STC SE1PC

- - . FORM APPROVED, BUDGET BUREAU NO. 04-R015" FEDERALAVIAnONAGENCY -- INSTRUCTIONS - SUBMIT IN TRI R..ICATE TO LOCAL FAA FLIGHT STANDARDS INSPECTOR.

ISSUANCE

1. NAME AND ADDRESS OF APPLICANT 2. SUPPLEMENTAL TYPE CERTI F I CATE APPL I EO FOR:

AVIATI N SERVICE, INC. o AIRCRA.FT ~ ENGINE o PROPELLER 2355 KALAKAUA AVE. OR I GI NAL MODEL DES I GNA TI ON HONOLULU (Brinol Siddeley)HAWAII 968I5 NEW MODEL DESIGNATION (II deaired) None ,.DESCRIPTION Of CHANGE LIMI~TION OF APPLICABILITY. This spprovalshouldnot be extendedto other specific engine~of thesemodels on which other previouslyapprovedmodificationsare incorporatedunless it is determinedthat the interrelationshipbetweenthiscban&e and any other previouslyapproyedmodificationswill introduceno adverseeffect upon the airworthinessof thateqine.

CertificationBases: en 10, en 13 r--.

wilL DATA BE AVAILABLE FOR SALE OR RELEASE TO OTHER PERSONS? [;J YES o NO

b. WILL PARTS BE MANUFACTURED FOR SAL E (Ref. CAR 1.$5)1 DYES Gil NO

5. SIGNATURE AND TITLE OF APPLICANT ~4.,?;;;~~~~/~~li AI 127~g47 SHOP FQHEHAU0"; F ;PPlICATION TI TlE 6, To be Como/eteclbv FM NATURE AND lOCATION OF DATA AviationService,Inc. ReportNo. 1865dated 1/8/65.

Data on file in the B inaeringandManufacturingBranch,FAA, PacificResion, Honolulu,Hawaii.

ORIGINAL TYPE CERTIFICATE NO. FAA APPROVAL SUPPLEMENTAL TYP E CERTI FI CATE NO. GLENW. W<LSH ,....... Glan W. Welsh SIGNATURE SBlPC Chief, EngineeringandManufacturingBranch DATE OF APPROVAL FlightStandardsDivision January8, 1965 TITLE '* u.s. GOY[RNIIIINT ~RINTING OffiCI: .'1' O-lotf57 -------------------- ------------ FORM FAA-2417 (5-59)