STC SA470SW

FEDERAL AVIATION AGENCY FORM APPR°VED' BUDGET BUREAU N°' °4-R°15

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

SUPPLEMENTAL TYPE CERTIFICATE COPY WILL BE RETURNED TO APPLICANT UPON

ISSUANCE

1. NAME AND ADDRESS OF APPLICANT 2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:

Mitchell Industries, Inc. EA.RCRAFT C] ENG.NE dl PROPELLER Municipal Airport .. .

P O BOX 610 ORIGINAL MODEL DESIGNATION M-n-'ni w^iic TQ -, -7Cn/"7 65-80 & 65-A80 BeechMineral Wells, lexas 7oUo7 ——————————————— " vv" —————' NEW MODEL DESIGNATION (If demired) None

3. DESCRIPTION OF CHANGE Installation of Mitchell Automatic Pilot Model AK122 in accordance with Industries, Inc. Bulletin No. 204 dated 1-11-65 and subsequent F. A. A.

Bulletins and/ or supplements. Installation of Mitchell Lateral Guidance Coupler Model AK123 per Bulletin No. 206 dated June 10, 1964.

Note: Mitchell Industries, Inc. F. A. A. approved airplane flight manual supplement dated 1/18/65 required.

Mitchell approved Radio WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS? 53 YES 1 1 NO

b. WILL PARTS BE MANUFACTURED FOR SALE (Kef. CAR 1.55)7 LX] YES [_] NO

5. SIGNATURE AND TITLE OF APPLICANT /" S~

SIGNATURE 1-11-65 Vice President

DATE OF APPLICATION TITLE

6. To be Completed by FAA

NATURE AND LOCATION OF DATA Data listed in Item 3 above, and TIR A659SWS on file at SW-210.

Applicable regulations: CAR 3 effective 5/15/56, Amendments 3-1 and 3-2.

ORIGINAL TYPE CERTIFICATE NO. FAA APPROVAL SUPPLEMENTAL TYPE CERTIFICATE NO. &$ft rjf /^/^C^i^t^f S 1 GN A TU R E SA470SW ^ DATE OF APPROVAL ~fi' H. H. Slaughter ]__]_g_65 Chief. Engineering and Mannfart-nrino- RT- Tl TLE * U.S. GOVERNMENT PRINTING OFFICE : 1959 O—509657 FORM FA A-2417 (5-59)