What it approves
Installation of Mitchell pitch trim Model AK147.
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
1. NAME AND ADDRESS OF APPLICANT Mitehell Industrie., Inc.
Municipal Airport P. O. Box 610 Mineral Welle, Te«a« 74067 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
2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:
lyl AIRCRAFT I I ENGINE [~~l PROPELLER ORIGINAL MODEL DESIGNATION nt. *A Piper PA.24. PA*24.2SOr PA.zifiOO, NEW MODEL DESIGNATION (If demited)
3. DESCRIPTION OF CHANGE Installation of Mitchell Pitch Trim Model AK147 in accordance with Mitchell Industrie*, Inc. Bulletin No. 260 dated 12-21-64 and eubeequent F.A. A. approved bulletin* and/ or •upplemantt .
WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO
b. WILL PARTS BE MANUFACTURED FOR SALE (Ret. CAR
5. SIGNATURE AND TITLE OF APPLICANT 12-21-64
DATE OF APPLICATION OTHER PERSONS? Ljd YES I— J NO 1 .55)1 CXl YES F~~l NO /) / I a / "*~) ^/^ /K&Ss**S ' jd%%^<£r<'-'-r<'*+ — -
SIGNATURE Vice President TITLE
6. To be Completed by FAA
NATURE AND LOCATION OF DATA Data lifted in Item 3 above on file at SW-210.
Applicable regulation* seat aa original certification.
ORIGINAL TYPE CERTIFICATE NO. FAA API 1A15 & A1KA SUPPLEMENTAL TYPE CERTIFICATE NO.
SA4668W ;
DATE OF APPROVAL B. *t 1-14-65 -SMfi =ROVAL ^ ' ?/) ° <L^ / /6=^^t^£^o^ ^f^> J^J^ )
SI GNATURE ^^^ , Slaughter f . Knginaerinf and Manufacturing Branch ___Tl TLE * U.S. GOVERNMENT PRINTING OFFICE : 1959 O—509657 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.