Applicant's Approval Ref. No

This form of application should be submitted, in  duplicate, to the Director General of Civil Aviation (Attn: Director of Airworthiness) accompanied by the specific documents :
   

1.

Name of the item.

2.

Name and address  of the applicant.

.

3. 

 Place and year of development.

4.

Description :

a.       Type.

b.      Type of aircraft and category (e.g. normal utility, aerobatic etc.) for which the component / item of equipment / instrument is intended.

c.       Weight.

d.      Overall dimensions means of fixing and external connections, if any.

e.       Design specification.

5.

Particulars of approval held for the component/equipment and brief summary of experience on  equipment (e.g. aircraft types to which fitted) if any.

6.

Degree of compliance with applicable airworthiness standards.

7.

Details of tests carried out on the component/equipment and    copies of test reports thereon.

8.

Performance :

         i.            Working and ultimate pressure or load

       ii.            Limitations of voltage and frequency.

      iii.            Time rating  for example continuous, intermittent or duty cycle.

     iv.            Limits of accuracy of measuring instruments.

       v.            Endurance (based  on test evidence and/or operational experience).

     vi.            Any limitations in mounting attitude.

    vii.            Whether the equipment is "flameproof"  (explosion proof).

  viii.            Whether the equipment is fire-resistant.

     ix.            The compass safe distance.

       x.            Whether the equipment is radio-interference-free.

     xi.            Range of temperature, altitude and  humidity which the equipment will safely withstand.

    xii.            Degree of vibration which the equipment will withstand.

  xiii.            Degree of acceleration which the equipment will withstand.

  xiv.            Degree of water proofness or sealing of the equipment.

   xv.            Ability to resist sand and dust.

  xvi.            Ability to resist salt spray and aircraft  fluids (fuels, oils and hydraulic fluids).

A.   I  hereby  declare that the above particulars  are   true  in every respect.

B.   Following documents are  enclosed herewith :-

1.  Two    complete    sets     of    drawings    of      the component/equipment.
2.  Three unmounted photographs of the   component/equipmen
    (the photographs shall be of size 14.0x9.0 cms.)
3.  Type Instruction Manual
4.  Type  Service Manual.

 Signature of Applicant :

Designation :

Organisation :

Address :

Date :