STC SR00801DE

FAA Form 8110-2 (5/14) Page 1 of 3

Part 29 of the Civil Air Regulations.

Original Product – Type Certificate Number: H4SW Make:

Installation of Crew Mobility Restraint Kit in accordance with Laz-Tec Drawing List, Report No. LT-15212, Revision A, dated April 26, 2016, FAA approved May 13, 2016, or later FAA approved revisions .

1. The installation should not be incorporated in any aircraft unless it is determined that the interrelationship between this installation and any previously approved configuration will not introduce any adverse effect upon the airworthiness of the aircraft.

2. Flight Manual Supplement, Laz-Tec, LLC Document No. LT-15216, No Revision, dated January 19, 2016, or later FAA approved revision is required for this installation.

3. Instructions for Continued Airworthiness (ICA), Laz-Tec, LLC Document No. LT-15215, Revision A, dated February 12, 2016, FAA accepted March 15, 2016, or later FAA accepted revision is required.

4. If the holder agrees to permit another person to use this certificate to alter the product, the holder shall give the other person written evidence of that permission.

Date of Application: July 22, 2015 Date Reissued:

Date of Issuance: May 13, 2016 Date Amended:

Signature

SR00801DE

Laz-Tec, LLC 5500 Spur Cross Trail Parker, Colorado 80134

Bell Helicopter Textron Canada 412, S/N 33116 thru 33213 [except S/N 33130, 33139 thru 33149 and 33161 thru 33167] and S/N 36001 thru 36086;

412EP, S/N 36087 thru 36999 and 37002 thru 37999;

412CF, all S/N Gregory Johnson Program Manager, Denver Aircraft Certification Office Northwest Mountain Region

FAA Form 8110-2 (5/14) Page 2 of 3

To (Name and address of transferee)

From (Name and address of grantor)

United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate (Continuation Sheet) Number: SR00801DE FAA Form 8110-2 (5/14) Page 3 of 3

Certification Basis:

Based on 14 CFR §§ 21.115 and 21.101, and the FAA policy for significant changes in FAA Order 8110.48, the certification basis for the design change is as follows:

• The type certification basis for Bell Model 412, 412EP and 412CF Rotorcraft is shown on TCD S H4SW for parts not changed or affected by the change.

• The certification basis for parts changed or affected by the change since the reference date of application, July 22, 2015, is also shown in TCDS H4SW. Based on 14 CFR §§ 21.115 and 21.101, and FAA policy for significant changes in FAA Order 8110.48, the certification basis for this modification was determined to be:

Regulations at amendment level shown on TCDS H4SW:

29.301(a), 29.303, 29.305(a), 29.337(a), 29.341, 29.601(a), 29.605(a), 29.607, 29.609(a), 29.625(a), 29.853(a),

29.1529, 25.1541(a)(2)(b), 29.1581 Regulations at an intermediate amendment level:

29.307(a) Amdt 29-4, 29.561(a)(b)(3) Amdt 29-29, 29.603 Amdt 29-12, 29.613(d) Amdt 29-17, 29.785(a)(e) Amdt 29-29 ----------END----------

United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate (Continuation Sheet) Number: SR00801DE

FAA Form 8110-2 (5/14) Page 4 of

United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate (Continuation Sheet) Number: SR00801DE

FAA Form 8110-2 (5/14) Page 5 of

United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate (Continuation Sheet) Number: SR00801DE

FAA Form 8110-2 (5/14) Page 6 of

United States of America Department of Transportation Federal Aviation Administration Supplemental Type Certificate (Continuation Sheet) Number: SR00801DE

FAA Form 8110-2 (5/14) Page 7 of