Fillable Faa Form 8130-3 - Authorized Release Certificate printable pdf download

Faa Form 8130-3 - Authorized Release Certificate

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1. Approving Civil Aviation

3. Form Tracking Number:

Authority/Country:

AUTHORIZED RELEASE CERTIFICATE

FAA/United States

FAA Form 8130–3, AIRWORTHINESS APPROVAL TAG

4. Organization Name and Address:

5. Work Order/Contract/Invoice

Number:

6. Item:

7. Description:

8. Part Number:

9. Quantity:

10. Serial Number:

11. Status/Work:

12. Remarks:

13a. Certifies the items identified above were manufactured in conformity to:

14a.

14 CFR 43.9 Return to Service

Other regulation specified in Block 12

Certifies that unless otherwise specified in Block 12, the work identified in Block 11

Approved design data and are in a condition for safe operation.

and described in Block 12 was accomplished in accordance with Title 14, Code of

Federal Regulations, part 43 and in respect to that work, the items are approved for

Non-approved design data specified in Block 12.

return to service.

13b. Authorized Signature:

13c. Approval/Authorization No.:

14b. Authorized Signature:

14c. Approval/Certificate No.:

13d. Name (Typed or Printed):

13e. Date (dd/mmm/yyyy):

14d. Name (Typed or Printed):

14e. Date (dd/mmm/yyyy):

User/Installer Responsibilities

It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article.

Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified in

Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the country

specified in Block 1.

Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in accordance with the

national regulations by the user/installer before the aircraft may be flown.

FAA Form 8130–3 (02–14)

NSN: 0052-00-012-9005