gaca_gov_sa · form · processed · 1 chunks
GACA العربيه للطيران المحدي General Authority of Civil Aviation [Non-Text] AUTHORIZED RELEASE CERTIFICATE <table><tr><td colspan="2">1. Approving Civil Aviation Authority/Country</td><td rowspan="2" colspan="4">2. GACA Form 8130-3, AIRWORTHINESS APPROVAL TAG</td><td colspan="2">3. Form Tracking Number</td></tr><tr><td colspan="2">GACA/Saudi Arabia</td><td colspan="2"></td></tr><tr><td colspan="6">4. Organization Name and Address</td><td colspan="2">5. Work Order / Contract / Invoice No.</td></tr><tr><td colspan="2"></td><td colspan="2"></td><td>8. Part Number</td><td>9. Quantity</td><td>10. Serial No.</td><td>11. Status/Work</td></tr><tr><td></td><td></td><td colspan="2"></td><td></td><td></td><td></td><td></td></tr><tr><td colspan="8">12. Remarks</td></tr><tr><td colspan="4">13a. Certifies the items identified above were manufactured in conformity to</td><td colspan="4">14a. Return to Service in accordance with</td></tr><tr><td colspan="4">□ Approved design data and are in condition for safe operation.</td><td colspan="4">□ GACAR (Section 43.11)</td></tr><tr><td rowspan="2" colspan="4">□ Non-approved design data specified in Block-12.</td><td colspan="4">□ Other regulations specified in Block-12</td></tr><tr><td colspan="4">Certifies that unless otherwise specified in Block-12, the work identified in BLOCK-11 and described in Block-12 was accomplished in accordance with GACAR Part 43 and in respect to that work, the items are approved for return to service.</td></tr><tr><td>13b. Authorized Signature</td><td></td><td colspan="3">13c. Approval / Authorization No.</td><td>14b. Authorized Signature</td><td colspan="2">14c. GACA Approval / Certificate No.</td></tr><tr><td></td><td></td><td colspan="3"></td><td></td><td colspan="2"></td></tr><tr><td>13d. Name (Typed or Printed)</td><td></td><td colspan="3">13e. Date (dd/mm/yy)</td><td>14d. Name (Typed or Printed)</td><td colspan="2">14e. Date (dd/mm/yy)</td></tr><tr><td></td><td></td><td colspan="3"></td><td></td><td colspan="2"></td></tr><tr><td colspan="8">User / Installer Responsibilities</td></tr><tr><td colspan="8">It is important to understand that the existence of this document alone does not automatically constitute authority to install the part/component/assembly.</td></tr><tr><td colspan="8">Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the country specified in Block 1.Statements in Block-13a. and 14a. do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in accordance with the national regulations by the user / installer before the aircraft may be flown.</td></tr></table> GACA-AVSES-AIR-F041 Rev: 7, Date: 17 Dec 25 Page 1 of 1