STC SA547SW

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.

Municipal Airport P.O. Box 610 Mineral Wells, Texas 76067

2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:

|y | AIRCRAFT I I ENGINE I. j PROPELLER ORIGINAL MODEL DESIGNATION fc H-295 U-1QSA. H NEW MODEL DESIGNATION (It deiired) None

3. DESCRIPTION OF CHANGE Installation of Mitchell Automatic Pilot. Model AK177 in accordance with Mitchell Industries, Inc. Bulletin no. 293 dated 10-13-66 and subsequent F. A. A. approved bulletins and/or supplements. Installation of Mitchell Lateral Guidance Radio Coupler Model AK123 in accordance with Mitehell Industries, Inc. Bulletin No. 206 dated June 10. 1964. Installation of Mitchell Automatic Trim Model AK178 in accordance with Mitchell Industries, Inc. Bulletin No. 294 dated 10*13-65.

NOTES: 1. Mitchell Industries, Inc. FAA approved placard 13A235-177 required for Helio H-391, H-391B, H-395 It H-395A.

2. Mitchell Industries. Inc. F.A.A. approved placard 13A235-177-1 required for Helio H-250 fc H-295.

ft. WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS? Lxl YES II NO

b. WILL PARTS BE MANUFACTURED FOR SALE (Re/. CAB l.S5)1 K] YES II NO

5. SIGNATURE AND TITLE OF APPLICANT 8-4-65 Rev. 10-13-65

DATE OF APPLICATION

SIGNATURE TITLE

6. To be Completed by FAA

NATURE AND LOCATION OF DATA Data in Item 3 above end TIR A772SWS on file *t SW-210; also TIR A805SWS- Reference Project: A805SWS Applicable Regulations: S n» as original certification.

ORIGINAL TYPE CERTIFICATE NO.

1A8 UPPLEMENTAL TYPE CERTIFICATE NO.

SA547SW

DATE OF APPROVAL 10/4/65 Revision 1 11/15/

FAA APPROV,

SIGNATURE / Glen W Welsh Chief, Engineering and Manufacturing Branch Tl TLE « U.S. GOVERNMENT PRINTING OFFICE : 1959 O—509657 FORM FAA-2417 (5-59)