STC SA01869WI

Number SA01869WI

This certificate, issued to Middle Fork Mods, LLC 170 Plummer Road Challis, ID 83226

Part * of the * Regulations.

Original ProductType Certificate Number: * See attached Federal Aviation Administration (FAA) Make: Approved Model List (AML) SA01869WI for approved Model: aircraft models and applicable airworthiness regulations

Description of the Type Design Change: Installation of tail tie down assembly in accordance with FAA Approved Master Drawing List as listed on AML SA01869WI, amended July 23, 2019, or later FAA Approved revision. Maintained in accordance with the Instructions for Continued Airworthiness (ICA) as listed on AML SA01869WI, amended July 23, 2019, or later FAA Approved revision.

Limitations and Conditions: Approval of this change in type design applies to the aircraft listed on AML SA01869WI only. This approval should not be extended to other aircraft of these models on which other previously approved modifications are incorporated unless it is determined by the installer that the relationship between this change and other previously approved modifications will introduce no adverse effect u pon the airworthiness of that aircraft. A copy of this certificate, AML SA01869WI, and the ICA must be maintained as part of the permanent records for the modified aircraft.

If the holder agrees to permit another person to use this certificate to alter the product, the holder shall give the other person written evidence of that permission.

Date of application: January 13, 2017 Date reissued: February 9, 2018, April 2, 2018 Date of issuance: January 31, 2018 Date amended: July 25, 2019

FAA FORM 8110-2 (5/14) PAGE 1 OF 2 PAGES By direction of the Administrator

(Signature)

Acting Manager, Seattle ACO Branch (Title)

Transfer the ownership of Supplemental Type Certificate Number

to (Name of Transferee)

(Address of Transferee)

(Number and Street)

(City, State, and ZIP Code)

from (Name of Grantor) (Print or Type)

(Address of Grantor)

(Number and Street)

(City, State, and ZIP Code)

Signature of Grantor (In Ink):

U.S. GPO: 1987-763-289