European Aviation Safety AgencyEASA Form 2Part-145 Approval

Competent authority:Application for initial grant

European Aviation Safety Agency (EASA)Application for change

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1. Registered name of applicant:
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2. Trading name (if different):

3. Postal Address:

4. Address of site(s) requiring approval:

5. Contact Details:

NamePosition
TelFax
E-mail(s)

6.Scope of Part-145 Approval relevant to this application:

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Note (1) Address to send the application:

European Aviation Safety Agency

Postfach 10 12 53

DE-50452

Cologne - Germany

Email:

Fax: +49 221 89990999

Note (2) application for change:

Applications for change shouldbe forwarded directly to the Team Leader allocated by EASA and responsible for the surveillance of the approval.

Note (3) on Fees Payable

For detailed information regarding the current fees and charges please refer to the EASA fees and charges Regulation which can be found on the EASA web site

In accordance with the current Fees & Charges Regulation applicants and holders of Agency approvals are required to supply a signed certificate from an authorised representative of the organisation concerned regarding the elements detailed below in order for the Agency to be able to determine the corresponding fee category. Please provide the following information:

7.Staff number:

(a). The total number of staff employed by the organisation in order to comply with EASA Part-145.

(b). The number of contracted staffassociated with the proposed approval.

Main Site:Additional site(s):
Please detail all additional sites

a) Employeesa) Employees
b) Contractorsb) Contractors

8. Regulation (EC) No. 2042/2003 specifies that an approval may be granted to an organisation which may be either a natural person, a legal entity or part of a legal entity. Would you therefore please include with this application confirmation of the legal status of your organisation andenclose a copy of your Certificate ofIncorporation.

Date of Certificate of Incorporation

9 . Name and position of the (proposed*) Accountable Manager:
* ‘Proposed’ is applicable only in the case of a new Part-145 Applicant.

10. Signature of the (proposed*) Accountable Manager:

* ‘Proposed’ is applicable only in the case of a new Part-145 Applicant

11. Place12. Date of application

SCOPE OF REQUESTED PART-145 APPROVAL

CLASS / RATING / LIMITATION / BASE / LINE
AIRCRAFT / A1
Aeroplanes/airships
above 5700 Kg / Quote aeroplane/airship type
A2
Aeroplanes/airships
5700 Kg and below / Quote aeroplane/airship manufacturer or group or type
A3 Helicopters / Quote helicopter manufactureror group or type
A4 Aircraft other than A1, A2 or A3 / Quote aircraft type or group
ENGINES / B1 Turbine / Quote engine type
B2 Piston / Quote engine manufacturer or group or type
B3 APU / Quote engine manufacturer or type
COMPONENTS OTHER THAN COMPLETE ENGINES OR APUs / C1 Air Cond & Press / Quote aircraft type or aircraft manufacturer or
component manufacturer or the particular component
and or cross refer to a capability list in the exposition.
C2 Auto Flight
C3 Comms and Nav
C4 Doors – Hatches
C5 Electrical Power
C6 Equipment
C7 Engine – APU
C8 Flight Controls
C9 Fuel – Airframe
C10 Helicopter –Rotors
C11 Helicopter –Trans
C12 Hydraulic
C13 Instruments
C14 Landing Gear
C15 Oxygen
C16 Propellors
C17 Pneumatic
C18 Protection ice/rain/fire
C19 Windows
C20 Structures
SPECIALISED
SERVICES / D1 Non Destructive Testing. / Quote particular NDT methods

End of form

PART 145 - EASA Form 2 / 01.06.2007 / Page 1/3