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..... Me kleatifisetian 2e (,- ics4 O INSTRUCTIONS: Mot of type an entries. See FAR 41% FAA 43 Appendix U. and AC 43.91 (or subsequent revision !Steen for insqintions and disposition of this form. This report Is required by Una (49 US C. 1421K Failure t report Can result Is a civil mobil, not to e
tthe Fail Avid= Admlainice and IF OD APPROVED 0 REJECTED BY FAA De an* Menu:Setae* X **Mon Awhothation Other (speedy) FAA Nips Rep& Station I Paton Approved by Troop* CUBIC" MIWOOkillall. Cecesp Date of Apperef or RMection • - 9 —a9-- IY comma., Brit= of Deeps* we . 526705494 IA' • M
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