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    Form 337

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    api-287640313
    This document summarizes the Paperwork Reduction Act Statement requirements for information collections by federal agencies. It states that federal agencies may not conduct or sponsor collections of information from the public unless the collection displays a valid OMB control number. It provides the OMB control number for this specific information collection. It estimates that the average time to complete and review the information collection is 30 minutes per response. It instructs respondents to direct any comments on the accuracy of the burden estimate or how to reduce the burden to the FAA.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Form 337

    Uploaded by

    api-287640313
    451 views3 pages
    This document summarizes the Paperwork Reduction Act Statement requirements for information collections by federal agencies. It states that federal agencies may not conduct or sponsor collections of information from the public unless the collection displays a valid OMB control number. It provides the OMB control number for this specific information collection. It estimates that the average time to complete and review the information collection is 30 minutes per response. It instructs respondents to direct any comments on the accuracy of the burden estimate or how to reduce the burden to the FAA.

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    form 337

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    This document summarizes the Paperwork Reduction Act Statement requirements for information collections by federal agencies. It states that federal agencies may not conduct or sponsor collections of information from the public unless the collection displays a valid OMB control number. It provides the OMB control number for this specific information collection. It estimates that the average time to complete and review the information collection is 30 minutes per response. It instructs respondents to direct any comments on the accuracy of the burden estimate or how to reduce the burden to the FAA.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    451 views3 pages

    Form 337

    Uploaded by

    api-287640313
    This document summarizes the Paperwork Reduction Act Statement requirements for information collections by federal agencies. It states that federal agencies may not conduct or sponsor collections of information from the public unless the collection displays a valid OMB control number. It provides the OMB control number for this specific information collection. It estimates that the average time to complete and review the information collection is 30 minutes per response. It instructs respondents to direct any comments on the accuracy of the burden estimate or how to reduce the burden to the FAA.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Paperwork Reduction Act Statement: A federal agency may not conduct or sponsor, and a person is not required to

    respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the
    requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.
    The OMB Control Number for this information collection is 2120-0020. Public reporting for this collection of information is
    estimated to be approximately 30 minutes per response, including the time for reviewing instructions, completing and reviewing
    the collection of information. All responses to this collection of information are mandated by 14 CFR Part 43. Comments
    concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800
    Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ASP-110.

    OMB No. 2120-0020


    Exp: 5/31/2018

    MAJOR REPAIR AND ALTERATION


    (Airframe, Powerplant, Propeller, or Appliance)

    US Department
    of Transportation
    Federal Aviation
    Administration

    Electronic Tracking Number


    For FAA Use Only

    INSTRUCTIONS: Print or type all entries. See Title 14 CFR 43.9, Part 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for
    instructions and disposition of this form. This report is required by law (49 U.S.C. 44701). Failure to report can result in a civil penalty for each
    such violation. (49 U.S.C. 46301(a))

    1. Aircraft

    Nationality and Registration Mark

    Serial No.

    Make

    Model

    Name (As shown on registration certificate)

    Address (As shown on registration certificate)

    Series

    Address

    2. Owner

    City

    State

    Zip

    Country

    3. For FAA Use Only

    5. Unit Identification

    4. Type
    Repair

    Alteration

    Unit

    Make

    Model

    Serial No.

    (As described in Item 1 above)

    AIRFRAME
    POWERPLANT
    PROPELLER
    Type

    APPLIANCE

    Manufacturer

    6. Conformity Statement
    B. Kind of Agency

    A. Agency's Name and Address


    Name

    U. S. Certificated Mechanic

    Address

    Foreign Certificated Mechanic

    City

    State

    Zip

    Manufacturer

    C. Certificate No.

    Certificated Repair Station


    Certificated Maintenance Organization

    Country

    D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on the reverse or attachments hereto
    have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information
    furnished herein is true and correct to the best of my knowledge.
    Extended range fuel
    per 14 CFR Part 43
    App. B

    Signature/Date of Authorized Individual

    7. Approval for Return to Service


    Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the
    Administrator of the Federal Aviation Administration and is
    Approved
    Rejected

    BY

    FAA Flt. Standards


    Inspector

    Manufacturer

    Maintenance Organization

    FAA Designee

    Repair Station

    Inspection Authorization

    Certificate or
    Designation No.

    Signature/Date of Authorized Individual

    FAA Form 337 (10/06)


    Page 1

    Persons Approved by Canadian


    Department of Transport

    Other (Specify)

    NOTICE
    Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be
    compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements.

    8. Description of Work Accomplished


    (If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.)

    Nationality and Registration M ark

    Additional Sheets Are Attached

    FAA Form 337 (10/06)


    Page 2

    Date

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