STC SA214SW

FEDERAL AVIATION AGENCY

SUPPLEMENTAL TYPE CERTIFICATE FORM APPROVED. BUDGET BUREAU NO. O4-R015

INSTRUCTIONS - SUBMIT IN TRI PLICATE TO LOCAL FAA FLIGHT STANDARDS INSPECTOR.

COPY WILL BE RETURNED TO APPLICANT UPON

ISSUANCE

1. NAME AND ADDRESS OF APPLICANT J. HAY HvOBMOTT & CO., INC.

P. 0. DRAW. 90.

HARVBI, LA.

AVHTIQH BIVISIO"!.

2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:

I g] AIRCRAFT PH ENGINE Q PROPELLER

ORIGINAL MODEL DESIGNATION NEW MODEL DESIGNATION (If

DESCRIPTION OF CHANGE Removal of paferated MOM on cabin heat and Garb, beat aide* on P/;i, 0750130- 9 12 & U ttifttar Aiaeobly on Cewna Kodel 130 with Continental Q&70-K Type Engine"^ «»*— ^^ Removal In acoordanM with f*0emwtt Dr .' Jated 4». WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS?

b. WILL PARTS BE MANUFACTURED FOR SALE (*tf. CAR J.5S)7 YES YES l~l NO NO

5. SIGNATURE AND TITLE OF APPLICANT HWATURt ^ .. e jfp^ ,.fe*DATE OF APPLICATION TITLE

6. To fee Comp/eted by FAA

ATURE AND LOCATION OF DATA Drawing No. I dated 4/5/C3, end Flight Bngineerlng Eecord of Aircraii:

Alteration dated 4/5/1.3, on file at SU-210.

Applicable GA&'a aane as original certification.

ORIGINAL TYPE CERTIFICATE NO.

3A6 -I-LEUEHTAL TYPE CERTIFICATE NO.

3A2145W DATE OF APPROVAL 4/5/63

FAA APPROVAL U. H. Slaughter Chief, Engineering and Manufacturing Branch FORM FAA-2417 15-59)