(b) Airworthiness Directives. Regardless of the type of airworthiness certificate being requested, you should review this block and indicate the aircraft is in compliance with all applicable ADs (refer to 14 CFR part 39, Airworthiness Directives, and 14 CFR § 21.99, Required design changes).
1 If all ADs are in compliance, you should check the box and then enter the latest AD biweekly supplement number published as of the date of application. You should use a four-digit year, a dash, and publication number format (for example, “2010-04”). As an example, if the day of your application is 11/28/2010, you would find 2010-24 as the latest supplement published on 11/23/2010. You would then enter “2010-24” in the block.
2 For a special airworthiness certificate in the light-sport category or the experimental category operating light-sport, you should list all applicable manufacturer safety directives available as of the date of application (for example, “SD-001”). If there are no manufacturer safety directives, “None” should be entered. This block should also contain the latest AD biweekly supplement and either the manufacturer’s list of safety directives or “None” (for example, “2010-04, SD-001, SD-002” or “2010-04, None”).
3 Each AD contains an applicability statement specifying the product (aircraft, aircraft engine, propeller, or appliance) to which it applies. Unless stated otherwise ADs only apply to type-certificated aircraft, including ADs issued for an engine, propeller, or appliance (refer to AC 39-7, Airworthiness Directives).
(c) Aircraft Listing. Older aircraft (predating TCDS) may have been originally certificated with aircraft specifications. This block should contain the page number of aircraft specification where the type or model is found. For example, a 1928 Travel Air 3000 has an aircraft specification of #31, where the aircraft type is listed on page 65 of that specification. If applicable, you should mark the box and enter the listing page number(s) as appropriate. If this block does not apply or there is no aircraft listing, you should leave the box unmarked and enter “N/A.”
(d) Supplemental Type Certificate. This block is applicable for all standard airworthiness certifications. This block is also applicable for special airworthiness certifications in the restricted, limited, provisional, and primary categories. When one or more STCs are installed, you should mark the box and complete the block with the required information. When no STCs are installed, you should leave the box unmarked and the block blank.
1 You should enter the STC number of each STC installed. If more space is needed, you should use an attachment. When using an attachment, you should list the STCs installed by STC number only. For aircraft involved in FAA STC projects, ensure the STC number for the completed project is listed in the block at the time of application.
2 For a special airworthiness certificate in the experimental or light-sport category, you should leave the box unmarked and enter “N/A” in the block.
(3) Item C, Aircraft Operation and Maintenance Records.
(a) Check if Records Are in Compliance with 14 CFR § 91.417, Maintenance Records. Your maintenance records must comply with 14 CFR § 91.417 and be in the English language. This block is applicable to all aircraft and should be marked to indicate the recordkeeping requirements of the regulation have been met.
1 Compliance to 14 CFR § 91.417(a)(2)(i) requires the total service time of the airframe, each engine, propeller, and rotor.
2 Compliance to 14 CFR § 91.417(a)(2)(ii) requires a maintenance record of the current status of life-limited parts of each airframe, engine, propeller, rotor, and appliance.
(b) Total Airframe Hours. You should enter into this block the aircraft’s total time in service measured in hours. Time in service should be determined from your aircraft and maintenance records.
(c) Experimental Only.
1 This block should only be completed when— (aa) You are submitting an application for a new or renewed special airworthiness certificate in the experimental category (experimental certificate), (bb) You are requesting a change from an experimental certificate back to a previously held standard airworthiness certificate, or (cc) You are requesting a change from an experimental certificate back to a previously held special airworthiness certificate in another category.
2 You should enter “0” if you are applying for an original issuance of an experimental certificate with zero hours flown.
3 If you are renewing an experimental certificate or making an application to change back a previously held certificate, you should enter in this block the number of hours the aircraft has flown since the issue of your current experimental certificate.
(4) Item D, Certification. You will need to read and verify the certification statement on the application before completing this item. There are three blocks to complete:
(a) Date of Application. You should enter the date that you attest to the certification statement in month/day/year format (for example, “02/09/2010”).
(b) Name and Title. You should either print or type the full name and title of the person certifying the application. A full name may include first name, a middle initial, and last name. Titles may include owner, president, director, or agent. Examples of a full name and title are “John E. Doe, Owner” and “John Doe, Director of Quality Assurance.” If the signature is by
15 the owner’s agent, a notarized letter from the aircraft’s registered owner authorizing the agent to act on the owner’s behalf is required.
(c) Signature. The person whose name appears in the “Name and Title” block should sign the signature block.
d. Section IV, Inspection Agency Verification. You should only complete this section for standard airworthiness applications of used aircraft or surplus U.S. military aircraft.
To qualify for a standard airworthiness certificate, you must show the aircraft conforms to a type design approved under a TC or an STC. All applicable ADs must also be in compliance.
The aircraft must be inspected and found airworthy by one of four methods (refer to paragraph (1)(a) through (1)(d) of this section). Finally, the responsible person at the inspection agency will date and sign this block (refer to 14 CFR § 21.183(d), Used aircraft and surplus aircraft of the U.S. Armed Forces).
(1) Boxes. You should mark the applicable box and provide a certificate number or aircraft manufacturer name or firm in the corresponding block.
(a) 14 CFR part 121 Certificate Holder. You should mark this box and enter the certificate number (block 2) when the aircraft has been inspected and found airworthy by a part 121 certificate holder.
(b) Certificated Mechanic. You should mark this box and enter the certificate number (block 3) when the aircraft has been inspected and found airworthy by a certificated mechanic.
(c) Certificated Repair Station. You should mark this box and enter the certificate number (block 6) when the aircraft has been inspected and found airworthy by a mechanic at a certificated repair station. In the case of used aircraft and surplus aircraft of the U.S. Armed Forces, the FAA may accept a previously performed inspection in lieu of a 100-hour inspection. In this circumstance the applicant should list the foreign repair station name and number (if applicable) in block 6. Using permanent blue or black ink, the applicant should strike/draw a line through the title of block 5, initial the line-through, and provide a statement in block 5 that an equivalent inspection was performed.
(d) Aircraft Manufacturer. You should mark this box and enter the manufacturer name (block 5) when the aircraft has been inspected and found airworthy by the manufacturer who holds the TC.
(2) Date. You should enter the date the inspection agency attests to the verification statement. You should enter the date in month/day/year format (for example, “02/09/2010”).
(3) Title. The authorized person at the inspecting agency completes this portion. The authorized person will print or type their full name in the space. A full name may include first, middle initial as appropriate, and last name. Titles may include mechanic, technician, inspector, manager, or director. “John E. Doe, Avionics Technician” and “John Doe, Director of Quality Assurance” are some examples of a full name and title.
(4) Signature. The person whose name appears in the “Title” block should sign the signature block.
e. Section V, FAA Representative Certification. This section will be completed by the FAA inspector or designee.
f. Section VI, Production Flight Testing. You should complete this section if you are a manufacturer applying for a special flight permit with the purpose of flight testing production aircraft. If you are a manufacturer producing fully assembled aircraft in the light-sport category, you should only complete items A and C. Item B should be left blank (refer to 14 CFR § 21.197(a)(3), Special flight permits).
(1) Item A, Manufacturer.
(a) Name. You should enter the name of the manufacturer or legal name of the company.
(b) Address. You should enter the company’s full physical address, which includes street address, city, state, and zip code.
(2) Item B, Production Basis.
(a) Production Certificate. You should mark this box if the manufacturer holds a PC and has produced the aircraft under this certificate. If the box is marked, a PC number should be entered in the block space.
(b) Type Certificate. You should mark this box if this aircraft was produced under a TC and not a PC.
(c) Other. This box should not be marked.
(3) Item C.
(a) Give Quantity of Certificates Required for Operating Needs. For manufacturers in serial production (except LSA manufacturers), you may request more than one certificate per application submitted. You should enter the quantity (in digits) of certificates needed for your operation. For example, entering “4” requests four certificates for use during production flight tests that can be transferred from one aircraft to another. However, for LSA production flight tests, permits are not transferable. Because each LSA is individually issued a special flight permit, you should enter “1” for one certificate.
(b) Date of Application. You should enter the current date as the special flight permit application date in the month/day/year format (for example, “02/09/2010”).
(c) Name and Title. You should either print or type the full name and title. A full name usually includes first name, a middle initial, and last name. Titles may include owner, president, director, or authorized agent. “John E. Doe, Owner” and “John Doe, Director of Quality Assurance” are some examples of a full name and title.
(d) Signature. The person whose name appears in the “Name and Title” block should sign this block.
g. Section VII, Special Flight Permit Purposes Other than Production Flight Test.
(1) Item A, Description of Aircraft. Entries in this section should match the data recorded on the aircraft’s registration certificate and the aircraft’s ID plate as applicable.
(a) Registered Owner. You should enter the name on the aircraft’s registration certificate.
(b) Address. You should enter the owner’s address listed on the aircraft’s registration certificate.
(c) Builder. You should enter the name of the manufacturer or builder as it appears on the aircraft’s ID plate.
(d) Model. You should enter the model designation as shown on the aircraft’s ID plate.
(e) Serial Number. You should enter the serial number as shown on the aircraft ID plate.
(f) Registration Mark. You should enter the U.S. nationality designator letter “N” followed by the registration marks as shown on the aircraft registration certificate.
(2) Item B, Description of Flight.
(a) Customer Demonstration Flights. You should mark this block if the special flight permit is for a customer demonstration flight.
(b) From. You should enter the aircraft’s current location (for example, “Kansas City, Missouri”, or the airport identifier “MCI”).
(c) To. You should enter the aircraft’s intended destination (for example, “Dallas, Texas”, or the airport identifier “DFW”).
(d) Via. This block should contain the name(s) of an airport or city at some intermediate point(s) in the flight. Entering “via” points provides a general direction of the flight route (refer to 14 CFR § 21.199(a)(2), Issue of special flight permits). For example, a flight from “Kansas City, Missouri” (or “MCI”), to “Dallas, Texas” (or “DFW”), may be flown via “Wichita, Kansas” (or “ICT”), and “Oklahoma City, Oklahoma” (or “OKC”). You should leave this block blank if there are no planned intermediate points.
(e) Departure Date. You should enter the date the flight is planned using month/day/year format (for example, “02/09/2010”).
(f) Duration. The duration is the length of time needed for the special flight permit.
The duration is not the same as the planned duration of the actual flight. Factors such as fueling stops, weather conditions, overnight stops, or any other reasonable condition should be given consideration when establishing the duration. The length of time needed for the aircraft to reach its intended destination should be given in whole number days or weeks (for example, “7 days” or “2 weeks”) (refer to 14 CFR § 21.199).
(3) Item C, Crew Required to Operate the Aircraft and Its Equipment. In this section, you should mark the boxes of the crew required to operate the aircraft and its equipment.
If additional crew members other than the ones listed in boxes are necessary, mark the “Other” box. You should then write the additional required crew member’s function (for example, test engineer, avionics technician) in the space provided to the right of the “Other” box.
(4) Item D, The Aircraft Does Not Meet the Applicable Airworthiness Requirements as Follows. In the space provided, you should detail the conditions where the aircraft does not comply with the applicable airworthiness requirements. You should keep in mind this is your basis for requesting a special flight permit and will need to be specific (refer to 14 CFR § 21.199(a)(4)).
(5) Item E, The Following Restrictions Are Considered Necessary for Safe Operation. In the space provided, you should write any restrictions you consider necessary for safe operation of the aircraft (for example, reduced airspeed, operating weight, turbulence avoidance, crew limitations, or qualifications). The application will be reviewed and additional conditions and/or limitations may be prescribed for safe operation (refer to 14 CFR § 21.199(a)(5) and (6)).
(6) Item F, Certification. If this section applies to your application, you should read the certification statement and verify that you meet the requirements before completing this item.
There are three blocks to complete:
(a) Date of Application. In this block, you should enter the current date using month/day/year format (for example, “02/09/2010”).
(b) Name and Title. You should either print or type the full name and title. A full name usually includes first name, a middle initial, and last name. Following the full name, the block requests the title of that person. Titles may include owner, president, director, or authorized agent. “John E. Doe, Owner” or “John E. Doe, Director of Quality Assurance” are some examples of a full name and title.
(c) Signature. The person whose name appears in the “Name and Title” block should sign the block. If the signature is the owner’s agent, a notarized letter from the registered owner authorizing the agent to act on the owner’s behalf is required.
h. Section VIII, Airworthiness Documentation. This section will be completed by the FAA inspector or designee.
10. Submitting the Completed FAA Form 8130-6. Once you have completed the applicable sections and the FAA Form 8130-6 is signed, you should submit it to your local FAA office. Be prepared to provide additional documentation required by the regulations for final airworthiness certification. If you are an authorized agent to act in someone’s behalf, a notarized letter of authority should be included with the application form. For manufacturers holding an FAA production approval, an application may be submitted to an authorized Designated Airworthiness Representative, Designated Manufacturing Inspection Representative, or Organization Designation Authorization unit member, as appropriate.
11. Where to Find This AC. You can find this AC at http://www.faa.gov/regulations_policies/advisory_circulars/.
James D. Seipel Manager Production and Airworthiness Division
Appendix A A-1 Appendix A. Acronyms AC Advisory Circular AD Airworthiness Directive CAR Civil Air Regulation CFR Code of Federal Regulations FAA Federal Aviation Administration ID Identification LSA Light-Sport Aircraft N/A Not Applicable PC Production Certificate STC Supplemental Type Certificate TC Type Certificate TCDS Type Certificate Data Sheet
Appendix B B-1 Appendix B. Related 14 CFR Parts
1. 14 CFR part 1, Definitions. 14 CFR part 1 provides definitions for terms used in the application.
2. 14 CFR part 21, Certification Procedures for Products, Articles, and Parts.
14 CFR part 21 sets forth rules for the issuance of and change to type certificates, and issuance of production certificates, airworthiness certificates, and export airworthiness approvals. It also sets forth the rules governing the holders of these certificates and the approval of certain articles.
3. 14 CFR part 39, Airworthiness Directives. 14 CFR part 39 provides a legal framework for the FAA’s system of Airworthiness Directives.
4. 14 CFR part 43, Maintenance, Preventive Maintenance, Rebuilding, and Alteration.
14 CFR part 43 sets forth rules governing the maintenance, preventive maintenance, rebuilding, and alteration of aircraft having a U.S. airworthiness certificate, certain foreign-registered aircraft, and related products and articles.
5. 14 CFR part 45, Identification and Registration Marking. 14 CFR part 45 sets forth rules for display of nationality and registration marks, display of special airworthiness classification marks, identification plates for products, and identification of certain replacement and critical aircraft articles.
6. 14 CFR part 47, Aircraft Registration. 14 CFR part 47 sets forth rules for registering an aircraft.
7. 14 CFR part 91, General Operating and Flight Rules. 14 CFR part 91 sets forth rules governing the operation of most aircraft within the United States.
Appendix C C-1 Appendix C. Related Publications
1. FAA Order 8130.2, Airworthiness Certification of Aircraft and Related Products.
2. FAA Order 8130.34, Airworthiness Certification of Unmanned Aircraft Systems and Optionally Piloted Aircraft.
3. AC 20-27, Certification and Operation of Amateur-Built Aircraft.
4. AC 20-65, U.S. Airworthiness Certificates and Authorizations for Operation of Domestic and Foreign Aircraft.
5. AC 21-4, Special Flight Permits for Operation of Overweight Aircraft.
6. AC 21-37, Primary Category Aircraft.
7. AC 39-7, Airworthiness Directives.
8. AC 45-2, Identification and Registration Marking.
Appendix D D-1 Appendix D.
Examples of FAA Form 8130-6, Application for Airworthiness Certificate
Figure FAA Form 8130-6 Example Reference D-1 Standard, Normal 14 CFR § 21.183(a) D-2 Standard, Transport 14 CFR § 21.183(a) or (b) D-3 Standard, Transport, Used Aircraft, No Previous U.S.
Airworthiness Certificate 14 CFR § 21.183(d) D-4 Standard, Import Glider 14 CFR § 21.183(c) D-5 Standard, Surplus Military 14 CFR § 21.183(d) D-6 Standard, Other, Import, JAR/VLA 14 CFR § 21.183(c) D-7 Special, Primary 14 CFR § 21.184(a) D-8 Special, Light-Sport (with TC installations) 14 CFR § 21.190 D-9 Special, Light-Sport (without TC installations) 14 CFR § 21.190 D-10 Special, Limited 14 CFR § 21.189 D-11 Special, Provisional, Class I 14 CFR § 21.221 D-12 Special, Restricted 14 CFR § 21.185 D-13 Special, Experimental, Research and Development 14 CFR § 21.191(a) D-14 Special, Experimental, To Show Compliance with the CFR 14 CFR § 21.191(b) D-15 Special, Experimental, Amateur Built (with TC installations) 14 CFR § 21.191(g) D-16 Special, Experimental, Operating Light-Sport, Operating Lightsport Kit-Built 14 CFR § 21.191(i) D-17 Special, Experimental, Unmanned Aircraft 14 CFR § 21.191(a),(c), or (f) D-18A/B
Special, Special Flight Permit, Ferry flight for Repairs, Alterations, Maintenance, or Storage 14 CFR § 21.197(a)(1) D-19A/B
Special, Special Flight Permit, Operation in Excess of Maximum Certificated Take-off Weight 14 CFR § 21.197(b) D-20A/B
Special, Special Flight Permit, Production Flight Testing 14 CFR § 21.197(a)(3) D-21A/B
Special, Special Flight Permit, Production Flight Testing, Light-Sport Manufacturer 14 CFR § 21.197(a)(3) D-22A/B Special, Special Flight Permit, Production Flight Testing, Unmanned Aircraft Manufacturer 14 CFR § 21.197(a)(3) D-23 Multiple, Normal and Restricted 14 CFR § 21.187
Appendix D Figure D-1. Sample FAA Form 8130-6, Application for U.S. Airworthiness Certificate, Standard - Normal, Under 14 CFR § 21.183(a) (Face Side Only) FAA FORM 8130-6, APPLICATION FOR U.S. AIRWORTHINESS CERTIFICATE Form Approved O.M.B. No. 2120-0018 APPLICATION FOR INSTRUCTIONS - Print or type. Do not write in shaded areas; these are for FAA U.S. Department of Transportation U.S. AIRWORTHINESS use only. Submit original only to an authorized FAA Representative. If additional space is required, use attachment. For special fight permits complete Sections Federal Aviation CERTIFICATE II. VI, and VIl as applicable.
Administration
1. REGISTRATION MARK 2. AIRCRAFT BUILDER'S NAME (Make) AIRCRAFT MODEL DESIGNATION 4. YR. MFR FAA CODING I. AIRCRAFT DESCRIPTION 5. AIRCRAFT SERIAL NO. N5206Q 6. ENGINE BUILDER'S NAME (Make) Cessna Aircraft Company 172S 7. ENGINE MODEL DESIGNATION 2002 17259111 Lycoming Engines IO-360-L2A
8. NUMBER OF ENGINES 9. PROPELLER BUILDER'S NAME (Make) 10. PROPELLER MODEL DESIGNATION 11. AIRCRAFT IS /Check applicable McCauley Propeller Systems 1A170E/JHA7660 IMPORT APPLICATION IS HEREBY MADE FOR: (Check applicable items) A V STANDARD AIRWORTHINESS CERTIFICATE (Indicate category) NORMAL UTILITY ACROBATIC TRANSPORT COMMUTER BALLOON OTHER SPECIAL AIRWORTHINESS CERTIFICATE (Check appropriate items)
PRIMARY LIGHT-SPORT (tredicate Class) Airplane Power-Parachute Weight-Shift-Control Glider Lighter than Air
LIMITED
CLASS I PROVISIONAL (Indicate class)
CLASS II II. CERTIFICATION REQUESTED AGRICULTURE AND PEST CONTROL 2 AERIAL SURVEY AERIAL ADVERTISING o be conducted) RESTRICTED (Indicate operations) FOREST (Midlife conservation) PATROLLING WEATHER CONTROL OTHER (Specity) RESEARCH AND DEVELOPMENT 2 AMATEUR BUILT 3 EXHIBITION AIR RACING CREW TRAINING 6 MARKET SURVEY TO SHOW COMPLIANCE WITH THE CFR OPERATING (Primay Category) KIT BUILT AIRCRAFT _ 8A Existing aircraft without an airworthiness certificate & do not meet § 103.1 EXPERIMENTAL (Indicate operation(s) to be conducted) OPERATING Operating Light-Sport Kit-built
LIGHT-SPORT 8C erating light-sport previously issued special light-sport category airworthin ificate under & 21.
UNMANNED 9A RESEARCH AND DEVELOPMENT 9C CREW TRAINING AIRCRAFT 9B MARKET SURVEY
FERRY FLIGHT FOR REPAIRS, ALTERATIONS, MAINTENANCE, OR STORAGE SPECIAL FLIGHT PERMIT (Indicate EVACUATE FROM AREA OF IMPENDING DANGER operation to be conducted, then complete Section Vi or Vil as applicable on reverse side) OPERATION IN EXCESS OF MAXIMUM CERTIFICATED TAKE-OFF WEIGHT DELIVERING OR EXPORTING 15 PRODUCTION FLIGHT TESTING
CUSTOMER DEMONSTRATION FLIGHTS MULTIPLE AIRWORTHINESS CERTIFICATE (Check ABOVE "Restricted Operation and "Standard" or "Limited" as applicable) A. REGISTERED OWNER (As shown on certificate of aircraft registration) IF DEALER, CHECK HERE →
NAME ADDRESS Flight Corp. 10 Lane Ave., Doby, TX 78907 III. OWNER'S CERTIFICATION B. AIRCRAFT CERTIFICATION B AIRCRAFT SPECIFICATION OR TYPE CERTIFICATE DATA SHEET (Give No and ( complete items as indicated) AIRWORTHINESS DIRECTIVES (Check if all applicable ADs are complied with and give the number Revision /NVo.) 3A12 of the last AD SUPPLEMENT available in the beekly series as of the date of application) 2002-12 AIRCRAFT LISTING (Give page number(s)) SUPPLEMENTAL TYPE CERTIFICATE (List number of each STC incorporated) N/A
AIRCRAFT OPERATION AND MAINTENANCE RECORDS CHECK IF RECORDS IN TOTAL AIRFRAME HOURS EXPERIMENTAL ONLY (Enter hours flown since last certificate issued COMPLIANCE WITH 14 CFR section 91.417 10 or renewed) D. CERTIFICATION - I hereby certify that I am the registered owner (or his agent) of the aircraft described above, that the aircraft is registered with the Federal Aviation Administration in accordance with Title 49 of the United States Code 44101 et seg: and applicable Federal Aviation Regulations, and that the aircraft has been inspected and is airworthy and eligible for the amronniness certicate requested DATE OF APPLICATION NAME AND TITLE (Print or type) SIGNATURE 06/20/2002 Joe Quality, Director, QA Gor Quality A. THE AIRCRAFT DESCRIBED ABOVE HAS BEEN INSPECTED AND FOUND AIRWORTHY BY: (Complete the section only if 14 CFR part 21.183(0) apples) IV. INSPECTION VERIFICATION 14 CFR part 121 CERTIFICATE HOLDER (Give CERTIFICATED MECHANIC (Give Certificate No.) CERTIFICATED REPAIR STATION (Give Certificate AGENCY Certificate No.) AIRCRAFT MANUFACTURER (Gie name or firm) Na)
SIGNATURE (Check ALL applicable black tems A and B) THE CERTIFICATE REQUESTED V. FAA REPRESENTATIVE A. I find that the aircraft described in Section I or VIl meets requirements for AMENDMENT OR MODIFICATION OF CURRENT AIRWORTHINESS CERTIFICATE CERTIFICATION B. Inspection for a special flight permit under Section VII was conducted by: FAA INSPECTOR FAA DESIGNEE CERTIFICATE HOLDER UNDER 14 CFR part 65 14 CFR part 121 OR 135 14 CFR part 145 DATE MIDO/FSDO FAA INSPECTOR'S SIGNATURE or DESIGNEE'S FAA INSPECTOR'S CERTIFICATION FILE REVIEW
OFFICE SIGNATURE AND NO SIGNATURE FAA Form 8130-6 (04-11) All Previous Editions Superseded D-2