NSP Form T004 Request for FSTD Qualification Under Bilateral Agreement

Request for FSTD Qualification Under Bilateral Agreement

Sample/Template

(Date)

National Simulator Program Manager

FAA National Simulator Program, AFS-205

P.O. Box 20636

Atlanta, GA 30320

RE: Qualification of an FSTD Under the Terms and Agreements of a Bilateral Agreement

This is to advise you of our intent to request Federal Aviation Administration qualification of the (Aircraft Type/Level) Flight Simulation Training Device (FSTD) located in (City, Country) at the (Facility). We request the FSTD receive qualification under the terms of the Simulator Implementation Procedure (SIP) between the United States and (National Aviation Authority). The FSTD will be sponsored by (Name of Training Center/Air Carrier), FAA Designator (Four Letter Code).

In accordance with FSTD Guidance Bulletin 04-02, we have enclosed a copy of the Preliminary Statement of Qualification Configuration List (Form T001A) and the latest (NAA) FSTD Evaluation Report. We understand both the (TPAA) and the National Simulator Program (NSP) will review this request. In addition, the NSP will provide notification of the results of the review within ten working days of the receipt of this request. We also understand that the qualification of FSTD’s, under the provisions of a SIP, may be subject to the collection of fees in accordance with Title 14, Code of Federal Regulations (14CFR) Part 187.

Sincerely,

(Sponsor Management Representative)

cc:

(Sponsor TPAA)

Enclosures:

Preliminary Statement of Qualification Configuration List

(NAA) FSTD Evaluation Report

NSP Form T004: 11/30/2022

OMB Control Number 2120-0680: Expiration Date 11/30/2025

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