Application for Trafik- og Byggestyrelsen (Danish Transport and Construction Agency) Approval of Flight Conditions for a "Part 21 Permit to Fly" EASA Form 18 TBST-CFL-168 Similar to EASA form 37 Use this '7$-form only when safety of design is notinvolved Applicant Name Street No. City Postal code Contact Person (if applicable) Telephone Fax E-mail Applicability/Description Applicability (Aircraft manufacturer/type) Serial Number Nationality and Registration marks OY- Permit to Fly Requested duration for the Permit to Fly Purpose From (Maximum 12 months) Until Unlimited (Only in combination with Purpose, item 15) 1. Development 2. Showing compliance with regulations or certification specifications 3. Design organisations or production organisations crew training 4. Production flight testing of new production aircraft 11. Flying the aircraft to a location where maintenance or airworthiness review are to be performed, or to a place of storage 12. Flying an aircraft at a weight in excess of its maximum certificated takeoff weight for flight beyond the normal range over water, or over land areas where adequate landing facilities or appropriate fuel is not available 5. Flying aircraft under production between production facilities 13. Record breaking, air racing or similar competition 6. Flying the aircraft for customer acceptance 14. Flying aircraft meeting the applicable airworthiness requirements before conformity to the environmental requirements is shown 7. Delivering or exporting the aircraft 8. Flying the aircraft to Authority acceptance 9. Market survey, including customer’s crew training 10. Exhibition and airshow Trafik- og Byggestyrelsen | Edvard Thomsens Vej 14 | 2300 København S | www.tbst.dk | Tlf: +45 7221 8800 | info@tbst.dk 15. For non-commercial flying activity on individual non-complex aircraft or types for which the Agency agrees that a certificate of airworthiness or restricted certificate of airworthiness is not appropriate Side 1 TBST-CFL-168 | 07/15 IMPORTANT! Description of the nonCompliance with the applicable airworthiness requirements To be filled only by the Danish Transport and Construction Agency Statement of technical satisfaction The certification team is satisfied that the applicant has shown that the aircraft is capable of safe flight under the conditions or restrictions necessary for safe operation of the aircraft in accordance with the hereby approved flight conditions. Notes/Remarks/Restrictions: Applicant’s declaration I confirm that the information contained herein is correct and complete. Date Name Signature This application should be sent by e-mail or regular mail to: Trafik- og Byggestyrelsen Danish Transport and Construction Agency Edvard Thomsens Vej 14 DK 2300 Copenhagen S Phone: +45 72218800 E-mail: certificering@tbst.dk DO NOT FORGET TO SIGN THE APPLICATION FORM Trafik- og Byggestyrelsen | Edvard Thomsens Vej 14 | 2300 København S | www.tbst.dk | Tlf: +45 7221 8800 | info@tbst.dk Side 2 TBST-CFL-168 | 07/15 EASA Form 18b - TS-CFL-168 FLIGHT CONDITIONS FOR A PERMIT TO FLY – APPROVAL FORM 1. Applicant 2. Approval form nr. Issue: 3. Aircraft manufacturer/type 4. Serial number(s) 5. Aircraft configuration The above aircraft for which a Permit to Fly is defined in 6. Justifications 7. Conditions/Restrictions The above aircraft must be used with the following conditions or restrictions: 8. Statement The flight conditions have been established and justified including any condition or restriction necessary for safe operation of the aircraft, including: a. the conditions or restrictions put on itineraries or airspace, or both, required for the flight(s); b. the conditions and restrictions put on the flight crew to fly the aircraft; c. the restrictions regarding carriage of persons other than flight crew; d. the operating limitations, specific procedures or technical conditions to be met; e. the specific flight test programme (if applicable); f. the specific continuing airworthiness arrangements including maintenance instructions and regime under which they will be performed. g. the method used for the control of the aircraft configuration, in order to remain within the established conditions. The aircraft has no features and characteristics making it unsafe for the intended operation under the identified conditions and restrictions. 9. Approved under [ORGANISATION APPROVAL NUMBER] If applicable 10. Date of issue 11. Name and signature 12. Danish Transport and Construction Agency approval reference and date SUBMIT Trafik- og Byggestyrelsen | Edvard Thomsens Vej 14 | 2300 København S | www.tbst.dk | Tlf: +45 7221 8800 | info@tbst.dk Side 3 TBST-CFL-168 | 07/15
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