STC SA209SW

FORM ACA-2M7 U.S. DEPARTMENT OF COMMERCE

1. NAME AND ADDRESS OF APPLICANT P.O. BOX 161^7 SaH ANTONIO, T^X^iS For* Approred. Badftt Burata He. 41-11S23 INSTRUCTIONS - Submit In triplicate to local CAA Aviation Safety Agent. Copy will be returned to applicant upon issuance.

2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:

bC 1 AIRCRAFT 1 1 EN6INE d| PROPELLER ORIGINAL MODEL DESIGNATION 8(10200 B.JJCII 31 S. 3.^3, cr^'.-Sa&H, C01IR.il) 980C NEW MODEL DESIGNATION (If dtmired) 3- DESCRIPTION OF CHANGE lUJ'i.iLLATION 0»" CU£3T COHT Jfc5 It/Nd t INC. NOS3 H3AX3R AS ?££ CiiBST CONV&WION3, UJC. DHA.JING LIST CCDL-90'TO Q.VE -3t 1/17/63* BSIT, A. DATdl> 5A6/63. and CHSoT CGHV3AG1QN3, INC, JUBSTITUTIOff OF SOUTir.lXBD gl+OB tti'iTJR XH PLACi 0?

?0^ QN£ TIM; INSTALLATION ONLY ON BaSCHCB^T/SOLETJ) 10?OO JER. NO. V5-35637 - i*SG» NO* Nlf?0 NOTE: FAA approved Airplane Flight Manual Suppfanent dated 6/11/63 required.

««. WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO WILL PARTS BE MANUFACTURED FOR SALE (get. CAS 5' SIGNATURE AND TITLE OF APPLICANT ————————— uCL* — L^ — l'.;'ii~i ——— , ————DATE OF APPLICATION OTHER PERSONS? ' T^kvES Q NO 1 *V 1 \ , f L

1.5Sj(T^-^^y- ———— tAL^ES \ | __ 1 NO — \ \^^\__-^^V^V^^TC^YA *" ^~^ SICNATURE 1 VICJ Pjisijli) —I i - j-j i irilJj i-iiiijii-j ..L TITLE

6. TO BE COMPLETED BY CAA

NATURE AND LOCATION OF DATA Data listed in Item 3 above on file at SW-210.

Reference Project A251SWS.

Applicable regulations flame an original certification.

ORIGINAL TYPE CERTIFICATE NO. CAA APF 765 SUPPLEMENTAL TYPE CERTIFICATE NO. / 8A209SW / ^' ——————————————————————————————————————————————————— - ——————————— -f, 'r, y dOFAPPKOVAL ^/tl.n.

6/11/63 Revised; 10/1.6/64 CUief COMM-DC 32484 ROVAL mm^ SI 6KATUBE Slaughter , Engineering and Manufaduring Branch Tl TLE FORM ACA-2«17 (7-56)