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Non incident statement 2025

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The document is an Incident/Accident Clearance Statement certifying the airworthiness of an engine operated by a specified company during a defined period. It confirms that the engine has not been involved in any reportable incidents or accidents, nor subjected to severe stress, and that no parts from military sources have been used. The statement aims to clarify the airworthiness status of aircraft components in compliance with aviation regulations, emphasizing the importance of maintaining safety standards in the commercial aviation industry.

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Click ‘Get Form’ to open the non incident statement in the editor.
Begin by entering the date at the top of the form. This is essential for record-keeping.
In the first section, input the engine serial number and company name, along with the delivery and redelivery dates. Ensure accuracy as this information is critical.
Next, fill in the configuration details including engine type/part number, serial number, total service hours (TSN), and cycle since new (CSN). These fields validate the engine's operational history.
In paragraph one, confirm that neither the engine nor any installed parts have been involved in a reportable incident or accident. Check applicable boxes if necessary.
Paragraph two requires you to certify that no parts were sourced from military origins or previously fitted to state aircraft. This ensures compliance with industry standards.
Finally, sign and print your name and position as an authorized airline representative at the bottom of the form.

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2015	4.7 Satisfied (45 Votes)

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What is a statement of incident?

An incident report is a tool that documents any event that may or may not have caused injuries to a person or damage to a company asset. It is used to capture injuries and accidents, near misses, property and equipment damage, health and safety issues, security breaches and misconducts in the worksite.

What is a non clinical incident?

An event or circumstance that could have (i.e. near miss) or did cause unexpected or unwanted. harm, loss or damage to any individual(s) involved (including patients but not related to clinical care, staff, visitors etc) or damage to/loss of property/premises for which the Health Board is responsible.

What is a non-incident statement?

Commonly referred to as the NIAS (Non incident or accident statement) or NIS (Non incident statement), this is a letter which acts as a statement that a component, part or aircraft has not been involved in an accident or incident during a noted time scale of operation and is issued by a CAMO (Continued

What does nis mean in aviation?

Non-Incidence / Accident Statement.

What is an ATA 106 non-incident statement?

In the aviation world, an ATA-106 certifies, among other things, that ownership of the part was transferred legally, not involved in an incident, and not obtained from a government source.

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