1. Approving Civil Aviation 2. 3. Form Tracking Number: 1. Approving Civil Aviation 2. 3. Form Tracking Number: 1.

3. Form Tracking Number: 1. Approving Civil Aviation 2. 3. Form Tracking Number: 1. Approving Civil Aviation 2. 3. Form Tracking Number:
Authority/Country: Authority/Country: Authority/Country:
AUTHORIZED RELEASE CERTIFICATE 6221168 AUTHORIZED RELEASE CERTIFICATE 6221168 AUTHORIZED RELEASE CERTIFICATE 6221168
FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG
4. Oranization Name and Address: 5. Work Order/Contract/Invoice 4. Oranization Name and Address: 5. Work Order/Contract/Invoice 4. Oranization Name and Address: 5. Work Order/Contract/Invoice
Number: Number: Number:
Textron Aviation Inc. (PC4) Textron Aviation Inc. (PC4) Textron Aviation Inc. (PC4)
Textron Aviation Inc. 3148216 Textron Aviation Inc. 3148216 Textron Aviation Inc. 3148216
1 Cessna Blvd, Wichita, KS 67215 1 Cessna Blvd, Wichita, KS 67215 1 Cessna Blvd, Wichita, KS 67215
6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work: 6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work: 6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work:

10 10 20
FASTENER 0450277-209 1 N/A New FASTENER 0450277-209 1 N/A New SWITCH V7-1C17E9-201 1 N/A New
12. Remarks: 12. Remarks: 12. Remarks:

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AUTHORIZED
UTHORIZED RELEASE DOCUMENT AUTHORIZED
UTHORIZED RELEASE DOCUMENT AUTHORIZED
UTHORIZED RELEASE DOCUMENT

PO#: 21495
214956 PO#: 21495
214956 PO#: 21495
214956
13a. Certifies
es the items identifed above were manufactured in conformity to: 14a.
14 14 CFR 43.9 Return to Serv
Service Other regulation sp
specified in Block 12 13a. Certifies
es the items identifed above were manufactured in conformity to: 14a.
14 14 CFR 43.9 Return to Serv
Service Other regulation sp
specified in Block 12 13a. Certifies
es the items identifed above were manufactured in conformity to: 14a.
14 14 CFR 43.9 Return to Serv
Service Other regulation sp
specified in Block 12
Approved
proved design data and are in a condition for sa
safe operation. Certifies that unless otherwise specified in Block 12, the work identified in Block Approved
proved design data and are in a condition for safe
sa operation. Certifies that unless otherwise specified in Block 12, the work identified in Block Approved
proved design data and are in a condition for safe
sa operation. Certifies that unless otherwise specified in Block 12, the work identified in Block
11 accordance with Title 14,
1 and described in Block 12 was accomplished in acco 111 and described in Block 12 was accomplished in accordance
acco with Title 14, 11 accordance with Title 14,
1 and described in Block 12 was accomplished in acco
Non-approved
n-approved
approved design data specified in Block 12. that work, the items are
Code of Federal Regulations, part 43 and in respect to th Non-approved
n-approved
approved design data specified in Block 12. Code of Federal Regulations, part 43 and in respect to that
th work, the items are Non-approved
n-approved
approved design data specified in Block 12. Code of Federal Regulations, part 43 and in respect to that
th work, the items are
approved
pprov for return to service. approved
pprov for return to service. approved
pprov for return to service.
ized Signature:
13b. Authorized 13c. Approval/Authorization No
No.: 14b. Authorized Signature 4c. Ap
14c. Approval/Certificate No.: ized Signature:
13b. Authorized 13c. Approval/Authorization No
No.: 14b. Authorized Signature 4c. Ap
14c. Approval/Certificate No.: ized Signature:
13b. Authorized 13c. Approval/Authorization No
No.: 14b. Authorized Signature 4c. Ap
14c. Approval/Certificate No.:

PC4 PC4 PC4

13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy): 13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy): 13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy):

JENNIFER FISHER 18/Jun/2018 JENNIFER FISHER 18/Jun/2018 JENNIFER FISHER 18/Jun/2018

User/Installer Responsibilities User/Installer Responsibilities User/Installer Responsibilities
It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article. It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article. It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article.

Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified
in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the
country specified in Block 1. country specified in Block 1. country specified in Block 1.

Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in
accordance with the national regulations by the user/installer before the aircraft may be flown. accordance with the national regulations by the user/installer before the aircraft may be flown. accordance with the national regulations by the user/installer before the aircraft may be flown.
FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005 FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005 FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005

1. Approving Civil Aviation 2. 3. Form Tracking Number: 1. Approving Civil Aviation 2. 3. Form Tracking Number: 1. Approving Civil Aviation 2. 3. Form Tracking Number:
Authority/Country: Authority/Country: Authority/Country:
AUTHORIZED RELEASE CERTIFICATE 6221168 AUTHORIZED RELEASE CERTIFICATE 6221168 AUTHORIZED RELEASE CERTIFICATE 6221168
FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG
4. Oranization Name and Address: 5. Work Order/Contract/Invoice 4. Oranization Name and Address: 5. Work Order/Contract/Invoice 4. Oranization Name and Address: 5. Work Order/Contract/Invoice
Number: Number: Number:
Textron Aviation Inc. (PC4) Textron Aviation Inc. (PC4) Textron Aviation Inc. (PC4)
Textron Aviation Inc. 3148216 Textron Aviation Inc. 3148216 Textron Aviation Inc. 3148216
1 Cessna Blvd, Wichita, KS 67215 1 Cessna Blvd, Wichita, KS 67215 1 Cessna Blvd, Wichita, KS 67215
6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work: 6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work: 6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work:

CO
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20 30 50
SWITCH V7-1C17E9-201
V7-1C17E9-20 1 N/A New
N
Ne RHEOSTAT 0413126-2 1 N/A New
N
Ne EMBLEM 0505052-15 1 N/A New
N
Ne
12. Remarks:
s: 12. Remarks:
s: 12. Remarks:
s:

AUTHORIZED RELEASE DOCUMENT AUTHORIZED RELEASE DOCUMENT AUTHORIZED RELEASE DOCUMENT

PO#: 21495
214956 PO#: 21495
214956 PO#: 21495
214956
13a. Certifies
es the
he items identifed above were manufactured in conf
conformity to: 14a. 14 C
CFR 43.9 Return to Service ulation specified in Block 12
Other regulation 13a. Certifies
es the
he items identifed above were manufactured in conf
conformity to: 14a. 14 C
CFR 43.9 Return to Service ulation specified in Block 12
Other regulation 13a. Certifies
es the
he items identifed above were manufactured in conf
conformity to: 14a. 14 C
CFR 43.9 Return to Service ulation specified in Block 12
Other regulation
Approved
proved design data and are in a condition for safe operation. Certifies that unless otherwise specified in Block 12, the work identified in Block Approved
proved design data and are in a condition for safe operation. Certifies that unless otherwise specified in Block 12, the work identified in Block Approved
proved design data and are in a condition for safe operation. Certifies that unless otherwise specified in Block 12, the work identified in Block
11
1 and described in Block 12 was accomplished in accordance
acco with Title 14, 111 and described in Block 12 was accomplished in accordance
acco with Title 14, 11 accordance with Title 14,
1 and described in Block 12 was accomplished in acco
Non-approved design data specified in Block 12. Code of Federal Regulations, part 43 and in respect to that work, the items are Non-approved design data specified in Block 12. Code of Federal Regulations, part 43 and in respect to that work, the items are Non-approved design data specified in Block 12. Code of Federal Regulations, part 43 and in respect to that work, the items are
approved for return to service. approved for return to service. approved for return to service.
13b. Authorized Signature: 13c. Approval/Authorization No.: 14b. Authorized Signature 14c. Approval/Certificate No.: 13b. Authorized Signature: 13c. Approval/Authorization No.: 14b. Authorized Signature 14c. Approval/Certificate No.: 13b. Authorized Signature: 13c. Approval/Authorization No.: 14b. Authorized Signature 14c. Approval/Certificate No.:

PC4 PC4 PC4

13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy): 13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy): 13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy):

JENNIFER FISHER 18/Jun/2018 JENNIFER FISHER 18/Jun/2018 JENNIFER FISHER 18/Jun/2018

User/Installer Responsibilities User/Installer Responsibilities User/Installer Responsibilities
It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article. It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article. It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article.

Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified
in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the
country specified in Block 1. country specified in Block 1. country specified in Block 1.

Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in
accordance with the national regulations by the user/installer before the aircraft may be flown. accordance with the national regulations by the user/installer before the aircraft may be flown. accordance with the national regulations by the user/installer before the aircraft may be flown.
FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005 FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005 FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005

Page 1 of 2
1. Approving Civil Aviation 2. 3. Form Tracking Number: 1. Approving Civil Aviation 2. 3. Form Tracking Number:
Authority/Country: Authority/Country:
AUTHORIZED RELEASE CERTIFICATE 6221168 AUTHORIZED RELEASE CERTIFICATE 6221168
FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG FAA/United States FAA Form 8130-3, AIRWORTHINESS APPROVAL TAG
4. Oranization Name and Address: 5. Work Order/Contract/Invoice 4. Oranization Name and Address: 5. Work Order/Contract/Invoice
Number: Number:
Textron Aviation Inc. (PC4) Textron Aviation Inc. (PC4)
Textron Aviation Inc. 3148216 Textron Aviation Inc. 3148216
1 Cessna Blvd, Wichita, KS 67215 1 Cessna Blvd, Wichita, KS 67215
6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work: 6.Item: 7. Description: 8. Part Number: 9. Quantity: 10. Serial Number: 11. Status/Work:

60 60
VALVE CHEK S2361-1 1 N/A New VALVE CHEK S2361-1 1 N/A New
12. Remarks: 12. Remarks:

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AUTHORIZED
UTHORIZED RELEASE DOCUMENT AUTHORIZED
UTHORIZED RELEASE DOCUMENT

PO#: 21495
214956 PO#: 21495
214956
13a. Certifies
es the items identifed above were manufactured in conformity to: 14a.
14 14 CFR 43.9 Return to Serv
Service Other regulation sp
specified in Block 12 13a. Certifies
es the items identifed above were manufactured in conformity to: 14a.
14 14 CFR 43.9 Return to Serv
Service Other regulation sp
specified in Block 12
Approved
proved design data and are in a condition for sa
safe operation. Certifies that unless otherwise specified in Block 12, the work identified in Block Approved
proved design data and are in a condition for safe
sa operation. Certifies that unless otherwise specified in Block 12, the work identified in Block
11 accordance with Title 14,
1 and described in Block 12 was accomplished in acco 111 and described in Block 12 was accomplished in accordance
acco with Title 14,
Non-approved
n-approved
approved design data specified in Block 12. that work, the items are
Code of Federal Regulations, part 43 and in respect to th Non-approved
n-approved
approved design data specified in Block 12. Code of Federal Regulations, part 43 and in respect to that
th work, the items are
approved
pprov for return to service. approved
pprov for return to service.
ized Signature:
13b. Authorized 13c. Approval/Authorization No
No.: 14b. Authorized Signature 4c. Ap
14c. Approval/Certificate No.: ized Signature:
13b. Authorized 13c. Approval/Authorization No
No.: 14b. Authorized Signature 4c. Ap
14c. Approval/Certificate No.:

PC4 PC4
13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy): 13d. Name (Typed or Printed): 13e. Date (dd/mmm/yyyy): 14d. Name (Typed or Printed): 14e. Date (dd/mmm/yyyy):

JENNIFER FISHER 18/Jun/2018 JENNIFER FISHER 18/Jun/2018

User/Installer Responsibilities User/Installer Responsibilities
It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article. It is important to understand that the existence of this document alone does not automatically constitute authority to install the aircraft engine/propeller/article.

Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified Where the user/installer performs work in accordance with the national regulations of an airworthiness authority different than the airworthiness authority of the country specified
in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the in Block 1, it is essential that the user/installer ensures that his/her airworthiness authority accepts aircraft engine(s)/propeller(s)/article(s) from the airworthiness authority of the
country specified in Block 1. country specified in Block 1.

Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in Statements in Blocks 13a and 14a do not constitute installation certification. In all cases, aircraft maintenance records must contain an installation certification issued in
accordance with the national regulations by the user/installer before the aircraft may be flown. accordance with the national regulations by the user/installer before the aircraft may be flown.
FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005 FAA Form 8130-3 (02-14) NSN: 0052-00-012-9005

COPY COPY COPY

Page 2 of 2