What it approves
Installation of Mitchell Automatic pitch trim system model AK134.
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 TXfE CERTIFICATE
1. NAME AND ADDRESS OF APPLICANT Mitchell Industries. Inc.
Municipal Airport P. O. Box 610 Mineral Wells. Texas
3. DESCRIPTION OF CHANGE Installation of Mitchell Automatic accordance xwlth Mitchell Industrie 24, 1 965 antf) subsequent F.A.A. a
ILL DATA BE AVAILABLE FOR SALE OR RELEASE TO D. WILL PARTS BE MANUFACTURED FOR SALE (Kef. CAR
5. SIGNATURE AND TITLE OF APPLICANT Rev. 2-24.65 11-9-64DATE OF APPLICATION Form Approved, Budget Bureau No. 04-R015 INSTRUCTIONS - Submit in triplicate to local FAA Flight Standards Inspector. Copy will be returned to applicant upon issuance.
2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:
|"y| AIRCRAFT 1 1 ENGINE [ ] PROPELLER
ORIGINAL MODEL DESIGNATION <".•«•««» 1R?.F.0 IflZF, 1R2G It 1 A2H NEW MODEL DESIGNATION (If desired) Nnn* Pitch Trim System Model AK134 in
s. Inc. Bulletin No. 252 dated February pproved Bulletins and/ or supplements.
OTHER PERSONS? Kl YES 1 1 NO 1 .55.)? S3 YES CU NO // ^~}/ /XL^^ ^ff^/fY^^ ^-^ ^^ <—^SIGNATURE Vice President TITLE
6. To b« completed by FAA
NATURE AND LOCATION OF DATA Data listed in Item 3 above, TIE A640SH8 and Flight Te.t dated March S. 1965 (See SIC SA489SW file) on file at SW-210.
Applicable regulations »*»• a* or*8ln*l certification.
ORIGINAL TYPE CERTIFICATE NO. FAA APP 3A13 ^PLEMENTAL TYPE CERTIFICATE NO.
3A450SW ^ _„ fE 6F APPROVAL V « 1/0 /£C **J/O/tO ROVAL "' ' SIGNATURE . H. Slaughter tilef , Engineering and Manufacturing Branch Tl TLE 3540 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.