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PROPELLER O CI APPLIANCE Type Manutacturer 6 Conformity Statement A. Agency's Name and Address B. Kind of Agency Writ StOVP lahlrintiri ,/ U. S Cenecated methane I Manulacturer menu 33 Barrett road Focnin Certacared Mechanic C. Certificate No. ca. Fnfietd Soy CT Ceitirkated Repair Suw

each such violation. (49 U.S.C. 946301(a)) 1. Aircraft Nationality and Registration Mark N750A Serial No 760750 Make Sikorsky Model S-76C Serra 2. Owner Name (As shown on regrsvatbn certificate) Air Ghislaine Inc. Address (As shown on rogntration maker.) mans 103 Fain Rd Cry Wilmington