STC SA643SW

FEDERAL AVIATION AGENCY

1. NAME AND ADDRESS OF APPLICANT Tedder Aviation Company P. 0. Box 5 Texarkana, Texas 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

2. SUPPLEMENTAL TYPE CERTIFICATE APPLIED FOR:

I y\ AIRCRAFT 1 1 ENGINE L 1 PROPELLER

ORIGINAL MODEL DESIGNATION Boeing 75 Series NEW MODEL DESIGNATION (If demlred) none

3. DESCRIPTION OF CHANGE Installation of engine mount assembly to permit use of Jacobs Models R-755 Series engines per Tedder Aviation Company's Drawing No. T-755.

NOTE: This is structural approval only.

WILL DATA BE AVAILABLE FOR SALE OR RELEASE TO

b. WILL PARTS BE MANUFACTURED FOR SALE (Kef. CAR

5. SIGNATURE AND TITLE OF APPLICANT January 22, 1966

DATE OF APPLICATION OTHER PERSONS? f*"1 YES 1 1 NO

1.55)1 nO YES 1 ~] NO

SIGNATURE TITLE

6. To be Completed by FAA

NATURE AND LOCATION OF DATA Data listed in Item 3 afeove and FAA- 12 5 7 on file in SW-210.

Reference Project: A891SWS Applicable regulations: same as original certification.

ORIGINAL TYPE CERTIFICATE NO. FAAAP 743 SUPPLEMENTAL TYPE CERTIFICATE NO.

SA643SW ^ DATE OF APPROVAL (/ *" C*i May 6, 1966 =ROVAL ' " S 1 GN A TU R E en W. Welsh ief, Engineering and Manufacturing Branch Tl TLE * U.S. GOVERNMENT PRINTING OFFICE : 1959 O—509657 FORM FAA-2417 (5-59)