4 APPENDIX 8. SAMPLE FAA FORM 8000-38,
FABRICATION/ASSEMBLY OPERATION CHECKLIST (CONTINUED)
FABRICATION/ASSEMBLY OPERATION CHECKLIST (Continued) Accomplished By Kit Manufacturer Amateur PROPULSION (Continued)
16. Install Fuel Tank
17. Fabricate Fuel System Components
18. Install Fuel System Components
MAIN ROTOR DRIVE SYSTEMS AND CONTROL MECHANISM(S)
1. Fabricate Special Static and Dynamic Main Rotor Rigging Tools
2. Fabricate/Assemble Main Rotor Drive Train
3. Install Main Rotor Drive Train Assembly
4. Fabricate/Assemble Main Rotor Shaft and Hub Assembly
5. Install Main Rotor Shaft and Hub Assembly
6. Align Main Rotor Shaft-Drive Train, Shaft and Hub Assembly
7. Fabricate Main Rotor Rotating Controls
8. Install Main Rotor Rotating Controls
9. Fabricate Main Rotor Non-Rotating Controls
10. Rig Main Rotor Rotating and Non-Rotating Controls
11. Fabricate Main Rotor Blades
12. Install Main Rotor Blades on Rotor Hub
13. Statically Balance and Rig Main Rotor System
14. Dynamically Track and Balance Main Rotor System
TAIL ROTOR DRIVE SYSTEMS AND CONTROL MECHANISM(S)
1. Fabricate Special Static Tail Rotor Rigging Tools
2. Fabricate Vertical Trim Fin
3. Install Vertical Trim Fin
4. Fabricate Horizontal Stabilizer
5. Install Horizontal Stabilizer
6. Fabricate Tail Rotor Drive System
7. Install Tail Rotor Drive System
8. Fabricate Tail Cone or Frame
9. Install and Rig Tail Cone or Frame
10. Rig Vertical Trim Fin
11. Fabricate Tail Rotor Shaft and Hub Assembly
12. Install Tail Rotor Shaft and Hub Assembly
13. Fabricate Tail Rotor Rotating and Non-Rotating Controls
14. Rig Tail Rotor Rotating and Non-Rotating Controls
15. Fabricate/Assemble Tail Rotor Blades
16. Install Tail Rotor Blades
17. Statically Balance and Rig Tail Rotor System
18. Dynamically Track and Balance Tail Rotor System
FAA Form 8000-38 (12-91)
5 APPENDIX 8. SAMPLE FAA FORM 8000-38,
FABRICATION/ASSEMBLY OPERATION CHECKLIST (CONTINUED)
FABRICATION/ASSEMBLY OPERATION CHECKLIST (Continued) Accomplished By Kit Manufacturer Amateur
COCKPIT/INTERIOR
1. Fabricate Instrument Panel
2. Install Instrument Panel and Instruments
3. Fabricate Seats
4. Install Seats
5. Fabricate Electrical Wiring, Controls/Switches
6. Install Electrical System Controls/Switches
TOTAL Comments
Printed Name Signature Date
FAA Form 8000-38 (12-91)
1 APPENDIX 9. SAMPLE AERONAUTICAL CENTER FORM 8050-88,
AFFIDAVIT OF OWNERSHIP FOR AMATEUR-BUILT AIRCRAFT
AFFIDAVIT OF OWNERSHIP FOR AMATEUR-BUILT AIRCRAFT U.S. Identification Number N130EA Builder’s Name Early A. Builder Model VAN’S RV-6 Serial Number 1001 Class (airplane, rotorcraft, glider, etc.) Airplane Type of Engine Installed (reciprocating, turbopropeller, etc.) reciprocating Number of Engines Installed 1 Manufacturer, Model and Serial Number of each Engine Installed LY-CON, O-320 EXP., L023–48X Built for Land or Water Operation Land Number of Seats 2
MUST CHECK ONE
More than 50% of the above-described aircraft was built from miscellaneous parts and I am the owner.
9 More than 50% of the above-described aircraft was built from a kit (prefabricated parts) and I am the owner. The bill of sale from the kit manufacturer is attached.
Early A. Builder (Signature of Owner) Address 1240 Bois d’Arc Road City Savoy State TX Zip Code 75479 Telephone 903 555-1212 State of County of Subscribed and sworn to before me this day of My commission expires
(Signature of Notary Public) AC Form 8050-88 (9/98) (0052-00-559-0002) Supersedes previous edition
APPENDIX 10. SAMPLE AERONAUTICAL CENTER FORM 8050-2,
AIRCRAFT BILL OF SALE
FORM APPROVED UNITED STATES OF AMERICA OMB NO. 2120-0042 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION
KIT ABORAEL BILL OF SALE
FOR AND IN CONSIDERATIONOFTHE FULL LEGAL UNDERSIGNED OWNER (S)
BENEFICIAL TITLE THE AIRCRAFT DES- CRIBED AS FOLLOWS:
REGISTRATION NUMBER N 130EA UNITED STATES AIRCRAFT MANUFACTURER & MODEL VAN'S RV-6 AIRCRAFT SERIAL No.
1001 DOES THIS DAY OF 20
HEREBY SELL, GRANT, TRANSFER AND
DELIVER ALL RIGHTS, TITLE, AND INTERESTS IN AND TO SUCH AIRCRAFT UNTO: Do Not Write In This Block
FOR FAA USE ONLY
NAME AND ADDRESS (IF INDIVIDUAL(S), GIVE LAST NAME, FIRST NAME, AND MIDDLE INITIAL.)
PURCHASER BUILDER, Early A. 1240 Bois d' Arc Road Savoy, IX 75479
DEALER CERTIFICATE NUMBER
EXECUTORS, ADMINISTRATORS, AND ASSIGNS TO HAVE AND TO HOLD SINGULARLY THE SAID AIRCRAFT FOREVER, AND WARRANTS THE TITLE THEREOF.
IN TESTIMONY WHEREOF HAVE SET HAND AND SEAL THIS DAY OF 20
NAME (S) OF SELLER SIGNATURE (S) TITLE (TYPED OR PRINTED) (IN INK) (IF EXECUTED (TYPED OR PRINTED)
FOR CO-OWNERSHIP, ALL MUST SIGN.)
SELLER VAN' S ACKNOWLEDGMENT (NOT REQUIRED BY LOCAL LAW FOR VALIONY OFTHE INSTRUMENT. POSES OF FAA RECORDING: HOWEVER. MAY BE REQUIRED ORIGINAL: TO FAA AC Form 8050-2 (9/92) (NSN 0052-00-629-0003) Supersedes Previous Edition 1
1 APPENDIX 11. SAMPLE LETTER FOR REQUESTING AN AIRCRAFT REGISTRATION NUMBER UNDER 14 CFR § 47.15 [Insert Date]
Federal Aviation Administration Aircraft Registration Branch, AFS-750 P.O. Box 25504 Oklahoma City, OK 73125-0504
Sir/Madam:
This is a request for a U.S. identification number assignment for my amateur-built aircraft.
Aircraft Description:
Make/Builder: Early A. Builder Type (airplane, rotorcraft, glider, or balloon): Airplane Model: VAN’S RV-6 Serial Number: 1001
This aircraft has not previously been registered anywhere (reference 14 CFR § 47.15(a)(1)).
X Normal Request ($5); fee attached (check or money order) X Special Registration Number Request ($10) ; fee attached (check or money order)
Choices 1st 130EA 2nd 130JR 3rd 130FE 4th 130JJ 5th 130TX
Sincerely, Early A. Builder Early A. Builder Owner
APPENDIX 12. SAMPLE FAA FORM 8130-12,
ELIGIBILITY STATEMENT, AMATEUR-BUILT AIRCRAFT Form Approved OMB NO. 2120-0018 Instructions: Print or type all information except signature.
US Department ELIGIBILITY STATEMENT Submit original to an authorized FAA representative.
Administration of Transportatior Federal Aviation AMATEUR-BUILT AIRCRAFT Notary Public Completes Section IV. Applicant completes Section I thru III.
1. REGISTERED OWNER INFORMATION Name(s) Early A. Builder Address(es) _ 1240 Bois d'Arc Road Savoy TX 75479 No. & Street City State Zip Telephone No. (s) ( 903) 555-1212 (214) 555-1212 Residence Business II. AIRCRAFT INFORMATION Model VAN'S RV-6 Engine(s) Make LY-CON 0-320 EXP Assigned Serial No. 1001 Engine(s) Serial No. L 023-48X Registration No. - N130EA Prop./Rotor(s) Make _ Sensenich Aircraft Fabricated: Plan _ Kit X Prop./Rotor(s) Serial No. (s) 195001 III. MAJOR PORTION ELIGIBILITY STATEMENT OF APPLICANT certify the aircraft identified in Section Il above was fabricated and assembled Early A. Builder Name of Person(s) (Please Print) for my (their) education or recreation. (we) have records to support this statement and will make them available to the FAA upon request.
-NOTICE- Whoever in any matter within the jurisdiction of any department or agency of the United States conceals or covers up by any trick, scheme, or device a material fact, or who makes any false, fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more I hereby certify that all statements and answers provided by me in this statement form are complete and true to the best of my knowledge, and I agree that they are to be considered part of the basis for issuance of any FAA certificate to me. I have also read and understand the Privacy Act statement that accompanies this form.
Signature of Applicant (In Ink) Date Early A. Builder XX/XX/XX IV. NOTARIZATION STATEMENT FAA Form 8130-12 (4-03) Sup NSN: 0052-00-889-9002 1
1 APPENDIX 13. SAMPLE PROGRAM LETTER TO ACCOMPANY
APPLICATION FOR AIRWORTHINESS CERTIFICATE [Insert local FAA office or DAR] Date: 01/30/2001
TO:
In accordance with 14 CFR § 21.193, I request a Special Airworthiness Certificate for my aircraft for the purpose of operating amateur-built aircraft. The aircraft description is as follows:
Builder: Early A. Builder Registration No.: N130EA Model: VAN’S RV-6 Serial No.: 1001 No. of Engines: 1 No. of Seats: 2 Design Criteria: my own design built from plans built from a kit X
The aircraft is complete and the following items have been accomplished.
Yes No I enclose FAA Form 8130-6 with Sections I, II, and III complete.
Yes No I enclose FAA Form 8130-12 with Sections I, II, and III complete and notarized in Section IV.
Yes No I possess Aeronautical Center Form 8050-3.
Yes No I enclose a three-view drawing or photographs of the aircraft.
Yes No I have weighed the aircraft to determine that the most forward and aft center of gravity positions are within established limits. The weight and balance report is available at the aircraft, and a copy is submitted with this application.
Yes No I have maintained a construction log for the project, including photographs showing methods of construction and workmanship during the construction. Log entries describe all inspections conducted during construction.
Yes No The marking requirements of Part 45 have been complied with, including permanent attachment of a fireproof identification (data) plate, permanent application of appropriate registration marks, and the word “EXPERIMENTAL” displayed near each entrance t o the cabin or cockpit.
Yes No The following placard is displayed in the cockpit in full view of all occupants (not required for single-place aircraft).
“PASSENGER WARNING - THIS AIRCRAFT IS
AMATEUR-BUILT AND DOES NOT COMPLY WITH
FEDERAL SAFETY REGULATIONS FOR STANDARD AIRCRAFT.”