What it approves
Installation of automatic pitch trim model AK 138.
What the certificate says
From the PDF’s text layer, without the form’s printed wording. Layout and order may differ; the PDF is the record.
FEDERAL AVIATION AGENCY
SUPPLEMENTAL TYPE CERTIFICATE FORM APPROVED, BUDGET BUREAU NO. 04-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 MitcheU Industries, lac.
Municipal Airport P.O. Box 610 Mineral Well., Texas 7606?
2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:
1X1 AIRCRAFT I I ENGINE 1, J PROPELLER ORIGINAL MODEL DESIGNATION J^J 175A fc 175B Cessna 172. 172A. 172B. 17JC. 172D. 172ENEW MODEL DESIGNATION (If detired) Nona
3. DESCRIPTION OF CHANGE Installation of Mitchell Industries, Inc. Automatic Pitch Trim Model AK138 per MitcheU Industries Bulletin No. 242 dated July 16, 1964 and subsequent F. A. A.
approved bulletins and/or supplements.
KILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS?
b. WILL PARTS BE MANUFACTURED FOR SALE (Kof. CAR 1.55)1 YES
CD YES CD NO
5. SIGNATURE AND TITLE OF APPLICANT 7*16-64
SIGNATURE Vice PresidentDATE OF APPLICATION TITLE
6. To be Completed by FAA
NATURE AND LOCATION OF DATA Data listed in Item 3 Applicable regulations aa* 7X1 A579W8 (SM STO SA1098W) en file at SW-210.
as original certification.
ORIGINAL TYPE CERTIFICATE NO.
1A12 & 3A17 SUPPLEMENTAL TYPE CERTIFICATE NO.
SA4113W
DATE OF APPROVAL / "77
FAA APPROVAL S I 6N A TU R E B. Slaughter Chief, Ingfesering and Meaufacturing BranchTl TLE * U.S. GOVERNMENT PRINTING OFFICE : I95» O—509S57 FORM FAA-2417 (5-59)
ADs that name this STC · 0
An AD can apply because an STC is installed, or mention one in its text.