Certificate for single common information service provider referred to in Article 14(3)

LOGO EASA or NAA as applicable

CERTIFICATE FOR SINGLE COMMON INFORMATION SERVICE PROVIDER [CERTIFICATE NUMBER/ISSUE No] Pursuant to Regulation (EU) …/…. (and to Regulation (EU) …/....), the [competent authority] hereby certifies [NAME OF THE SINGLE COMMON INFORMATION SERVICE PROVIDER] [ADDRESS OF THE SINGLE COMMON INFORMATION SERVICE PROVIDER] as a single common information service provider. This certificate is valid whilst the certified single common information service provider remains in compliance with Regulation (EU) …/… and the other applicable regulations and, when relevant, with the procedures in the singles common information service provider’s documentation as required by Regulation (EU) …/…, Part-…. Subject to compliance with the foregoing conditions, this certificate shall remain valid unless it has been surrendered, limited, suspended or revoked. Date of issue: Signed: [Competent authority]