Faa Form 8130-6, Application For Us - U.s. Department Of Transportation Page 2

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FOR TRAINING PURPOSES ONLY
A. MANUFACTURER
NAME
ADDRESS
B. PRODUCTION BASIS (Check applicable item)
PRODUCTION CERTIFICATE (Give production certificate number)
TYPE CERTIFICATE
OTHER:
C. GIVE QUANTITY OF CERTIFICATES REQUIRED FOR OPERATING NEEDS
DATE OF APPLICATION
NAME AND TITLE (Print or type)
SIGNATURE
A. DESCRIPTION OF AIRCRAFT
REGISTERED OWNER
ADDRESS
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)
D. THE AIRCRAFT DOES NOT MEET THE APPLICABLE AIRWORTHINESS REQUIREMENTS AS FOLLOWS:
E. THE FOLLOWING RESTRICTIONS ARE CONSIDERED NECESSARY FOR SAFE OPERATION: (Use attachment if necessary)
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 (Print or type)
SIGNATURE
A. Operating Limitations and Markings in Compliance With 14 CFR Section 91.9,
G. Statement of Conformity, FAA Form 8130-9 (Attach when required)
As Applicable
H. Foreign Airworthiness Certification for Import Aircraft
(Attach when required)
B. Current Operating Limitations Attached
I. Previous Airworthiness Certificate Issued in Accordance With
C. Data, Drawings, Photographs, etc. (Attach when required)
14 CFR Section
CAR
(Original attached)
D. Current Weight and Balance Information Available in Aircraft
J. Current Airworthiness Certificate Issued in Accordance With
E. Major Repair and Alteration, FAA Form 337 (Attach when required)
14 CFR Section
(Copy attached)
K. Light-Sport Aircraft Statement of Compliance, FAA Form 8130-15 (Attach when required)
F. This inspection Recorded in Aircraft Records
FAA Form 8130-6 (04-2011) All Previous Editions Superseded
Electronic Format - PDF
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