[state] Part 6 — Approved Maintenance Organisation



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IS: 6.2.1.3 Approved Maintenance Organisation Certificate

The following is an AMO certificate



[STATE]

APPROVED MAINTENANCE ORGANISATION CERTIFICATE

Number


This certificate is issued to

Whose principal place of business address is

Upon finding that its organisation complies in all respects with the requirements of the [Civil Aviation Regulations Part 6], relating to the establishment of an Approved Maintenance Organisation and is empowered to operate an Approved Maintenance Organisation.

With the following ratings:

This certificate shall continue in effect, unless cancelled, suspended, revoked, or expired, until

(enter date 12 months after first issue, 24 months after second and further issues)






Date of Issue: dd/mm/yyyy




Signature: ________________________________













Printed Name: _____________________________













Title: _____________________________________







This certificate is non-transferable.




CAA AAMO Form dated 11/2014

ICAO Doc. 9389, Manual of Procedures for an Airworthiness Organisation, Appendix 6-E-3

EASA 145, Appendix III

IS: 6.2.1.5 Application for an AMO Certificate

The following application may be used for an AMO certificate.



[STATE]

Civil Aviation Administration



Application for Approved Maintenance
Organisation Certificate and/or Ratings


1. Approved Maintenance Organisation Name, Number, Location and Address

2. Reasons for Submission

a. Official Name of Approved Maintenance Organisation:


Number:

 Original Application for Certificate and Rating

 Change in Rating

 Change in Location or Housing and Facilities


b. Location where business is conducted:


 Change in Ownership

 Other (Specify)






c. Official Mailing Address of Approved Maintenance Organisation










(Number, Street, City, State, & Postal Code)


































d. Doing Business As:






















3. Ratings Applied for:

 Airframe
 Class 1
 Class 2
 Class 3
 Class 4

 Powerplant
 Class 1
 Class 2
 Class 3

 Propeller
 Class 1
 Class 2

 Avionics/ Radio
 Class 1
 Class 2
 Class 3

 Instrument
 Class 1
 Class 2
 Class 3
 Class 4




 Accessories
 Class 1
 Class 2
 Class 3



 Limited
 Airframe
 Powerplant
 Propeller
 Instruments

 Accessories
 Landing Gear
 Floats
 Avionics/radio

 Rotor Blades
 Fabric
 Emergency Equip.
 Non-Dest. Test

 Other



 Specialised Service
(List Process Specification(s))
















4. List of Maintenance Functions contracted to an outside Maintenance Organisation:


5. Applicants Certification

Name of Owner (Include name(s) of individual Owner, all partners, or corporation name given the state, province, or country and date of incorporation)




I hereby certify that I have been authorised by the approved maintenance organisation identified in Item 1 above to make this application and that statements attached hereto are true and correct to the best of my knowledge.

Date:


Authorised Signature:







AMO ARSC dated 12/98 Page 1of 2



For CAA Use Only

Record of Action
Approved Maintenance Organisation Inspection


For CAA Use Only

6. Remarks (Identify by item number. Include deficiencies found and ratings denied)


7. Findings - Recommendations

8. Date of Inspection

 A. AMO was found to comply with requirements of Part 6.

 B. AMO was found to comply with requirements of Part 6, except for deficiencies listed in Item 6.

 C. Recommend Certificate with rating applied for on application be issued.

 D. Recommend Certificate with rating applied for on application (EXCEPT those listed in Item 6) be issued.






9. CAA Office

Signature(s) of Inspector(s)

Printed Names of Inspectors




























10. Supervising or Assigned Inspector

ACTION TAKEN

CERTIFICATE ISSUED

Inspector’s Signature




 APPROVED
As shown on certificate issued

Number







on date shown

 DISAPPROVED



Date

Inspector’s Printed Name

Title

AMO ARSC dated 12/98 Page 2 of 2

FAA Form 8310-3
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