0
Form Approved
MAJOR R.EPAIR AND ALTERATION
OMS No. 2120-0020
US Deportment
(Airframe, Powerplant, Propeller, or Appliance)
For FAA Use Only
of Tronsoor101,on
Office Identification
~
Federal Avlallon
Hou. F:"~J)(\ Admlnl•trallon
INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix 8, 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 such violation (Section 901 Federal Aviation Act of 1958).
Make
Model
Bell
412EP
1. Aircraft
Serial No.
Nationality and Registration Mark
36106
N82628
Name (As shown on registration certificate)
Address (As shown on registration certificate)
2. Owner
Textron
Financial
9001 Airport
Freeway,
Suite
800
Ft. Worth, TX 76180
3.
For FAA Use Only
4. Unit Identification 5. Type
Unit
Make Model
. '
Serial No.
Repair Alteration
AIRFRAME
.,..,..,..,.,.,.,.,..,. • .,..,. • .,. ••• u.,. (As described in Item 1 above)' ·
.... """ ..
... .. .,. .... .,. ....
POWER PLANT
..
..
-
PROPELLER
Type
412
Tailboorn
212-030-100-177A
x
APPLIANCE
Manufacturer
Bell
6. Conformity Statement
A. Agency's Name and Address
8. Kind of Agency
C. Certificate No.
U.S. Certificated Mechanic
Helipro
Completions
Ltd.
Foreign Certificated Mechanic
9510
Max Conrad Drive
x
Certificated Repair Station H09R0230
Spring,
Texas 77389
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
s;gnatu,e of Authod,ed lnd;,;du,~
~
May 18,
1998
Vicente Salinas
\_ .\ .... "' "--.A_...,,
'
7. Approval for Return To Service
Pursuant to the authority given persons specified below, the unit identified in
it~m 4 was inspected in the manner prescribed by the
Administrator of the Federal Aviation Administration and is
l8! APPROVED O REJECTED
FAA Fii. Standards
Manufacturer
Inspection Authorization
Other {Specify)
Inspector
BY
....__
..
FAA Des1gnee
Repair
Station
Person Approved by Transport
x
Canada Airworthiness Group
' -
Date of Approval or Re1ection Certificate or
Signature of Authorized
lndivid~al "\
~
~
Designation No.
May
18,
1998
H09R0230
Vicente Salinas
l
~
"' ( _ a-.--=
FAA Form 337 •? ss,
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