# Commission Regulation (EU) No 965/2012 of 5 October 2012 laying down technical requirements and administrative procedures related to air operations pursuant to Regulation (EC) No 216/2008 of the European Parliament and of the Council, Appendix I

Extent: E+W+S+N.I.

Other type of transportation to be specified.
Replaced by the name of the State of the operator.
. . .
For use of the CAA.
For use of the CAA.
Approval reference, as issued by the CAA.
Replaced by the operator's registered name.
Operator's trading name, if different. Insert ‘ Dba ’ (for ‘ Doing business as ’ ) before the trading name.
The contact details include the telephone and fax numbers, including the country code, and the email address (if available) at which operational management can be contacted without undue delay for issues related to flight operations, airworthiness, flight and cabin crew members' competency, dangerous goods and other matters as appropriate.
Operator's principal place of business address.
Operator's principal place of business telephone and fax details, including the country code. Email to be provided if available.
Insertion of the controlled document, carried on board, in which the contact details are listed, with the appropriate paragraph or page reference. E.g.: ‘ Contact details … are listed in the operations manual, gen/basic, chapter 1, 1.1 ’ ; or ‘ … are listed in the operations specifications, page 1 ’ ; or ‘ … are listed in an attachment to this document ’ .
Operator's registered name.
Issue date of the AOC (dd-mm-yyyy).
Title, name and signature of the CAA representative. In addition, an official stamp may be applied on the AOC.
AIR OPERATOR CERTIFICATE
(Approval schedule for air transport operators)
Types of operation:
Commercial air transport (CAT)
□Passengers; □Cargo;
□Other : …
State of the operator
Civil Aviation Authority
AOC # :
Operator name
Dba trading name
Operator address :
Telephone :
Fax
Email:
Operational points of contact:
Contact details, at which operational management can be contacted without undue delay, are listed in … .
This certificate certifies that … is authorised to perform commercial air operations, as defined in the attached operations specifications, in accordance with the operations manual, Annex V to Regulation (EU) 2018/1139 and its delegated and implementing acts.
Date of issue :
Name and Signature :
Title:
CAA Form 138 Issue 1

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Source: https://www.legislation.gov.uk/eur/2012/965/annex/II/appendix/I (the official version)
Page: https://openlegislation.uk/eu-regulation-2012-965/annex-II/appendix-I
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.