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MAJOR REPAIR AMD
ALTERATION
(Airframo, Poworplartt, Propaiter,
or Appliance)
Form Approved
OMB
No
2120-0020
For
FAA
U»» Only
Office
Identification
IHSTRUCÿNS:
for
eachsuch
violation (Section 901
Federal
Avlatton Act of
1958ÿ
-
---
-
-
-
-
-
--
■'
Model
1 1.Aircraft
2.
Owner
Make
CESSNA
Serial No.
17281021
__
_
Name
(As
shown on registration
certifies
to)
FLIGHT
MANAGEMENT, LLC
172R
_
Nationality
and
Registration Mark
USA N24730
3.
For
FAA
U— Only
Address
(As
shown
on
registration
certificate)
891
BRIDGETON
LANE
PERRYSBURG
OH 43551
I
APPLIANCE
Unit
Mako
T
4.
Unit Identification
Model
Scrtal No.
»•
Typ°
—
Repair
Alteration
1
I
AIRFRAME
_____
_
(A, /inscribed In Item 1
above)
-
(
V.
----
-
—
XX
I
POWERPLANT
I
PROPELLER
—
Typo
A. Agency's
Name
and
Address,
XX
U S CartWoted Mechanic!
_
Foretan
CwtWoatod
l*och«ajc_
Ccrtfflcated
Repair
Stattorÿ
XXER854K
RADIO CLASS 1,11,111
iTniNSTR.Sÿ
EXPRESS
AVIONICS,
INC
11431
W.
AIRPORT SERVICE
RD.
rT»—
SWANTON,
OHIO 43558
-
-
--
1
-
-
„,vi
doscrttxd
onttw
rover*
or
atuclrmate
ho«to
D.
.
certify
m.'
U S.
Federal
Avledoo
RosjdaUone
end
me,
,he
—
"
*>»«
ft"
\s££EZ22£2*
i—
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ajagamssash—
|Date
DECEMBER
19,
2001
THOMAS
A.
CORWIN
7.
Approval for
Return
To
Seivtcc
__
&
rsuar
Tjlnla
it tD
tne
aumoiuy
g
jntor
of
the
Fedora
FAA
Fit.
Standards
Inspector
1
Avl,
jttan
Administration
Manufacturer
and
%
8 APPROVED
U
KCJ
Inspection
Authorization
FAA
Designee
-
XX
Repair Station
person Approved
by
Transport
Canada Alrworthlnoss
Group
Signature
of Authorized Individ
Other
(Spoctry)
DECEMBER
19,
2001.
FAA Form
XVT
/19JVH
Designation
No.
XXER854K
THOMAS A.
CORWIN.
MODEL 172R
SECTION
6
WEIGHT & BALANCE
/ EQUIPMENT
LIST
Summary of Contents for 172R
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