Defence Aviation Safety Authority

Approval Certificate

AUS.DASA.145.[XXX]

Pursuant to Defence Aviation Safety Regulation 145and subject to the

conditions specified below, the Authority hereby certifies

Unit/Organisation

Address

Address

StatePostcode

DARNO-[XXXXX]

as aMAINTENANCE ORGANISATION

approved according to DASR 145to maintain the products listed in the attached Approval Schedule and

issue related certificates of release to service using the above reference.

CONDITIONS

1.This approval is limited to that specified in the attached Approval Schedule, and

2.This approval requires compliance with the procedures specified in the DASR 145 approved Maintenance Organisation Exposition, and

3.This approval is valid whilst the approved Maintenance Organisation remains in compliance with DASR 145.

4.Subject to compliance with forgoing conditions, this approval shall remain valid for an unlimited duration unless the approval has been surrendered, superseded, suspended or revoked.

For and on behalf of the Defence Aviation Safety Authority, / JD Hood
Air Commodore
Date of issue: / XX/YY/ZZZZ
Issue number: / X

DASR Form 3 V0.x

AH6079075Page 1 of 5

Defence Aviation Safety Authority

MaintenanceOrganisationApprovalSchedule

MaintenanceOrganisationApprovalCertificate

AUS.DASA.145.[XXX]

Organisation
Unit/Organisation
Street
Town
State Postcode / Street
Town
State Postcode / Street
Town
State Postcode
Street
Town
State Postcode / Street
Town
State Postcode / Street
Town
State Postcode
CLASS / RATING / LIMITATION / BASE / LINE
AIRCRAFT / Enter rating from table 1 below / individual aircraft types / Yes / Yes
CLASS / RATING / LIMITATIONS
ENGINES / Copy from table 2 below / (List for individual types)
Copy from table 2 below
COMPONENTS OTHER THAN COMPLETE ENGINES OR APUs / Copy from table 3 below / See options in table 3 below
Component Capability List (CCL)
SPECIALISED SERVICES / D1
Non-Destructive Testing / Copy from Table 4
D5
Arms, Munitions and
Pyrotechnic Systems Specific

Limitations:

All shortfalls (as identified at AH[xxxxx] and any shortfalls subsequently identified by the Authority during the DASR transition period) are to be addressed to the satisfaction of and in a timeframe agreed with the Authority.

This approval schedule is limited to those products, parts and appliances and to the activities specified in the scope of work section contained in the DASR 145 approved Maintenance Organisation Exposition.

MOE reference: [XXX including revision/version & date]

Date of issue: / 27/03/2018
Issue number: / X

AH6079075

DASR Form 3 V6.0Page 1 of 2

Defence Aviation Safety Authority

MaintenanceOrganisationApprovalSchedule

MaintenanceOrganisationApprovalCertificate

AUS.DASA.145.[XXX]

GUIDANCE SECTION

DELETE THE GUIDANCE SECTION after completing FORM 3 and prior to final save and PDF

Do not change font or size of text.

Copy text to tables above

Tailor Organisation section to list main repair work venues (including separate component work venues).

Add extra boxes as required

Delete empty and not applicable boxes/ tables

Organisation
Unit/Organisation
Street
Town
State Postcode / Street
Town
State Postcode / Street
Town
State Postcode
CLASS / RATING / LIMITATION / BASE / LINE
TABLE 1
AIRCRAFT / A1
Aeroplanes/Airships above 5700 kg
A3
Helicopters
A4
Aircraft other than A1, A2 or A3 / individual aircraft types / YES/NO / YES/NO
YES/NO / YES/NO
Class / Rating / Limitations
TABLE 2
ENGINES / B1
Turbine / (List for individual types)
B2
Piston
B3
APU
Date of issue: / 27/03/2018
Issue number: / X

AH6079075

DASR Form 3 V6.0Guidance 1 of 2

Defence Aviation Safety Authority

MaintenanceOrganisationApprovalSchedule

MaintenanceOrganisationApprovalCertificate

AUS.DASA.145.[XXX]

TABLE 3
COMPONENTS OTHER THAN COMPLETE ENGINES OR AUXILARY POWER UNITS / C1Air Cond & Press
C2Auto Flight
C3Comms and Nav
C4Doors – Hatches
C5Electrical Power
C6Equipment
C7Engine – APU
C8Flight Controls
C9Fuel - Airframe
C10Helicopter – Rotors
C11Helicopter – Trans
C12Hydraulic
C13Instruments
C14Landing Gear
C15Oxygen
C16Propellers
C17Pneumatic
C18Protection Ice/Rain/Fire
C19Windows
C20Structural
C21Water Ballast
C22Propulsion Augmentation
C51Attack Systems
C52Radar / Surveillance
C53Weapons systems
C54Crew Escape
C55Missiles/Drones/Telemetry
C56Reconnaissance
C57Electronic warfare / List limitations
or
Components in accordance with the Component Capability List (CCL) defined in the Company MOE
or
Components in accordance with the section X defined in the Company MOE
TABLE 4
SPECIALISED SERVICES / D1
Non-Destructive Testing / Liquid Penetrant Testing (PT)
Magnetic Particle Testing (MT)
Ultrasonic Testing (UT)
Eddy Current Testing (ET)
Radiographic Testing (RT)
Date of issue: / 27/03/2018
Issue number: / X

AH6079075

DASR Form 3 V6.0Guidance 2 of 2