Aircraft Airworthiness Certificate

Production Flight Testing

A. Manufacturer

Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

B. Production Basis ( Check applicable item)

PRODUCTION CERTIFICATE (Give production certificate number)
TYPE CERTIFICATE
OTHER

Production Certificate

Other

C. Give Quantity of certificates required for operating needs

Date of Application

Name and Title

Special Flight Permit Purposes Other Than Production Flight Test

A. Description of Aircraft

Registered Owner

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Builder (Make)

Model

Serial Number

Registration Mark

B. Description of Flight

Customer Demonstration Flights

(Check if applicable)

From

To

Via

Departure Date

Duration

C. Crew Required To Operate the Aircraft and Its Equipment

PILOT
CO-PILOT
FLIGHT ENGINEER
OTHER (Specify)

Text - Other

D. The Aircraft Does Not Meet The Applicable Airworthiness Requirements As Follows:

E. The Following Restriction Are Considered Necessary for Safe Operation:

F. Certification

I hereby certify that I am the registered owner (or his agent) of the aircraft described above; that the aircraft is registered with the Federal Aviation Administration in accordance with Title 49 of the United States Code 44101 et seq. and applicable Federal Aviation Regulations; and that the aircraft has been inspected and is safe for the flight described.

Date

Name and Title

Airworthiness Documentation (FAA/DESIGNEE use only)

Airworthiness Documentation Checklist

H. Foreign Airworthiness Certification for Import Aircraft

Previous Airworthiness Certificate Issued in Accordance With

CFR Section

CAR

Current Airworthiness Certificate Issued in Accordance With

CFR Section

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Airworthiness Certificate

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Airworthiness Certificate

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CAPACITY OF PERSON SIGNING (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)

Date

I AGREE TO PAY THE ABOVE TOTAL AMOUNT ACCORDING TO THE CARD ISSUER AGREEMENT AND HEREBY AUTHORIZE THE CHARGE FOR THE TOTAL AMOUNT ABOVE FOR THE PROCESSING OF SELECTED FAA DOCUMENTS. I UNDERSTAND THAT MY APPLICATION WILL BE PROCESSED IN THE ORDER IN WHICH IT IS RECEIVED BY NATIONAL AVIATION CENTER, A PRIVATE FEE FOR SERVICE REGISTRATION COMPANY, NOT OWNED OR OPERATED BY ANY GOVERNMENTAL AGENCY. I UNDERSTAND THAT APPLICATION AND PROCESSING FEES ARE NON-REFUNDABLE AS PER NATIONAL AVIATION CENTER'S NO REFUND POLICY.

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Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Airworthiness Certificate

Step 1 of 3

Aircraft Description

Certification Requested

Standard Airworthiness Certificate

Special Airworthiness Certificate

Owner's Certification

Inspection Agency Verification

FAA Representative Certification

B. Inspection for a special flight permit under Section VII was conducted by:

Production Flight Testing

A. Manufacturer

Special Flight Permit Purposes Other Than Production Flight Test

B. Description of Flight

F. Certification

Airworthiness Documentation (FAA/DESIGNEE use only)

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PAYMENT AUTHORIZATION

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