Work Order For Aircraft Services

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Fliegen Works Inc.
phone:(503) 221-4001
th
921 SE 47
Ave.
fax:(503) 262 7476
Portland, OR 97215
Work Order for Aircraft Services
*Required data
This form is to be completed before any work can begin on the aircraft. Please be as detailed as possible.
Print or Type. Be sure to include billing information and approval signature for prompt service.
1) *Applicant
Name:
4)
*Phone:
2)
*Address:
5)
Fax:
3)
*Contact:
:
6) Email
Aircraft Information
7)
*Manufacturer:
10) *Reg.
No.:
8)
*Model:
11)
*Owner:
9) *Serial
No.:
12) *Location of Work
(physical location of aircraft to be
inspected):
13) *Description of
Work: (be as detailed as possible describing modification/repair needed (i.e., framestation, location of
holes, type of antenna, scope of work requested))
14) *Associated Data
(list all data you will be sending for this project (i.e., photos, SRM pages, drawings, STCs,
etc.)):
Schedule
18) FAA ACO / MIDO / FSDO Inspector
Contact
(if applicable):
16) Inspection
Date:
:
17) *Completion Date
15) Today’s Date:
19) *Services
Requested:
20) Project
Type:
INTERNAL PROJECT SPECS
(check all that apply)
(check all that apply)
DER Approval:
FAA FORM 337
(Applicant
TCDS: _________________
supplied Data)
Drawing Data Creation:
COORD. FIELD APPROV
.
Cert. Basis: _________________
Report Data Creation:
ONE TIME STC
Job No.: _________________
Onsite Evaluation:
MULTIPLE STC
Est. Proj. Hrs: _________________
Project Management:
AMMEND STC#:
PCE: _________________
Billing Information
Due Date: _________________
21) * PO#: (or Verbal by)
22)
*Approval: (Signature of person approving
Contract Work Req’d: ____________
project)
Report
Number:
FW-_______ - ______
______________________________________
_____________________
Form FWxxx WOFAS VERSION 1.1 09/039

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