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Appendix V — Application Form — EASA Form 19

Regulation (EU) 2021/700

1.This Appendix contains an example of the form used for applying for the aircraft maintenance licence referred to in Annex III (Part-66).

2.The competent authority of the Member State may modify the EASA Form 19 only to include additional information necessary to support the case where the national requirements permit or require the aircraft maintenance licence issued in accordance with Annex III (Part-66) to be used outside the requirements of this Regulation.


APPLICATION FOR INITIAL/AMENDMENT/RENEWAL OF PART-66 AIRCRAFT MAINTENANCE LICENCE (AML)

EASA FORM 19

APPLICANT’S DETAILS:

Name: ………………………………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

Tel: ……………………………………………………………………….. E-mail: …………………………………………………………………….

Nationality: …………………………………………………………... Date and Place of Birth: ………………………………………….

PART-66 AML DETAILS (if applicable):

Licence No: …………………………………………………………………. Date of Issue: …………………………………………………….

EMPLOYER’S DETAILS:

Name: ………………………………………………………………………………………………………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………………………………………….

Maintenance Organisation Approval Reference: ………………………………………………………………………………………

Tel: …………………………………………………………………………….. Fax: ……………………………………………………………………

APPLICATION FOR: (Tick relevant boxes)

Initial AML

Amendment of AML

Renewal of AML

(Sub)categories

Aeroplane Turbine

Aeroplane Piston

Helicopter Turbine

Helicopter Piston

A

B1

B2

B2L

B3

C

L (see below)

Avionics

See system ratings below

Piston engine non-pressurised aeroplanes of MTOM of 2t and below

Complex motor-powered aircraft

Aircraft other than complex motor-powered aircraft

System ratings for B2L licence:

1. autoflight

2. instruments

3. com/nav

4. surveillance

5. airframe systems

L-licence subcategories:

L1C: Composite sailplanes

L1: Sailplanes

L2C: Composite powered sailplanes and composite ELA1 aeroplanes

L2: Powered sailplanes and ELA1 aeroplanes

L3H: Hot-air balloons

L3G: Gas balloons

L4H: Gas balloons

L4H: Hot-air airships

L4G: ELA2 gas airships

L5: Gas airship other than ELA2

Type endorsements/Rating endorsement/Limitation removal (if applicable): …………………………………………………………………………………………………………………………………………………………………….

I wish to apply for initial/amendment of/renewal of Part-66 AML, as indicated, and confirm that the information contained in this form was correct at the time of application.

I herewith confirm that:

1.I am not holding any Part-66 AML issued in another Member State;

2.I have not applied for any Part-66 AML in another Member State; and

3.I never had a Part-66 AML issued in another Member State which was revoked or suspended in any other Member State.

I also understand that any incorrect information could disqualify me from holding a Part-66 AML.

Signed: …………………………………………………………………. Name: ……………………………………………………………………….

Date: ………………………………………………………………………………………………………………………………………………………….

I wish to claim the following credits (if applicable):

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

Experience credits for Part-147 training

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

Examination credits for equivalent exam certificates

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………….

Please enclose all relevant certificates

Recommendation (if applicable): It is hereby certified that the applicant has met the relevant Part-66 maintenance knowledge and experience requirements and it is recommended that the competent authority grants or endorses the Part-66 AML.

Signed: .............................................................. Name: ..................................................................................

Position: ........................................................... Date: ....................................................................................

EASA Form 19 Issue 5

Appendix VI — Aircraft Maintenance Licence referred to in Annex III (Part-66) — EASA Form 26

Regulation (EU) 2023/989

1.An example of the aircraft maintenance licence referred to in Annex III (Part-66) can be found on the following pages.

2.The document shall be printed in the standardised form shown but may be reduced in size to allow it being generated by computer. When the size is reduced, care shall be taken to ensure that sufficient space is available in those places where official seals or stamps are required. Computer-generated documents need not have all the boxes incorporated when any such box remains blank, so long as the document can clearly be recognised as an aircraft maintenance licence issued in accordance with Annex III (Part-66).

3.The document may be filled in either in English or the official language of the Member State of the competent authority. In the latter case, a second copy in English shall be attached to the document for any licence holder who needs to use the licence outside that Member State to ensure understanding for the purpose of mutual recognition.

4.Each licence holder shall have a unique licence holder number, established on the basis of a national identifier and an alpha-numeric designator.

5.The document may have the pages in a different order to the one of this example and needs not have some or any divider lines as long as the information contained is positioned in such a manner that each page lay-out can clearly be identified with the format of the example of the aircraft maintenance licence contained herein.

6.The document shall be prepared by the competent authority. However, it may also be prepared by any maintenance organisation approved in accordance with Annex II (Part-145), where the competent authority agrees to this and the preparation takes place in accordance with a procedure laid down in the maintenance organisation exposition referred to in point 145.A.70 of Annex II (Part-145). In all cases, the competent authority shall issue the document.

7.The preparation of any change to an existing aircraft maintenance licence shall be carried out by the competent authority. However, it may also be prepared by any maintenance organisation approved in accordance with Annex II (Part-145), where the competent authority agrees to this and the preparation takes place in accordance with a procedure laid down in the maintenance organisation exposition referred to in point 145.A.70 of Annex II (Part-145). In all cases, the competent authority shall change the document.

8.The holder of the aircraft maintenance licence shall keep it in good condition and shall ensure that no unauthorised entries are made. Failure to comply with this rule may invalidate the license or lead to the holder not being permitted to hold any certification privilege. It may also result in prosecution under national law.

9.The aircraft maintenance licence issued in accordance with Annex III (Part-66) shall be recognised in all Member States and it is not required to exchange the document when working in another Member State.

10.The Annex to EASA Form 26 is optional and may only be used to include national privileges, where such privileges are covered by national law outside the scope of Annex III (Part-66).

11.With regard to the aircraft type rating page of the aircraft maintenance licence, the competent authority may decide not to issue this page until the first aircraft type rating needs to be endorsed and may need to issue more than one aircraft type rating page depending on the number of type ratings to be listed.

12.Notwithstanding point 11, each page issued shall be in the format of this example and contain the specified information for that page.

13.The aircraft maintenance licence shall clearly indicate that the limitations are exclusions from the certification privileges. If there are no limitations applicable, the LIMITATIONS page shall state ‘No limitations’.

14.Where a pre-printer format is used for issuing the aircraft maintenance licence, any category, subcategory or type rating box which does not contain a rating entry shall be marked to show that the rating is not held.


I.

EUROPEAN UNION (*)

[STATE]

[AUTHORITY NAME & LOGO]

II.

Part-66

AIRCRAFT MAINTENANCE

LICENCE

III.

Licence No. [MEMBER STATE

CODE].66.[XXXX]

IVa. Full name of holder:

IVb. Date and place of birth:

V. Address of holder:

VI. Nationality of holder:

VII. Signature of holder:

EASA FORM 26 Issue 6

III. Licence No:

VIII. CONDITIONS:

This licence shall be signed by the holder and be accompanied by an identity document containing a photograph of the licence holder.

Endorsement of any categories on the page(s) entitled 'Part-66 CATEGORIES' only, does not permit the holder to issue a certificate of release to service for an aircraft.

This licence, when endorsed with an aircraft rating, meets the intent of ICAO Annex 1.

The privileges of this licence holder are prescribed by Regulation (EU) No 1321/2014 and, in particular, Annex III (Part-66) thereto.

This licence remains valid until the date specified on the limitation page unless previously suspended or revoked.

The privileges of this licence may not be exercised unless in the preceding two-year period, the holder had either six months of maintenance experience in accordance with the privileges granted by the licence, or met the provisions for the issue of the appropriate privileges.

IX. Part-66 CATEGORIES

VALIDITY

A

B1

B2

B2L

B3

L

C

Aeroplanes Turbine

n/a

n/a

n/a

n/a

Aeroplanes Piston

n/a

n/a

n/a

n/a

Helicopters Turbine

n/a

n/a

n/a

n/a

Helicopters Piston

n/a

n/a

n/a

n/a

Avionics

n/a

n/a

n/a

n/a

n/a

Complex motor-powered aircraft

n/a

n/a

n/a

n/a

n/a

Aircraft other than complex motor-powered aircraft

n/a

n/a

n/a

n/a

n/a

Sailplanes, powered sailplanes, ELA1 aeroplanes, balloons and airships

n/a

n/a

n/a

n/a

n/a

Piston engine non pressurised aeroplanes of 2 000 kg MTOM and below

n/a

n/a

n/a

n/a

n/a

X. Signature of issuing officer & date:

XI. Seal or stamp of issuing authority:

III. Licence No:

III. Licence No:




XII. PART-66 RATINGS

XIII. PART-66 LIMITATIONS

Aircraft Rating/ System ratings

Category/Subcategory

Stamp & Date

Licence valid until:

III. Licence No:

III. Licence No:


Annex to EASA FORM 26

XIV. NATIONAL PRIVILEGES outside the scope of Part-66, in accordance with [National Legislation] (Valid only in [Member State])

INTENTIONALLY LEFT BLANK

Official Stamp & Date

III. Licence No:

EASA Form 26 Issue 5