STC SA55SW

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 Pat Thayer Aviation t-lectronica,Inc.206 E« fermlm*! DriveInternational AirportAntonio, fexa»

2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:

K, | AIRCRAFT I I ENGINE I I PROPELLER

ORIGINAL MODEL DESIGNATION NEW MODEL DESIGNATION (If detired) Installation of electrical pitch trim system Inaccordance with Pat Thayer Aviation ileetronles, Inc.Drawing No. 1002, Kevltlon "A", dated 7-26-61, throughRevision C dated 5/3/62.

NOTE: Pat Thayer Aviation Electronics, Inc. FAA approved Airplane Flight Manual Supplement dated 5/4/62 required.

_. WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS? 3CD YES

b. WILL PARTS BE MANUFACTURED FOR SALE (Kef. CAR 1.55)7 jf~l YES NO NO

5. SIGNATURE AND TITLE OF APPLICANT February 22f 1962DATE OF APPLICATION TITLE

6. To be Compteted by FAA

NATURE AND LOCATION OF DATA H». 26Jt Data liatad in ItMt 3 ate**, en* ti*ea DO Btohart ». Craft*• rAA-1600* aateA 2/26/62. S/21/62 aa« 3/S/62 ea file at W-210.

l«f«r«nee Project A29SW-0.

Je»Uae»U GAl 03 of li/lS/45, ORIGINAL TYPE CERTIFICATE NO.

•IPPLEMENTAL TYPE CERTIFICATE NO.

•ASSfH

DATE OF APPROVAL b/27/62

FAA APPROVAL SI6NATURE Chief, lesinecriat & Hwifacturin* Tl TLE FORM FAA-2417 (5-59)

TRANSFER ENDORSEMENT Transfer the ownership of Supplemental Type Certificate Number to (Name of transferee).

(Address of transferee). I .VumttT tnd Ortrl) (do. Stale, fixl yP ndi) from (Name of grantor) (Print or type).

(Address of grantor) nJ atttt) (Cify. Suit, t*J ZIP nJft Extent of Authority (if licensing agreement):

Signature of grantor (In ink):