03 Mar 2017
Airworthiness Determination Form (ADF)
1. Project Information.
This form is intended to be filled out electronically and converted to .pdf format. The Word
document should be pre coordinated by the signatories before the conversion. Signatures
can be added to the .pdf document electronically.
1.1 Date:
Date of Recommendation
1.2 Prepared By:
1.3 Platform:
1.4 Project Title:
1.5 Requirement:
Cite document driving the change (e.g.,
UON, ORD, CDD/CPD, AF1067, ECP,
LOA, OFP/SW change list, or notification
from ARCA of airworthiness impact due
to Aerial Refueling coupling air system)
1.6 Modification Description (Applicant should use as much space as needed):
Distribution Statement A – Approved for public release; distribution unlimited