Form Approval OMB No. 2120-0018 12/31/2010 Export Certificate No. Application for Export Certificate of Airworthiness U.S. Department of Transportation Federal Aviation Administration INSTRUCTIONS – This application is to be submitted to an authorized FAA representative (one copy) when the product(s) to be exported is (are) presented for inspection. Use Part I for Class I products and Part II for Class II. 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 (Aircraft) NEWLY OVERHAULED 3. Name and address of foreign purchaser 5. Description of product(s) Type Make and Model (a) (b) Identification No. Serial Nos. (c) FAA T.C. or Spec. No. (d) 4. Country of destination 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 (4-08) Supersedes Previous Edition NSN: 0052-00-024-9005 American LegalNet, Inc. www.FormsWorkflow.com Part II – Application for Approval of Aeronautical Parts (Complete items 12-20) 12. Name and address of exporter 15. Parts are eligible for installation on _______________ 13. Name and address of foreign purchaser Make and model Class I product 16. The parts are (Check One) NEW FAA Spec. No. or T.C. NEWLY OVERHAULED 17. The parts are described (Check One) Below by name, part number and quantity 14. Country of destination 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 parts 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 parts 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) 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 parts described in Part II. Part I Part II Date FAA Inspector Quantity 23. EXPORT FILE SPOT-CHECKED BY: FAA Supervising Inspector FAA Form 8130-1 (4-08) Supersedes Previous Edition D.O. No. *U.S. Government Printing Office: 1996 – 405-552/45303 Date NSN: 0052-00-024-9005 American LegalNet, Inc. www.FormsWorkflow.com