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BASA CONSULTATION FAA AND DOA

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ARC FORM attached to announcement of the DCA on approval of repair station

1. Country 3. Certificate Ref. No.

AUTHORISED RELEASE CERTIFICATE -

DEPARTMENT OF CIVIL AVIATION OF AIRWORTHINESS APPROVAL TAG

THAILAND

4. Organization 5. Work Order / Contract / Invoice



6. Item 7. Description 8. Part No. 9. Eligibility* 10. Qty. 11. Serial/Batch No. 12. Status









13. Remarks





14. New Parts: 15. Used Parts:

Certifies that part(s) identified above except as otherwise specified in block 13 was (were) manufacturer/or Certifies that part(s) identified above except as otherwise specified in block 13 was carried

inspect in accordance with the airworthiness requirements of the stated country and/or in the case of parts to be out in accordance with the airworthiness requirements of the stated country and the notified

exported with the approved design data and with the notified special requirements of the importing country. special requirements of the importing country and in respect to that work, the part(s) is (are) in

condition for safe operation and considered ready for release to service.

16. Signature 19. Issued by or on behalf of Department of Civil Aviation



17. Name (typed or printed) 18. Date



DCA Form one * Cross-check eligibility for more details with parts catalog

USER/INSTALLER RESPONSIBILITIES

Note :

1. It is important to understand that the existence to the document alone does not automatically constitute authority to install the part/component/assembly.

2. Where the user/installer works in accordance with the national requirements of an Airworthiness Authority different from the Department of Civil Aviation of Thailand, it is essential that the

user/installer ensures that his/her Airworthiness Authority accepts parts/components/assemblies from the Department of Civil Aviation of Thailand.

3. Statements in block 14 and 15 do not constitute installation certification. In all case the aircraft maintenance record must contain an installation certification issued in accordance with the national

requirements by the user/installer before the aircraft can be flown.



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