full completion of all   Blocks on the form. A copy of the flight test report together with any recorded defects and rectification details should be kept on file by the manufacturer. The report should be signed as satisfactory by the appropriate certifying staff and a flight crew member, e.g., test pilot or flight test engineer. The flight tests performed are those required by 21.A.127 and GM 21.A.127, 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 safe operation aspects of this statement should be kept on file by the manufacturer.

Block 18 The Statement of Conformity may be signed by the person authorised to do so by the manufacturer in accordance with 21.A.130(a). A rubber stamp signature should not be used.

Block 19 The name of the person signing the certificate should be  typed  or printed in a  legible form.

Block 20 The date the Statement of Conformity is signed must be given.

Block 21 For production under Part 21 Subpart F, state ‘NOT APPLICABLE’

Additionally, for production under Part 21 Section A Subpart F, this Block must include validation by the CAA. For this purpose, the validation statement below should be included in the Block 21 itself, and not referred in a separate document. The statement can be pre-printed, computer generated or stamped, and should be followed by the signature of the representative of the CAA validating the certificate, the name and the position/identification of such representative of the CAA, and the date of such validation by the CAA.

VALIDATION STATEMENT:

‘After due inspection the <identify the issuing CAA> is satisfied that this document constitutes an accurate and valid Statement of Conformity  in  accordance  with Part 21 Section A Subpart F.’