What it approves
Installation of Mitchell Pitch trim System Modal AK 164
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 Mitchell Industries, Inc.
P. O. Box 610 Municipal Airport Mineral Wells. Texas 7606?
2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:
X | AIRCRAFT I I ENGINE 1 1 PROPELLER -24. I*A-li'-i50.
NEW MODEL DESIGNATION (If detlred) Nona
DESCRIPTION OF CHANGE Installation of Mitchell Pitch trim System Modal AK 164 in accordance with Mitehell Industries, lac. Bulletin No. 279 datad 5-25-65 and subsequent P. A. A. approved bulletins aad/or supplements.
4a. WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS?
b. WILL PARTS BE MANUFACTURED FOR SALE (Kef. CAK 1.55)1 YES YES CD NO CD NO
5. SIGNATURE AND TITLE OF APPLICANT 5-25-65
DATE OF APPLICATION
SIGNATURE Vice President TITLE
6. To fee Completed by FM
NATURE AND LOCATION OF DATA Data listed in item 3 above on file at SW-210.
Reference Project: Hone Applicable regulations: Sane as original certification.
ORIGINAL TYPE CERTIFICATE NO.
1A15 & A1EA «"PPLEMENTAL TYPE CERTIFICATE NO.
SA524SW
DATE OF APPROVAL 6/2/65 FAA APPROVAL.
SIGNATURE /^a, H. SlaughterChief, EnginaVring and Hanufaeturlng BranchTl 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.