Form P-4 · Page 1 of 2 | 1. Approving civil aviation authority / countryCASA – AUSTRALIA | AUTHORISED RELEASE CERTIFICATECASA FORM 1 | 3. Form tracking numberGG52965 | |||
| 4. Organisation name and addressInFlight Graphics Pty Ltd Factory 6, 1–3 Frederick Street, Sunbury VIC 3429, Australia | 5. Work order / contract / invoicePO611041 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 2 | See Attached Pages 2 to 2 | 6 | 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 52965. 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)11/09/2026 | ||
CASA Form 1 · Authorised Release Certificate · InFlight Graphics Pty Ltd, CASA Process Approval PA-592089
ATTACHMENT TO CASA FORM 1
Form tracking number GG52965 · PO PO611041 · Ambulance Victoria – Air Operations
| Item | Part image | P/N ordered | Description | Qty | Shelf life | Authorised document |
|---|---|---|---|---|---|---|
| 1 | AV-0066 INFG PN 6144B | ID PLATE – VH-YXJ FIREPROOF ID PLATE | 1 | N/A | AAV-EO-AW139-11-0007 | |
| 2 | AV-0068 INFG PN 6146B | PAINT MASK – VH-YXJ REGISTRATION – WING | 1 | 28/06/2027 | AAV-EO-AW139-11-0009 | |
| 3 | AV-0008 INFG PN 6086 | PLACARD – JACK POINT | 4 | 9/04/2028 | AAV-EO-AW139-11-0003 |
Shelf life = the earliest expiry (SLX) across the jobs that made each line.Released by Daniel Burton · 11/09/2026