# STC SA01869WI

- Type: Supplemental type certificate
- Status: Current, Amended
- Holder: Middle Forks Mod LLC, United States
- Description: Installation of a Tail Tie-Down Assembly
- Applied: January 13, 2017
- Status date: July 25, 2019
- Product: Aircraft, Small Airplane
- Certification basis: Part 3, Part 21, Part 23
- Data sheets: [TCDS 3A12](https://openairdocs.org/tcds/3A12), [TCDS 3A13](https://openairdocs.org/tcds/3A13), [TCDS 3A17](https://openairdocs.org/tcds/3A17), [TCDS 3A21](https://openairdocs.org/tcds/3A21), [TCDS A16CE](https://openairdocs.org/tcds/A16CE), [TCDS A18EU](https://openairdocs.org/tcds/A18EU), [TCDS A4CE](https://openairdocs.org/tcds/A4CE), [TCDS A4EU](https://openairdocs.org/tcds/A4EU)
- Certificate PDF: https://openairdocs.org/files/sha256/72/c3/72c360b21a804de7c5d6ac284b9bd5f57eb1ddf2231c9d212aa51f47417b76e4
- Approved model list and other attachments: [SA01869WI_AML.pdf](https://openairdocs.org/files/sha256/3b/65/3b655a65af6fb4c2c384e9b17a99181b3dcf8b67cf8371e8449f63df2894dd00)
- FAA DRS: https://drs.faa.gov/browse/excelExternalWindow/78AEDA1E8889B85A862585E700527DBD.0001
- DRS record last changed: December 5, 2025
- Page: https://openairdocs.org/stc/SA01869WI

## ADs that name it (0)

None.

## Approved models (131, first 50)

- Textron Aviation Inc. 172 ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172A ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172B ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172C ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172D ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172E ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172F (USAF T-41A) ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172G ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172H (USAF T-41A) ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172I ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172K ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172L ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172M ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172N ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172P ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172Q ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172R ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 172RG ([TCDS 3A17](https://openairdocs.org/tcds/3A17))
- Textron Aviation Inc. 172S ([TCDS 3A12](https://openairdocs.org/tcds/3A12))
- Textron Aviation Inc. 175 ([TCDS 3A17](https://openairdocs.org/tcds/3A17))
- Textron Aviation Inc. 175A ([TCDS 3A17](https://openairdocs.org/tcds/3A17))
- Textron Aviation Inc. 175B ([TCDS 3A17](https://openairdocs.org/tcds/3A17))
- Textron Aviation Inc. 175C ([TCDS 3A17](https://openairdocs.org/tcds/3A17))
- Textron Aviation Inc. 182 ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182A ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182B ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182C ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182D ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182E ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182F ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182G ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182H ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182J ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182K ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182L ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182M ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182N ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182P ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182Q ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182R ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182S ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 182T ([TCDS 3A13](https://openairdocs.org/tcds/3A13))
- Textron Aviation Inc. 206 ([TCDS A4CE](https://openairdocs.org/tcds/A4CE))
- Textron Aviation Inc. 206H ([TCDS A4CE](https://openairdocs.org/tcds/A4CE))
- Textron Aviation Inc. 207 ([TCDS A16CE](https://openairdocs.org/tcds/A16CE))
- Textron Aviation Inc. 207A ([TCDS A16CE](https://openairdocs.org/tcds/A16CE))
- Textron Aviation Inc. 210 ([TCDS 3A21](https://openairdocs.org/tcds/3A21))
- Textron Aviation Inc. 210-5 (205) ([TCDS 3A21](https://openairdocs.org/tcds/3A21))
- Textron Aviation Inc. 210-5A (205A) ([TCDS 3A21](https://openairdocs.org/tcds/3A21))
- Textron Aviation Inc. 210A ([TCDS 3A21](https://openairdocs.org/tcds/3A21))

All 131: https://openairdocs.org/stc/SA01869WI/models.md

## What the certificate says

Read from the PDF's text layer, without the form's printed wording; the layout is lost and the order can differ. The PDF is the record.

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

### SA01869WI_AML.pdf

**FEDERAL AVIATION ADMINISTRATION (FAA) APPROVED MODEL LIST (AML) SA01869WI FOR**

INSTALLATION OF MIDDLE FORK MODS, LLC TAIL TIE-DOWN ISSUE DATE: January 31, 2018

Page 1 of 2

**ITEM AIRCRAFT /**

**ROTORCRAFT MAKE**

**AIRCRAFT /**

**ROTORCRAFT MODEL**

**ORIGINAL TC NUMBER**

**CERTIFICATION**

**BASIS FOR**

**ALTERATION**

**FAA APPROVED**

**MASTER DRAWING LIST**

**FAA ACCEPTED**

**INSTRUCTIONS FOR**

**CONTINUED**

AIRWORTHINESS AML REV DATE Document Revision* Document Revision*

1. Textron Aviation Inc.

182, 182A, 182B, 182C, 182D, 182E, 182F, 182G, 182H, 182J, 182K, 182L, 182M, 182N, 182P, 182Q, 182R, 182S, 182T, R182, T182, TR182, T182T 3A13 Part 3 of the Civil Air Regulations and Part 23 of the Federal Aviation Regulations, as listed in the TCDS 16-020-SC4301 1 16-020-MT2901 3

2. Textron Aviation Inc.

210, 210A, 210B, 210C, 210D, 210E, 210F, T210F, 210G, T210G, 210H, T210H, 210J, T210J, 210K, T210K, 210L, T210L, 210M, T210M, 210N, P210N, T210N, 210R, P210R, T210R, 210-5 (205), 210-5A (205A) 3A21 Part 3 of the Civil Air Regulations 16-020-SC4301 1 16-020-MT2901 3

3. Textron Aviation Inc.

206, P206, U206, P206A, TP206A, U206A, TU206A, P206B, TP206B, U206B, TU206B, P206C, TP206C, U206C, TU206C, P206D, TP206D, U206D, TU206D, P206E, TP206E, U206E, TU206E, U206F, TU206F, U206G, TU206G, 206H, T206H A4CE Part 3 of the Civil Air Regulations 16-020-SC4301 1 16-020-MT2901 3

4. Textron Aviation Inc.

207, T207, 207A, T207A A16CE Part 23 of the Federal Aviation Regulations 16-020-SC4301 1 16-020-MT2901 3

**FEDERAL AVIATION ADMINISTRATION (FAA) APPROVED MODEL LIST (AML) SA01869WI FOR**

INSTALLATION OF MIDDLE FORK MODS, LLC TAIL TIE-DOWN ISSUE DATE: January 31, 2018

Page 2 of 2

**ITEM AIRCRAFT /**

**ROTORCRAFT MAKE**

**AIRCRAFT /**

**ROTORCRAFT MODEL**

**ORIGINAL TC NUMBER**

**CERTIFICATION**

**BASIS FOR**

**ALTERATION**

**FAA APPROVED**

**MASTER DRAWING LIST**

**FAA ACCEPTED**

**INSTRUCTIONS FOR**

**CONTINUED**

AIRWORTHINESS AML REV DATE Document Revision* Document Revision*

5. Textron Aviation Inc.

172, 172A, 172B, 172C, 172D, 172E, 172F (USAF T-41A), 172G, 172H (USAF T-41A), 172I, 172K, 172L, 172M, 172N, 172P, 172Q, 172R, 172S 3A12 Part 3 of the Civil Air Regulations 16-020-SC4301 1 16-020-MT2901 3

6. Textron Aviation Inc.

175, 175A, 175B, 175C, P172D R172E (USAF T-41B) (USAF T-41C or D), R172F (USAF T-41D), R172G (USAF T-41C or D), R172H (USAF T-41D), R172J, R172K, 172RG 3A17 Part 3 of the Civil Air Regulations 16-020-SC4301 1 16-020-MT2901 3

7. Textron Aviation Inc.

F172D, FP172D, F172E, F172F, F172G F172L, F172H, F172K, F172M, F172N, F172P

A4EU Part 3 of the Civil Air Regulations 16-020-SC4301 1 16-020-MT2901 3

8. Textron Aviation Inc.

FR172E, FR172F, FR172G, FR172H, FR172J, FR172K A18EU Part 3 of the Civil Air Regulations 16-020-SC4301 1 16-020-MT2901 3 * Or later FAA Approved Revision

FAA Approved:

Acting Manager, Seattle ACO Branch AMENDED: July 25, 2019 REISSUED:

## Every issue (4)

- July 25, 2019: Amended, Current. [certificate](https://openairdocs.org/files/sha256/72/c3/72c360b21a804de7c5d6ac284b9bd5f57eb1ddf2231c9d212aa51f47417b76e4), [SA01869WI_AML.pdf](https://openairdocs.org/files/sha256/3b/65/3b655a65af6fb4c2c384e9b17a99181b3dcf8b67cf8371e8449f63df2894dd00)
- April 2, 2018: Reissued, Historical. [certificate](https://openairdocs.org/files/sha256/ec/ea/ecea9de6a90fae463e4c0e2671a7cf1a25adcd5e033d921107823c6f46b3eb25), [SA01869WI_AML.pdf](https://openairdocs.org/files/sha256/54/a7/54a76c4214893d94b9ba316797db2b377dabfe58b45d796948033c7153c932f2)
- February 9, 2018: Reissued, Historical. [certificate](https://openairdocs.org/files/sha256/42/f4/42f4f719cdcdd471c97dd62ed93d38a2eaefc7f7d85fb73fcde53345004d7c98), [SA01869WI_AML.pdf](https://openairdocs.org/files/sha256/93/dd/93dd24ab3fe038d516757302347f8e597583a6aaabf9394ea14114c6ffebfa4a)
- January 31, 2018: Issued, Historical. [certificate](https://openairdocs.org/files/sha256/29/a2/29a2cd30ca1e3d919b6bc4a567151f3b4e154870ac2c31e56bd78ca5702ba0d6), [SA01869WI_AML.pdf](https://openairdocs.org/files/sha256/93/dd/93dd24ab3fe038d516757302347f8e597583a6aaabf9394ea14114c6ffebfa4a)

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