Form P-4 · Page 1 of 3 | 1. Approving civil aviation authority / countryCASA – AUSTRALIA | AUTHORISED RELEASE CERTIFICATECASA FORM 1 | 3. Form tracking numberGG52586 | |||
| 4. Organisation name and addressInFlight Graphics Pty Ltd Factory 6, 1–3 Frederick Street, Sunbury VIC 3429, Australia | 5. Work order / contract / invoice611077 Ambulance Victoria – Air Operations | ||||
| 6. Item | 7. Description | 8. Part number | 9. Quantity | 10. Serial number | 11. Status / work |
|---|---|---|---|---|---|
| 1 | See Attached Pages 2 to 3 | See Attached Pages 2 to 3 | 113 | N/A | NEW |
| 12. RemarksThe parts identified above were manufactured in accordance with approved design data and are in a condition for safe operation. Task card 52586. Manufactured under the InFlight Graphics Procedures and Quality Manual IG001 Rev 10 and Process Specification Manual IFGPS01 Rev 10. | |||||
| 13a. Certifies that the items identified above were manufactured in conformity to: ✓ Approved design data and are in a condition for safe operation Non-approved design data specified in block 12 | 14a. Maintenance release (CASR Part 145) Other regulation specified in block 12 Not applicable — new parts | ||||
| 13b. Authorised signatureDaniel Burton | 13c. Approval / authorisation numberPA-592089 | 13d. NameDaniel Burton | 13e. Date (d/m/y)23/06/2025 | ||
CASA Form 1 · Authorised Release Certificate · InFlight Graphics Pty Ltd, CASA Process Approval PA-592089
ATTACHMENT TO CASA FORM 1
Form tracking number GG52586 · PO 611077 · Ambulance Victoria – Air Operations
| Item | Part image | P/N ordered | Description | Qty | Shelf life | Authorised document |
|---|---|---|---|---|---|---|
| 1 | AV-0117 INFG PN 6195 | PLACARD – LIFE VEST UNDER SEAT IN FRONT | 5 | 17/07/2026 | AAV-EO-KINGA-11-0004 | |
| 2 | AV-0095 INFG PN 6173D | PLACARD – HYDRAULIC FLUID SKYDROL | 12 | 25/04/2027 | AAV-EO-KINGA-11-0009 | |
| 3 | AV-0152 INFG PN 6230 | PAINT MASK – VH-AMS REGISTRATION – FUSELAGE | 1 | 26/12/2026 | AAV-EO-KINGA-11-0003 | |
| 4 | AV-0087 INFG PN 6165C | PLACARD – NO PUSH | 10 | 25/04/2027 | AAV-EO-KINGA-11-0001 | |
| 5 | AV-0144 INFG PN 6222B | PLACARD – CIRCUIT BREAKER IDENT | 20 | N/A | AAV-EO-KINGA-11-0004 | |
| 6 | AV-0143 INFG PN 6221D | PLACARD – FUEL CROSSFEED | 4 | N/A | AAV-EO-KINGA-11-0003 | |
| 7 | AV-0138 INFG PN 6216 | PLACARD – AIRSPEED LIMITATIONS | 30 | N/A | AAV-EO-KINGA-11-0007 | |
| 8 | AV-0099 INFG PN 6177D | PLACARD – NITROGEN ONLY | 1 | 25/04/2027 | AAV-EO-KINGA-11-0004 |
Shelf life = the earliest expiry (SLX) across the jobs that made each line.Released by Daniel Burton · 23/06/2025
ATTACHMENT TO CASA FORM 1
Form tracking number GG52586 · PO 611077 · Ambulance Victoria – Air Operations
| Item | Part image | P/N ordered | Description | Qty | Shelf life | Authorised document |
|---|---|---|---|---|---|---|
| 9 | AV-0105 INFG PN 6183C | PLACARD – FIRE EXTINGUISHER DISCHARGE INDICATOR | 30 | 25/04/2027 | AAV-EO-KINGA-11-0001 |
Shelf life = the earliest expiry (SLX) across the jobs that made each line.Released by Daniel Burton · 23/06/2025