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pdfFAA FORM 8130-6, APPLICATION FOR U.S. AIRWORTHINESS CERTIFICATE
Form Approved OMB No. 2120-0018
Expires: October 31, 2026
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this information collection is 2120-0018. Public reporting for this collection of information is estimated
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Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 761771524.
TEAR OFF THIS COVER SHEET BEFORE SUBMITTING THIS FORM
FAA Form 8130-6 (06/20) SUPERSEDES PREVIOUS EDITION
Form Approved OMB No. 2120-0018
Expires: October 31, 2026
FAA FORM 8130-6, APPLICATION FOR U.S. AIRWORTHINESS CERTIFICATE
APPLICATION FOR
U.S. AIRWORTHINESS
CERTIFICATE
U.S. Department
of Transportation
I. AIRCRAFT
DESCRIPTION
Federal Aviation
Administration
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.
1. REGISTRATION MARK
2. AIRCRAFT BUILDER’S NAME (Make)
3. AIRCRAFT MODEL DESIGNATION
4. YR. MFR.
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
FAA CODING
11. AIRCRAFT IS (Check if applicable)
IMPORT
APPLICATION IS HEREBY MADE FOR: (Check applicable items)
A
1
STANDARD AIRWORTHINESS CERTIFICATE (Indicate category)
B
NORMAL
UTILITY
7
PRIMARY
9
LIGHT-SPORT
2
LIMITED
5
PROVISIONAL (Indicate class)
II. CERTIFICATION REQUESTED
Airplane
(Indicate Class)
RESTRICTED (Indicate operation(s)
3
TRANSPORT
COMMUTER
BALLOON
OTHER
to be conducted)
C
Glider
Lighter than Air
CLASS I
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
SHOW COMPLIANCE WITH THE CFR
7
OPERATING (Primary Category) KIT BUILT AIRCRAFT
8
OPERATING
LIGHT-SPORT
to be conducted)
8
Weight-Shift-Control
2
EXPERIMENTAL (Indicate operation(s)
4
Power-Parachute
1
UNMANNED
AIRCRAFT
9
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
9D
EXHIBITION
9C
CREW TRAINING
9E
SHOW COMPLIANCE WITH THE CFR
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
PRODUCTION FLIGHT TESTING
MULTIPLE AIRWORTHINESS CERTIFICATE (Check ABOVE “Restricted Operation” and “Standard” or “Limited” as applicable)
6
A. REGISTERED OWNER (As shown on certificate of aircraft registration)
IF DEALER, CHECK HERE
NAME
III. OWNER’ S CERTIFICATION
ACROBATIC
SPECIAL AIRWORTHINESS CERTIFICATE (Check appropriate items)
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
Revision No.)
number 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
3
issued 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.)
AIRCRAFT MANUFACTURER (Give name or firm)
DATE as entered in logbook
6b
V. FAA
REPRESENTATIVE
CERTIFICATION
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:
MIDO/FSDO
OFFICE
CERTIFICATED REPAIR STATION (Give Certificate No.)
CERTIFICATED FOREIGN REPAIR STATION (Give Certificate No.)
PRINT NAME and TITLE of INSPECTOR as entered in logbook
(Check ALL applicable block items A and B)
DATE
6a
4
THE CERTIFICATE REQUESTED
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.
FAA Form 8130-6 (10/23) SUPERSEDES PREVIOUS EDITION
14 CFR part 121 OR 135
14 CFR part 145
FAA INSPECTOR’S CERTIFICATION FILE REVIEW SIGNATURE
1
Page 1 of 2
Form Approved OMB No. 2120-0018
FAA FORM 8130-6, APPLICATION FOR U.S. AIRWORTHINESS CERTIFICATE
Expires: October 31, 2026
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
A. DESCRIPTION OF AIRCRAFT
REGISTERED OWNER
ADDRESS
BUILDER (Make)
MODEL
SERIAL NUMBER
REGISTRATION MARK
VII. SPECIAL FLIGHT PERMIT PURPOSES OTHER THAN PRODUCTION FLIGHT TEST
B. DESCRIPTION OF FLIGHT
CUSTOMER DEMONSTRATION FLIGHTS
FROM
TO
VIA
DEPARTURE DATE
(Check if applicable)
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
SIGNATURE
G. Statement of Conformity, FAA Form 8130-9 (Attach when required)
B. Current Operating Limitations Attached
H. Foreign Airworthiness Certification for Import Aircraft
(Attach when required)
C. Data, Drawings, Photographs, etc. (Attach when required)
I. Previous Airworthiness Certificate Issued in Accordance With
D. Current Weight and Balance Information Available in Aircraft
E. Major Repair and Alteration, FAA Form 337 (Attach when required)
F. This inspection Recorded in Aircraft Records
FAA Form 8130-6 (10/23) SUPERSEDES PREVIOUS EDITION
14 CFR Section
CAR
(Original attached)
J. Current Airworthiness Certificate Issued in Accordance With
14 CFR Section
(Copy attached)
K. Light-Sport Aircraft Statement of Compliance, FAA Form 8130-15 (Attach when
required)
Page 2 of 2
File Type | application/pdf |
File Title | Microsoft Word - 8130-6_10102023_NoPAS |
Author | Glines, Tanya (FAA) |
File Modified | 2024-04-30 |
File Created | 2024-04-30 |