0
Form Approved
MAJOR REPAIR AND ALTERATION
OMB No. 2120-0020
US Department
(Airframe, Powerplant, Propeller, or Appliance)
For FAA Use Only
ofT ransportation
Federal Aviation
Office Identification
Administration
INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions
and disposition of this form. This report is required by law (49 U.S.C. 1421 ). Failure to report can result in a civil penalty not to exceed $1,000
for each violation I Section 901 of Federal Aviation Act of 1958).
Make Model
BELL HELICOPTER TEXTRON, INC.
412EP
1. Aircraft
Serial No.
Nationality and Registration Mark
36106 USA
N412SV
Name (As
shown on registration cerlificate)
Address (As shown on registration cerlificate)
AIRCRAFT ASSOCIATES INC PO BOX 2190
2. Owner
MANASSAS VA 20108-0826
3. For FAA Use Onlv
4. Unit Identification
5. Type
Unit Make
Model Serial No.
Repair Alteration
AIRFRAME
----------- (As described in Item 1 above)---------
x
POWER PLANT
PROPELLER
Type
APPLIANCE
Manufacturer
6. Conformity Statement
A. Aaencv's Name and Address
B. Kind of Aaencv
C. Certificate No.
U.S. Certificated Mechanic
EDWARDS
& ASSOCIATES, INC.
Foreign Certificated Mechanic
PO BOX 3689
x
Certified Repair Station
FKFR930D
BRISTOL TN 37625
Manufacturer
D.
I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments
hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the
information furnished herein is true and correct to the best of my knowledge.
Date
Signature of Authorized lndivi
~ual
,..
MAY/21/2008
JAMIE J NORWOOD
I~ .,.
~
.
-=
-
.....- c-,.,'T
7. Aooroval for Return To Servic.e' )
( )
Pursuant to the authority given persons specified below, the unit identified in item 4 waWspected i~e manner prescribed by the
Administrator of the Federal Aviation Administration and is
® APPROVED
,; REJECTED
FAA Flt. Standards
Manufacturer Inspection Authorization
Other
(Specify)
Inspector
BY
FAA Designee
x
Repair Station
Person Approved by
Transport Canada
Airworthiness Group
Date of Approval or Rejection
Certificate or Signature of Authorized
lndil
dual
Lr
Designation No.
MAY/21/2008
FKFR930D JAMIE J NORWOOD
'/'.,,_,~.,,,,.
.--r
I
FAA Form 337 (12-88)
u
C/
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