Form FAA-8130-6 Application for US Airworthiness Certificate

INFORMATION FOR APPLICANT
U.S. Department
of Transportation

Federal Aviation
Administration

APPLICATION FOR U.S. AIRWORTHINESS CERTIFICATE
Privacy Act Statement
Information on FAA Form 8130-6, Application for U.S. Airworthiness Certificate is solicited
under the authority of 49 U.S.C. 44103 as implemented by 14 CFR Part 21. The purpose
of this information is to evaluate an applicant’s application for a U.S. Airworthiness
Certificate. Submission of this data is mandatory and will become part of the Privacy Act
system of records DOT/FAA 801, Aircraft Registration System. Incomplete submission
may result in delay or denial of your request. Information maintained in the Privacy Act
system of records is routinely used to (1) provide aircraft owners and operators information
about potential mechanical defects or unsafe conditions of their aircraft in the form of
airworthiness directives, (2) locate specific individuals or aircraft for accident investigation,
violation, or safety related requirements, (3) prepare an Aircraft Registry in magnetic tape
and microfiche form as required by ICAO agreement, containing information on aircraft
owners by name, address, United States Registration Number, and type of aircraft, and (4)
DOT Prefatory Statement of General Routine Uses.
Paperwork Reduction Act Statement:
This information is collected for the purpose of issuing a U.S. Airworthiness Certificate to any applicant meeting
the criteria established in FAA Order 8130.2, Airworthiness Certification of Aircraft and Related Products. The
FAA uses the information to maintain and update the current database of aircraft having obtained approved
airworthiness certificates. The burden associated with completing FAA Form 8130-6 is 42 minutes. Providing
this information is mandatory if an applicant wishes to obtain an airworthiness certificate. The information is
protected under the provisions of the Privacy Act and the Privacy Act system of records DOT/FAA-801, Aircraft
Registration System. An agency may not conduct or sponsor and a person is not required to respond to a

collection of information unless it displays a currently valid OMB control number. The OMB control
number associated with this collection of information is 2120-0018. Comments concerning the
accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at:
800 Independence Ave. SW, Washington, DC 20591, Attn:Information Collection Clearance Officer,
AES-300.

TEAR OFF THIS COVER SHEET BEFORE SUBMITTING THIS FORM

FAA Form 8130-6 (04-2011) All Previous Editions Superseded

Electronic Format - PDF

FAA FORM 8130-6, APPLICATION FOR U.S. AIRWORTHINESS CERTIFICATE

I. AIRCRAFT
DESCRIPTION

U.S. Department
of Transportation
Federal Aviation
Administration
1. REGISTRATION MARK

Form Approved O.M.B. No. 2120-0018
Expiration Date 09/30/2017

APPLICATION FOR
U.S. AIRWORTHINESS
CERTIFICATE

INSTRUCTIONS - Print or type. Do not write in shaded areas; these are for FAA
use only. Submit original only to an authorized FAA Representative. If additional
space is required, use attachment. For special flight permits complete Sections
II, VI, and VII as applicable.

2. AIRCRAFT BUILDER’S NAME (Make)

3. AIRCRAFT MODEL DESIGNATION

5. AIRCRAFT SERIAL NO.

6. ENGINE BUILDER’S NAME (Make)

7. ENGINE MODEL DESIGNATION

8. NUMBER OF ENGINES

9. PROPELLER BUILDER’S NAME (Make)

10. PROPELLER MODEL DESIGNATION

4. YR. MFR.

FAA CODING

11. AIRCRAFT IS (Check if applicable)
IMPORT

APPLICATION IS HEREBY MADE FOR: (Check applicable items)
STANDARD AIRWORTHINESS CERTIFICATE (Indicate category)
A 1

II. CERTIFICATION REQUESTED

7

PRIMARY

9

LIGHT-SPORT (Indicate Class)

2

LIMITED

5

PROVISIONAL (Indicate class)

to be conducted)

UTILITY

to be conducted)

8

Power-Parachute

TRANSPORT

COMMUTER

BALLOON

OTHER

Weight-Shift-Control

Glider

Lighter than Air

CLASS I

2

CLASS II

1

AGRICULTURE AND PEST CONTROL

2

AERIAL SURVEY

3

AERIAL ADVERTISING

4

FOREST (Wildlife conservation)

5

PATROLLING

6

WEATHER CONTROL

0

OTHER (Specify)

1

RESEARCH AND DEVELOPMENT

2

AMATEUR BUILT

3

EXHIBITION

4

AIR RACING

5

CREW TRAINING

6

MARKET SURVEY

0

TO SHOW COMPLIANCE WITH THE CFR

7

OPERATING (Primary Category) KIT BUILT AIRCRAFT

8

OPERATING
LIGHT-SPORT

9

UNMANNED
AIRCRAFT

8A

Existing aircraft without an airworthiness certificate & do not meet § 103.1

8B

Operating Light-Sport Kit-built

8C

Operating light-sport previously issued special light-sport category airworthiness
certificate under § 21.190

9A

RESEARCH AND DEVELOPMENT

9B

MARKET SURVEY

9C

1

FERRY FLIGHT FOR REPAIRS, ALTERATIONS, MAINTENANCE, OR STORAGE

SPECIAL FLIGHT PERMIT (Indicate

2

EVACUATE FROM AREA OF IMPENDING DANGER

operation to be conducted, then complete
Section VI or VII as applicable on reverse side)

3

OPERATION IN EXCESS OF MAXIMUM CERTIFICATED TAKE-OFF WEIGHT

4

DELIVERING OR EXPORTING

6

CUSTOMER DEMONSTRATION FLIGHTS

5

CREW TRAINING

PRODUCTION FLIGHT TESTING

MULTIPLE AIRWORTHINESS CERTIFICATE (Check ABOVE “Restricted Operation” and “Standard” or “Limited” as applicable)

A. REGISTERED OWNER (As shown on certificate of aircraft registration)

IF DEALER, CHECK HERE

NAME

III. OWNER’S CERTIFICATION

ACROBATIC

1

EXPERIMENTAL (Indicate operation(s)

4

6

Airplane

RESTRICTED (Indicate operation(s)

3

C

NORMAL

SPECIAL AIRWORTHINESS CERTIFICATE (Check appropriate items)

B

ADDRESS

B. AIRCRAFT CERTIFICATION BASIS (Check applicable blocks and complete items as indicated)
AIRCRAFT SPECIFICATION OR TYPE CERTIFICATE DATA SHEET (Give No. and

AIRWORTHINESS DIRECTIVES (Check if all applicable ADs are complied with and give the number

Revision No.)

of the last AD SUPPLEMENT available in the biweekly series as of the date of application)

AIRCRAFT LISTING (Give page number(s))

SUPPLEMENTAL TYPE CERTIFICATE (List number of each STC incorporated)

C. AIRCRAFT OPERATION AND MAINTENANCE RECORDS
CHECK IF RECORDS IN
COMPLIANCE WITH
14 CFR section 91.417

TOTAL AIRFRAME HOURS

EXPERIMENTAL ONLY (Enter hours flown since last certificate issued
3

or renewed)

D. CERTIFICATION - I hereby certify that I am the registered owner (or his agent) of the aircraft described above, that the aircraft is registered with the Federal Aviation Administration in
accordance with Title 49 of the United States Code 44101 et seq. and applicable Federal Aviation Regulations, and that the aircraft has been inspected and is airworthy and eligible for the
airworthiness certificate requested.
DATE OF APPLICATION

NAME AND TITLE (Print or type)

SIGNATURE

IV. INSPECTION
AGENCY
VERIFICATION

A. THE AIRCRAFT DESCRIBED ABOVE HAS BEEN INSPECTED AND FOUND AIRWORTHY BY: (Complete the section only if 14 CFR part 21.183(d) applies)
2
5

14 CFR part 121 CERTIFICATE HOLDER (Give
Certificate No.)

3

CERTIFICATED MECHANIC (Give Certificate No.)

TITLE

No.)

SIGNATURE
THE CERTIFICATE REQUESTED

(Check ALL applicable block items A and B)

V. FAA
REPRESENTATIVE
CERTIFICATION

CERTIFICATED REPAIR STATION (Give Certificate

AIRCRAFT MANUFACTURER (Give name or firm)

DATE

A. I find that the aircraft described in Section I or VII meets requirements for
B. Inspection for a special flight permit under
Section VII
was conducted by:
DATE

6

4

AMENDMENT OR MODIFICATION OF CURRENT AIRWORTHINESS CERTIFICATE

FAA INSPECTOR

FAA DESIGNEE

CERTIFICATE HOLDER UNDER

14 CFR part 65

FAA INSPECTOR’S SIGNATURE or DESIGNEE’S
SIGNATURE AND NO.

MIDO/FSDO
OFFICE
4

FAA Form 8130-6 (04-2011) All Previous Editions Superseded

14 CFR part 121 OR 135

14 CFR part 145

FAA INSPECTOR’S CERTIFICATION FILE REVIEW
SIGNATURE
1

Electronic Format -PDF

Page 1 of 2

A. MANUFACTURER

VI. PRODUCTION
FLIGHT TESTING

NAME

ADDRESS

B. PRODUCTION BASIS (Check applicable item)
PRODUCTION CERTIFICATE (Give production certificate number)
TYPE CERTIFICATE
OTHER:
C. GIVE QUANTITY OF CERTIFICATES REQUIRED FOR OPERATING NEEDS
DATE OF APPLICATION

NAME AND TITLE (Print or type)

SIGNATURE

VII. SPECIAL FLIGHT PERMIT PURPOSES OTHER THAN PRODUCTION FLIGHT TEST

A. DESCRIPTION OF AIRCRAFT
REGISTERED OWNER

ADDRESS

BUILDER (Make)

MODEL

SERIAL NUMBER

REGISTRATION MARK

B. DESCRIPTION OF FLIGHT
FROM

CUSTOMER DEMONSTRATION FLIGHTS
TO

VIA



(Check if applicable)

DEPARTURE DATE

DURATION

C. CREW REQUIRED TO OPERATE THE AIRCRAFT AND ITS EQUIPMENT
PILOT

CO-PILOT

FLIGHT ENGINEER

OTHER (Specify)

D. THE AIRCRAFT DOES NOT MEET THE APPLICABLE AIRWORTHINESS REQUIREMENTS AS FOLLOWS:

E. THE FOLLOWING RESTRICTIONS ARE CONSIDERED NECESSARY FOR SAFE OPERATION: (Use attachment if necessary)

F. CERTIFICATION - I hereby certify that I am the registered owner (or his agent) of the aircraft described above; that the aircraft is registered with the Federal Aviation Administration in
accordance with Title 49 of the United States Code 44101 et seq. and applicable Federal Aviation Regulations; and that the aircraft has been inspected and is safe for the flight described.

VIII. AIRWORTHINESS
DOCUMENTATION (FAA/DESIGNEE
use only)

DATE

NAME AND TITLE (Print or type)

A. Operating Limitations and Markings in Compliance With 14 CFR Section 91.9,
As Applicable
B. Current Operating Limitations Attached
C. Data, Drawings, Photographs, etc. (Attach when required)

SIGNATURE

G. Statement of Conformity, FAA Form 8130-9 (Attach when required)
H. Foreign Airworthiness Certification for Import Aircraft
(Attach when required)
I. Previous Airworthiness Certificate Issued in Accordance With
14 CFR Section

CAR

(Original attached)

D. Current Weight and Balance Information Available in Aircraft
E. Major Repair and Alteration, FAA Form 337 (Attach when required)

J. Current Airworthiness Certificate Issued in Accordance With
14 CFR Section

F. This inspection Recorded in Aircraft Records

FAA Form 8130-6 (04-2011) All Previous Editions Superseded

(Copy attached)

K. Light-Sport Aircraft Statement of Compliance, FAA Form 8130-15 (Attach when required)

Electronic Format - PDF

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