Appendix C: Sample FAA Form 337
82011-IM, REV J
Sandel SG102 & MT102 Installation Manual
Page 11-1
11
Appendix C: Sample FAA Form 337
NOTICE
Weight and balance or operating limitation changes shall be entered in the appropriate aircraft
record. An alteration must be compatible with all previous alterations to assure continued conformity
with the applicable airworthiness requirements.
8. Description of Work Accomplished
(If more space is required, attach additional sheets. Identify with aircraft nationality and
registration mark and date work completed.)
A. Installed the following equipment and components:
1.
Sandel Avionics, Inc., SG102 AHRS
(or as appropriate)
.
B. The Sandel Avionics SG102 is interfaced to the following equipment:
1. SN4500 Primary Navigation Display
(By example state the following functional interface properties)...
C. Interference and functional tests and inspections were accomplished with reference to
Advisory Circular 23.1311.
(or as appropriate)
.
D. A system design and analysis was conducted with reference to Advisory Circular 23.1309-
1(C).
(Or as appropriate)
.
E. Federal Aviation Regulations, 23.1301, 23.1309(a)(b) and (d), 23.1351,
23.1357(a)(b)(c)(d), 23.1365, 23.1529, and 23.1581
(or as appropriate)
, were the basis of
compliance.
F. The aircraft equipment list, and weight and balance were revised and recorded within the
aircraft maintenance records.
G.
All pertinent records of this alteration are on file at
(State your repair station name and
number)
.
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