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No. 2120-0018 (9-07)
Exp. 9/30/2017
Application for Export
Certificate of Airworthiness
Export Certificate No.
U.S. Department of Transportation
Federal Aviation Administration
INSTRUCTIONS – This application is to be submitted to an authorized FAA representative (one copy) when the aircraft to be
exported is (are) presented for inspection. This application may be used, but is not required, for aircraft engines, propellers,
and articles. Use Part I for products and Part II for articles. For complete aircraft, execute items 1 through 11, as applicable.
For engines and propellers, omit item 5A. Part III is for FAA use only.
Part I – Application for Export Certificate of Airworthiness (Complete items 1-11)
1. Application is made for an export certificate of airworthiness to cover the product(s) described below which (are):
NEW
2. Name and address of exporter
USED
3. Name and address of foreign purchaser
5. Description of product(s)
Type
Make and Model
(a)
(b)
Identification
No.
Serial Nos.
(c)
4. Country of destination
FAA T.C.
or Spec. No.
(d)
Operating time (Hours)
(e)
Since
Overhaul
Total
A. AIRCRAFT
B. ENGINES
C. PROPELLERS
6. Does the product comply with all applicable Federal Aviation Regulations, Airworthiness Directives, and other FAA requirements?
YES
NO (Explain in “Remarks”)
7. Have applicable special requirements of the importing country been complied with?
YES
NO (Explain in “Remarks”)
8. Date title passed or is expected to pass to foreign purchaser:
9. For overseas shipment, preservation and packaging methods used to protect product(s) against corrosion and damage (List Spec. No. or
Title):
Effective duration of above methods:
10. Remarks
11. EXPORTER’S CERTIFICATION – The undersigned certifies that the above statements are true and that the product(s) described
herein is (are) airworthy and in a condition for safe operation except as may be noted under item 10 “Remarks” above.
Signature of applicant or authorized representative
Title
Date
FAA Form 8130-1 (04-2011) Supersedes Previous Edition
Electronic Format - PDF
NSN: 0052-00-024-9005
Page 1 of 2
Part II – Application for Approval of Articles (Complete items 12-20)
12. Name and address of exporter
15. Articles are eligible for installation on
13. Name and address of foreign purchaser
Make and model of product
14. Country of destination
FAA Spec. No. or T.C.
_______________
16. The articles are (Check One)
NEW
USED
17. The articles are described (Check One)
Below by name, part number and quantity
Invoicing/packing sheet No.
On the attached invoice or packing
sheet by name, part number and quantity
Name
(a)
Part number
(b)
18. Have applicable special requirements of the importing country been complied with?
Quantity
(c)
YES
NO (Explain in item 10 “Remarks”)
19. Preservation and packaging methods used to protect articles against corrosion and damage (List Spec. No. or Title):
Effective duration of above methods:
20. Exporters Certification – I certify that the foregoing statements are true and that the articles described herein are airworthy, conform to
FAA approved design data, are in a condition for safe operation except as may be noted in item 10 “Remarks”.
Signature of applicant or authorized representative
Title
Date
Part III – Approval (FOR FAA USE ONLY)
21. It is considered that the product(s) and articles described in Part I or Part II is (are) airworthy
and conform(s) to pertinent requirements except as noted in Item 10. (Check One)
Signature
Number
(Check one)
ODA
DMIR
DAR
22. Give quantity of approval tags, FAA Form 8130-3, issued for the articles described in Part
II.
Part I
Part II
Date
FAA Inspector
Quantity
23. EXPORT FILE SPOT-CHECKED BY:
D.O. No.
FAA Supervising Inspector
FAA Form 8130-1 (04/2011) Supersedes Previous Edition
Electronic Format - PDF
Date
NSN: 0052-00-024-9005
Page 2 of 2
File Type | application/pdf |
File Title | FAA Form 8130-1, Application for Export Certificate of Airworthiness |
Subject | Application for Export Certificate of Airworthiness |
Author | AIR-100 |
File Modified | 2016-10-18 |
File Created | 2011-05-05 |