Pointer Avionics skyhunter 406 - Page 245

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D~NT OF. TRANSPORTATION
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FEDERAL AVIATION ADMINiSTRATION
Budget Bureau No. 04-R060. I
~
MAJOR REPAIR
AND ALTERATION
FOR FAA USE ONL1.
.
OFFICE IDENTIFICATION LtuW
.
'I
(Airframe, Powerplant, Propeller, or Appliance)
F-~
kJ>c:>
INSTRUCTIONS: Print or type all entries.
•
for instructions and disposition of this form.
See FAR
43.9. FAR 43 Appendix B. and AC 43.9-1
( or subsequent revision thereof)
MAKE
MODEL
Bell He1icopter Textron
412
1. AIRCRAFT
SERIAL NO.
NATIONALITY AND REGISTRATION MARK
36106
USA
N82628
2. OWNER
NAME (As shown on registration certificatej
Bell Helicopter T~"'Ctron
ADDRESS (As shown on registration certificate)
P.O.
Box 482
Ft. Worth,
Texas
76101
- - --- -
...
- -----
- ---
3. fOI'< FAA' USE ·oNLY·
.
-
4. UNIT IDENTIFICATION
5. TYPE
UNIT MAKE
MODEL
SERIAL NO.
REPAIR
ALTER•
ATION
AIRFRAME
•••••••••••••••••••••* (As described in item 1 above)••••••••••••••••••••••
xxxx
-
-.,
POWERPLANT
A1A
MGR I
Bf
-·
.. -
-
A2
APPM
I
82
,-
RECEIVED
es
•
•
A4
B',
PROPELLER
AS
JUNO 5 1996
B5
-
..
TYPE
,u
17
I
r:n,F,~"0
87
APPLIANCE
-
AO
I
MANUFACTURER
cs
I
6. CONFORMITY STATEMENT
4 .. -
'
A. AGENCY'S NAME AND ADDRESS
B. KIND OF AGENCY
c. CERTIFICATE NO.
U.S. CERTIFICATED MECHANIC
Bell Helicopter Textron
FOREIGN CERTIFICATED MECHANIC
Limited
P.O.
Box 482
xx
CERTIFICATED REPAIR STATION
BlHR300N
Ft. Worth,
Texas
76101
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
anachments hereto have been made in accordance with the requirements of Pan
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 INDIVIDUAL ....
~
May 31,
1996
Wesley Mitchel~.L_.,,f)~h:.A
'
7. APPROVAL FOR RETURN TO SERVICE
( J
Pursuant to the authority given persons specified below. the unit identified in item 4 waY~ected in the manner prescribed by
th~ Administrator of the Federal Aviation Administration and is [xi APPROVED O REJE ED
FM FLT. STANDARDS
MANUFACTURER
INSPECTION AUTHORIZATION
OTHER (Specify)
INSPECTOR
BY
CANADIAN DEPARTMENT.
FAA DESIGNEE
xx
REPAIR STATION
Of TRANSPORT INSPECTOR
/)
OF AIRCRAFT
,
DATE OF APPROVAL OR CERTIFICATE OR
SIGNATURE O~ A~HOR~;!f'L;
REJECTION
May 31,
1996
DESIGNATION NO.
B1HR300N
Warren K. Pic1cer :;.....----
FAA Form 337 !7-67!
-
/
(8320)