What it approves
Installation of Mitchell Pitch trim system AK152.
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 oUrrLtMtn IAL ITrt v/tKllr IvA It FORM APPROVED< BUDGET BUREAU NO' 04-R015
INSTRUCTIONS - SUBMIT IN TRI PLICATE TO LOCAL FAA FLIGHT STANDARDS INSPECTOR.
COPYWILLBE RETURNED TO APPLICANT UPON
ISSUANCE
1. NAME AND ADDRESS OF APPLICANT Mitchell Industries, Inc.
P. O. Box 610 Municipal Airport Mineral Walla, Texas 76067
2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:
IX 1 AIRCRAFT 1 1 ENGINE 1 1 PROPELLER
ORIGINAL MODEL DESIGNATION Piper PA -24, PA-24-250, PA PA* SO-24 -400 NEW MODEL DESIGNATION (If demited) 3- DESCRIPTION OF CHANGE Installation of Mitchell Pitch Trim System Modal AK 152 in accordance with Mitchell Indus trios. Inc. Bulletin No. 264 datad 5*25*65 and subsequent F. A. A. approved bulletins and/or supplements.
WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS?
b. WILL PARTS BE MANUFACTURED FOR SALE (Kef. CAR 1.55)1 §£] YES l~1 NO §JP YES d] NO
5. SIGNATURE AND TITLE OF APPLICANT Rav. 5*25*65 1*19*65 DATE OF APPLICATION
SIGNATURE Vica President TITLE
6. To be Completed by FAA
NATURE AND LOCATION OF DATA Data listed la I tea 3 above oa file at SW-210.
Applicable regulations sane as original certification.
ORIGINAL TYPE CERTIFICATE NO.
1A15 and Alia SUPPLEMENTAL TYPE CERTIFICATE NO.
SM75SW
OATE OF APPROVAL Revised:
2/01/65 6/25/65
FAA APPROVAL pfa—Chlmf S 1 GN A TU R E B. H. Slaughter Tl TLE * U.S. GOVERHMEHT PB1HTIN6 OFFICE : 1959 0—SOM57 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.