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EFTA_00249329
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FOR AND IN CONSIDERATION OF $ 1.00 + OVC THE
LEGAL
UNITED STATES
N 722J E
KEYSTONE HELICOPTER S-76C
AIRCRAFT SERIAL No.
760750
DOES THIS
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DAY OF May
. 2021
OMB Control No. 2120-0042
bp. 0/130/2017
Do Not WIN In This Wadi
FOR FM USE ONLY
(IF INDIVIDUAL(S). GIVE LAST NAME. FIRST NAME. MD MIDDLE INMAL)
Industrial Integrity Solutions , LLC
2151 E. Convention Center Way #222
Ontario, Ca 91764
AND TO ITS` SUCCESSORS
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SIGNATURE(S)
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(TYPED OR PRINTED)
(IN INK) (IF EXECUTED FOR
(TYPED OR PRINTED)
Hyperion Air LLC
VAL ICC"( OF TIE INSTRUMENT.)
AC Fan, 0050-2 (01/12) (NSN 0052-00429-0003)
DIg
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SPZW04.944103
Manager
211331018187
85.00 05/13)2021
SDNY_GM_02762408
31(019650 Conveyance Recorded Jul/30/2021 08:53
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FEDERAL AVIATION AMINTSTRATION — MIKE INONRONEY AERONAUTICAL CENTER
WOW STATES
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SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249333
EFTA01332777
DocuSIgn Envelope
TC2I386F-TOCC-4AISECC14C030CC9F504
FORM APPROVED
OMB NO. 21204042
Do NotWYllo In TM Mee
FOR
UNDERSIGNED
AND
CRIBED
THE
AS FOLLOWS:
UNITED STATES
N722JE
Keystone (Sikorsky) model S-76C
AIRCRAFT SERIAL NO. 760750
DOES THIS
13
DAY OF June, 2019,
AND
INTERESTS
IN AND TO SUCH AIRCRAFT • UNTO:
PURCHASER
Hyperion Air, LLC
8100 Red Hook Quarter, B3
St. Thomas, U.S. Virgin Islands 00802
IN TESTIMONY WHEREOF, THE UNDERSIGNED HAS SET ITS HAND THIS 13
DAY OF St#A-
2019.
SELLER
(TYPED OR PRINTED)
SIGNATURE(S)
pt4 BLUE IN IQ (IF EXECUTED
SIGN)
TITLE
(TYPED OR PANTED)
ASI WINGS LLC
By: Aetna Inc., Its Managing
Member
r
im...row
J"M7t4 ant
Senior Vice President,
controller & Chief
Accounting Officer
James D. Clark
ORIGINAL TO FAA
AC Form 8050-2 (9/92) (NSN 0052-00429-0003) Supersedes Previous Edition
' and the following described engines: TURBOMECA model ARRIEL 2S2 bearing manufacturers serial numbers 42285
and 42288.
ADMIN 35381002v1
35.00 08/13/2019
SDNY_GM_02762412
•2
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8
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SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249334
EFTA01332778
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SDNY_GM_02762413
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249335
EFTA01332779
OstliCoutn4 Rumba 2120-0729
Boas 04/30/17
Paperwork Reduction Act Statemarm TM information collected an this lam le necessary to mar•aln areal regloration. We estimate Dating take approanatey 30
inhales lo compel, the form. Mee nobs that an agency may not coed:Last or sponsor. and a pirscn a not rcµried to reword lo. a collection Cl Norman wens *displays a
wild CMS coned number. Form Approved, OMB No. 2120-072A Comments concerning the accuraPy or the burden and suggestons for le0Aing the omen shots)) be
areas] to Its FAA at 500 Independence Avenue SW. Washinacn. DC 20591. ATTN. hiamanon Cotocton Clearance War. AES-200.'
DEPARTMENT OF TRANSPORTATION • FEDERAL AVIATION ADMINISTRATION
FAILURE 70 RENEW REGASTRA RON Mt
(See 14 CFR §§ 47.15(0, 47.40 and 47.41)
N 7223E
MANUFACTURER
KEYSTOtE HELICOPTER
08/16/2011
SERIAL NUMBER
760750
MODEL
S-76C
DATE OF EXPIRATiON
06312020
CORPORATION
(Owner 1)
ASI WPIGSLIS
(Owner 2)
BS Enter any additional owner names on page two.
(Address)
(Address)
Gay HARTFORD
Country
UNITEDSTATES
151 FARMINGTON AVE
state CT
zip 06156-0001
Physical Address: Required Wan mating address is a P.O. Bea or mai drop.
(Address)
(Address)
ay
Stale
Zip
Country
TO RENEW REGISTRATION: REVIEW aircraft registration ingot-WO,
SELECT the aPPnXITile itaterron ENTER any change Y1 addteSS h the
spaces below, ssqL4 DATE, & SEND forrn YAM the 55 renewal fee to te :
FAA Aircraft Registry. PO Box 25509, Oklahoma City OK 73125-0504, a
by courier to: 6425 S Denning Rm 118, °Mahone City OK 73169-6937
a
MEETS CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3, AIRCRAFT IS
ri UPDATE THE MAILING / PHYSICAL ADDRESS AS SHOWN BELOW.
REQUIREMENTS OF 14 CFR §47.3. MRCRAFT IS NOT REGISTERED
NEW PHYSICAL ADDRESS: Canoga" if physical oaken has changed, or
he new mailing addross s a PO Box a Mail Drop.
Review Aircraft Registration File Information for this aircraft
al: http://renistry.faa.00W8ittalflinnoirY.
Assistance may be obtained
at our web page httiXffrengtry.faa.qoyfrenewreoistration
by email at
fate acraft.rentstryafaa.vev or
by aleph:no at: (866) 762 - 9434 (loll free). or (405) 954 - 3116
When mailing fees, please use a check or money order made
payable to the Federal Avision Administration.
Signature and Title Requirements for Common Registration Typos:
- Individual
corner met sign, ale would be 'owner'
• Pannershe
general partner signs showing 'general partner as
title.
- Corporation
corporate officer or manager signs, slowing full title.
- Limited Lasity Co authored member. manager. or &leer idenbied in
the LAC organization document signs. tinning full tots
- Co-owner
each co-owner must sign; showing -co-owner as AM.
- Government
authorizer] person must so end tow tar full tile
Note: All signatures must be In Ink, or other permanent media.
To correct entries: Draw a single sne through error. Make correct entry En
remaking space. or complete the form orine. An apple-awn loon we be
rejected it any entry is coward try arrection tape Cf sinelany obscured.
CHFCK All amicable blOCKS) below, re/WI FTF Erali gam ea stas.
ells form with any fees lo the: FAA Ascraft Registry,
PO Box 25504, Oklahoma City. OK. 73125-0504. or by courier to:
6425 S Deming Rm. 118, Ckiahoma City OK 73189.6837
O
O
(Show purchasers name and address.)
O
K
O
OTHER: Specify
O
AND ADDRESS. The S10 reservation fee is enclosed.
SIGNATURE OF OWNER 1
(WNW MM)
(required Said)
ilLE
(reared Add)
OATS
Electronically COI'S by Ragletered Osalsve
32502017
SIGNATURE OF OWNER 2
TITLE
DATE
Use page 2 for ado:Nona] signatures.
AC Form 8050-113 (04/12)
Fee paid: $5 (201703281152554432N8)
SDNY_GM_02762414
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249336
EFTA01332780
SDNY_GM_02762415
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249337
EFTA01332781
OMB Cotiaol Ntabes 2120-0729
Eaputs040011 /
Note', Twelve (12) owner names may be entered on this page. If you require more, enter the first 12 names and then print
this page by pressing the 'Print Page 2' button below. Next dick the Reset' button to dear the data fields (from page 2
only) to add more names. Repeat action as needed.
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TIME
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
NAME OF OWNER
DATE
SIGNATURE
TITLE
AC Form 8050-1B (04/12)
REF N-NUM: 722JE
SDNY_GM_02762416
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249338
EFTA01332782
SDNY GM 02762417
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249339
EFTA01332783
D
1116-
P.
ATTORNEYS
& COUNSELORS
0 a
o
August 4, 2014
o >
05.o
Jana L. Hammer, Manager
ri
o
Aircraft Registration Branch
1:
Federal Aviation Administration
P.O. Box 25082
Oklahoma City, Oklahoma 73125
RE:
Executive Jet Management;
One (I) Keystone Helicopter S-76C;
Serial
Number
760750;
U.S.
Registration Number N722JE;
Our File Number: 5502.0015
Dear Ms. Hammer:
On behalf of AS1 Wings LLC, as registered owner (or co-owner) of the above described
aircraft, we hereby request that a duplicate Certificate of Registration be issued for the above
referenced aircraft. The original was inadvertently returned to the FAA for mailing, but the
address listed is not the address where the helicopter is located.
Please deliver the duplicate Certificate of Registration to the attention of the undersigned
in the Public Documents Room.
We are enclosing $2.00, in payment for the duplicate certificate fee.
Very truly yours,
l a
AinA44/V
P4t4t1(
Brandt S. Sterling
Legal Assistant
142181527010
$2.00 08104/2014
100 North Broadway Ave. • Suite 1500 • Oklahoma City, OK 73102-8609 •
vAvw.debeegilchrist.com
SDNY_GM_02762418
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249340
EFTA01332784
VNIOMMIO
All0 11WOH1/1)10
C Wd h 911H 1,101
263 NO11 V8ISIO3'; liV2i3b17
V 1/3 H.LIM U31Id
SDNY_GM_02762419
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249341
EFTA01332785
V.S. Department
of Transportation
Federal Aviation
Administration
Date of Issue: August 4, 2014
ASI WINGS LLC
151 FARMINGTON AVE
HARTFORD, a
06156-0001
Flight Standards Service
Aircraft Registration Branch,
AFS-760
P.O. Box 26504
Oklahoma City, Oklahoma 731254504
(405) 9544116
Toll Free: 1.666-762-9434
WEB Address: hltpg/registry.faa.gov
146046
This facsimile must be carried in the Aircraft as a Temporary Certificate of
Registration for
N722JE KEYSTONE HELICOPTER S-76C Serial 760750 and is valid until Sep 03, 2014.
This is not an airworthiness certificate. For airworthiness information, contact the nearest
Federal Aviation Administration Flight Standards District Office.
r
Manager, FAA Atrcra Registry, AFS-750
Federal Aviation Administration
APS-710-FAX-4 (01/14)
SDNY_GM_02762420
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249342
EFTA01332786
SDNY GM 02762421
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249343
EFTA01332787
PRINT PAGE 1
PRIVACY
ACT STATEMENT
OW ControlNumb 2120-0729
Elpites0S/linOt4
Papenwork Rocluct on Act Statement Il-e Infcm.w4., col000d on the ixrn 94OJEaily lo maIntel &reran regitealen Wo emlmale thai It will :Nit ap70ST4lely )3 mInutes
10 ccevfete tle 4,4n Please nc(.3 tat al agency may nue:now., or sponoor. and a Fowl!, R rot moo Imo *; eepond *. a ccaomen of Wermakon vJess It also ays a road
pal coniroi runt.... Form Approved. OMB No. 2120.0729 tp-rnents corcernng ma accuracy of hts barman, suggestion: for reexin he ex0en SAnue De droved l0
the FM at. BOO Ireacendenee Avenue SW. Wastingteri.00 20591. ATTN: tedotmatke Collection Clearance Ulcer. AES-2C0.'
FAILURE 70 RENEW REGISTRAnom WILL
(SOO 14 C.F.R §§ 47.150), 47.404nd 47.41)
N 722JE
SERIAL NUMBER
760750
MANUFACTURER
Keystone Helicopter
MODEL
S-76C
August 16, 2011
August 31. 2014
Corporation
(Owner I) ASI Wines LLC
Review Aircraft
at ilitOMORMIN.lea.doviairtraftinduirv.
for this aircraft
964 • 3116
^Nee
Typos:
panne' as 11110.
sAoMrg AJI tee.
&Tar Idenolied li the
showing lull tine
'co-owne? as file.
shoe' lair full tale
media.
Make coned entry In
cede be
obscured.
Registration File Information
(Owner 2)
Assistance
at our web
by a-mar at
by telephone
Men malting
payable lo
Signature and
- InclMcmis
PlatnershIp
- CaPC44.19n
- UMIIo0 LlablIty
Commer
• Government
Note: All signatures
To correct
remaining spook
*POW I any
may be Obtained
page: linpfitetretry.raa dovrrenewrecitilmtion.
&Jr, Enter any eddidonel owner names on page Teo.
(Address)
151 Farmington Avenue
laa.areraftrealittlESIMI 49X. or
at: (866)762 . 9434 (toll Iran or (405)
fees, &AM use n then or tretneY order
the Eager& Avtallol AOmInseaton.
Title Requirements for Common Registration
owner must sign. nee would be 'Ownot
general partner skins showing 'general
ccrporale races or manager signs.
Co autheeized member, manager, or
LLC erg:minim* document signs.
each co-owner must sign: showing
SNINOC1201 person Moil Mr and
must be Ni Ink, or other permanent
entries: Drew a single lire through error.
or complete the form on4lre. An oPPIcalle41IONn
envy Is Covered by eerreceon tape or sinterly
(Address)
Cry Hanford
Stale CT zip 06156.0001
Cooney
Physical Address: Required when marling address is a P.O. Box or mall *op.
(AdCreSt9
(AdtesS)
Ch.y
Stele
VO
Country
SELECT the aPPMPriele statement. ENTER
aircraft iwalataticin information.
. any dirge in address in the
Ete SO renewal lee to the:
Cay OK 73125-0504, or
City OK 731694937
CF 14 CFR/47.3, AIRCRAFT IS
AS SHOWN BELOW.
spaces below. EIW, DATE. a SEND form with
FM Antra Registry. PO Box 25504, Oklehtere
by courier to: 6425 $ Canning Room 118. Oklahoma
E:1 I (WEI CERTIFY, THE NAME(S) AND ADDRESSES
TO CANCEL
CHECK all spoked,
form with any
PO Box
6425 S Denting
O
CANCELLATION
O
THE
(Shore
blocks below. COMPLETE. $.12L
AIRCRAFT:
MI6 S tal this
or by courier to:
fern to the: FM Aircraft Registry,
25504, Odahoma City, OK, 73125-0504.
Rm. 118. Oldahorna C4Y OR 731694937
purchaser's name and eddrOSS)
El
UPDATE THE MAILING! PHYSICAL ADORESS
REQUIREMENTS OF 14 CFR §47.3.MRCRAFT
.
NEW PHYSICAL ADDRESS: complete if physical address has changed. or
the new mailing address is a PO Box or Mall Drop.
OTHER,
PLEASE
AND
Specify
RESERVE WRONGER IN THE OWNER'S NAME
ADDRESS. The S10 reservation fee is enclosed.
SIGNATURE OF
I
rod fob
(requf red fold)
linda Westbrook
TITLE
"maw re ASWMCS. LLC
(require* SO
Aswan Careen Seeger, al Anna re,
DATE i
7 /9 4204
. IGNATURE OF OWNER 2
TITLE
DATE
Use page 2 for additional signatures.
AC Form 8050-I B (04112)
SDNY_GM_02 762422
0
0
g
a
t.
C.
C
O
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249344
EFTA01332788
VINONV1)10
1,110 VIVON71)M
91. II WU hI 1111' hIPZ
as Nou V31
1. 4 "..103r.
111/A 1411M 03113
SDNY_GM_02762423
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249345
EFTA01332789
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE006014974
FFR -1B DOC ID eole 5/1/14
141211307096 15 5/1/14
SONY_CPO_02762424
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249346
EFTA01332790
SDNY_GM_02762425
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249347
EFTA01332791
U.S. Department
al Trarsportation
Federal Aviation
Administration
December II, 2012
AS! WINGS LLC
I5I FARMINGTON AVE
HARTFORD CT 06156-0001
Dear Sirs:
Flight Standards Service
Avast Registration Branch. AFS-750
P.O. Box 25504
Oldshome City, Oldahoma 73125-0504
(405)954-3118
Toll Free: 1-880-7824434
WEB Address: httpltregistrytialgov
An AC Form 8050-64, Assignment of Special Registration Numbers, was issued on September
16, 2011, as authorization to the change the registration number on a KEYSTONE
HELICOPTER S-76C aircraft, serial number 760750, from N722JE to special number N162AE.
This authorization was good for one year from the form's date of issue. The form was required
to be signed and returned to this office within five days after the special registration number was
permanently affixed to the aircraft. As of the date of this letter, no completed authorization has
been received by this office.
This authorization expired on September 16, 2012. Accordingly, the assignment of special
registration number N162AE to this aircraft was cancelled on December I I, 2012, and returned
to the pool of available N-numbers.
You may apply to reserve any available N-number as a special number in your name, or request
an available N-number be assigned to an aircraft to change that aircraft's registration number.
Information about requesting the reservation or assignment of a special registration number may
be viewed on our web site, httc://registry.faa.gov.
If you have any questions, our toll free telephone number is I (866) 762-9434.
Manager, Aircraft Registration Branch, AI;S-1.)0
AFS-750-REREG-I4 (09/10)
SDNY_GM_02762426
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249348
EFTA01332792
SDNY_GM_02762427
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249349
EFTA01332793
U.S Department
of Transportation
Federal Aviation
Administration
October 12, 2012
ASI WINOS 11.0
Ill FARACINOTON AVE
HARTFORD CT 04156-000I
Dear Sirs:
FSght Standards Sawa
Aircraft Registration Branch AFS-750
P.O. Box 25504
Oklahoma City, Oklahoma 73125-0504
(405) 04-3116
Toe Free: 1-805-762-0434
WEB Address: http:/hegtstry.taa.gov
The FAA Aircraft Registration Branch (Registry) issued an Assignment of Special Registration
Numbers, AC Form 8050-64, on September 16, 2011. This form authorized a change of
registration number from N722JE to N162AE to be completed within one year of its issue date
for the KEYSTONE HELICOPTER S-76C aircraft with serial number 760750. Within five days
of placing N162AE on the aircraft a signed copy of this form showing the date of the change was
required to be returned to the Registry. The authorization to change registration numbers
expired on September 15, 2012, without a completed copy of the form being received by the
Registry. We ask that you confirm the status of this registration number change so that the
matter may be closed appropriately. If no response is received within 30 days from the date of
this letter, the number change will be cancelled and N162AE returned to the pool of available N-
numbers.
The attached form may be used to confirm the status of this registration number change. If
special registration number N162AE has been placed on this aircraft, then upon receipt of your
notification, the Registry will update our records and issue a revised registration certificate
showing the special registration number.
The attached form also may be used to confirm that the N-Number change was not made, to
request the reservation of the special number in your name, or to make a new request for
N162AE to be assigned as special registration number to change the N-number of this or another
aircraft.
If we may be of any assistance, our toll free telephone number is 1 (866) 762-9434.
anager, Aircra
mistra ion ranch, AFS-750
AFS-750-REREG-13 (03/I I)
SDNY_GM_02762428
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249350
EFTA01332794
SDNY_GM_02762429
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249351
EFTA01332795
Directions:
Select and complete the appropriate section below then send, with the indicated fee (if appropriate), to die FAA
Aircraft Registration Branch.
U.S. Postal Service. Regular and Priority Mail
FAA Aircraft Registration Branch
P.O. Box 25504
Oklahoma City, OK 73125-0504
Commercial Delivery Seamless:
FAA Aircraft Registration Branch
Registry Building. Rm. 118
6425 South Denning
Oklahoma City, OK 731694937
Make fee payment by check or money order payable to the Federal Aviation Administration.
For additional information call toll free 1.866.762.9434. or visit hand egistry.faa,ROY
FAX No: (405) 954.3548
Dear Aircraft Registry:
K Special registration number N162AE, was not painted on KEYSTONE HELICOPTER S-76C, serial
number 760750.
K
1/We do not wish to reserve this number at this time.
K
Please reserve this N162AE in our name. The $10.00 special N-number reservation fee is
enclosed.
K
Please assign N162AE to
KEYSTONE
S-76C
760750
HELICOPTER
a- ..
(Sala' tilmbel
for an N-number change. 520.00 is enclosed to cover both the special number request and
assignment fees.
Or:
K Special registration number N162AE, was placed on KEYSTONE HELICOPTER S-76C, serial number
760750 on
<„,„,„i.“, Please issue a revised registration certificate.
K The completed and signed Assignment of Special Registration Numbers, AC Form 8050-64, is
enclosed.
K The Assignment of Special Registration Numbers, AC Form 8050-64, is lost or destroyed. Please
accept this as notice that the authorized N-number change has been completed.
Name of Owner:
&mature/Title
Date
AFS-750-REREG-13 (03/11)
SDNY_GM_02762430
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249352
EFTA01332796
SDNY GM 02762431
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249353
EFTA01332797
GO
U.S. Department
or Transpalaticn
Federal Aviation
Administration
Special Registration Number
NI62AE
Aircraft Make and Model
KEYSTONE HELICOPTER S-76C
Present Registration Number
N722JE
Serial Number
760750
Issue Date:
Sep 16, 2011
ICAO AIRCRAFT ADDRESS CODE FOR NI62AE - 50174441
ASI WINGS LLC
151 FARMINGTON AVE
HARTFORD CT 06156-0001
illunllinoll1lilullulliiilluillinuillkinliinuild
This is your authority to change
the United States registration
number on the above described
aircraft to the special
registration number shown.
Carry duplicate of this form in the
aircraft together with the
old registration certificate as
interim authority to operate the
aircraft pending receipt of revised
certificate of registration.
Obtain a revised orctificate of
airworthiness from your near-
est Right Staralards District
Office.
The latest FAA Form 81304,
Application For Airworthiness
on file is dated:
Dec 08, 2008
The airworthiness classification
and category:
STD TRANSP
INSTRUCTIONS:
SIGN AND RETURN THE ORIGINAL of this form to the Civil Aviation Registry, AFS-750, within 5 days after the special
registration number is placed on the aircraft. A revised certificate will then be issued.
The authority to use the special number expires: Sep 16, 2012
CERTIFICATION: I certify that the special registration number was placed
on the aircraft described above.
Signature of Owner.
RETURN FORM TO:
Civil Aviation Registry, AFS-750
P.O. Box 25504
Oklahoma City, Oklahoma 73125-0504
Title of Owner:
Date Placed on Aircraft:
AC FORM 005044 (5/2005) Supeniodea PTOVi011• &tidos
SDNY_GM_02762432
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249354
EFTA01332798
SDNY_GM_02762433
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249355
EFTA01332799
L
A I Insured Aircraft Title Service, Inc.
T S
P.O. Box 19527
Oklahoma City, Ok 73144
4848 SW 3601Street
Oklahoma City, Ok 73159
o-mail address: ials(40eastilink.net
web site: vawicinstmedaircraft.com
(405) 681-6663
(800) 654-4882
FAX (405) 681.9299
Date:
August 26, 2011
Dear Sir/Madam:
Please Reserve N
in NAME ONLY for:
Please Tteserve N 162AV
N# Change Request
and assign for the following aircraft:
N 722JE
Make
Keystone Helicopter Model
S-76C
Serial #
760750
Which is (1) being purchased by
ASI Wings LLC
(2) registered to
XX
112381430476
$20.00 08/26/2011
Payment of the required $10.00 fee per number to reserve/assign is attached. If the preferred N number is not
available, please contact the undersigned for a selection of a new number. Please send the confirmation of
reservation/8050-64 form to Insured Aircraft title Service, Inc. in the Public Documents room of the FAA.
Additional Information: • please see attached relinquishment
Requested by:
atiakatit-
Aun
a Jones
Fe:
$10.00
SDNY_GM_02762434
QD
P
O
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249356
EFTA01332800
VHOHV1)10
All3 VII0HrDIO
9S T lid 92 HU ILO
tIOILV21.91038 1P030i0V
/43 H I im anid
SDNY_GM_02762435
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249357
EFTA01332801
FORM APPROVED
OMB No. 2120-0042
scomeAL AVIATOR ADMINISTRATION-MIKE MONRONEY AERONAUTICAL CENTER
"(
i
UNITED STATES
722JE
c
I
AIRCRAFT MANUFACTURER 8 MODEL
Keystone
(Sikorsky)
S -76C
-
(
AIRCRAFT SERIAL No.
q
76O75O
• (
TYPE OF REGISTRATION (chock One box)
pl.
individual
O 2. Partnership
al 3. Corporation
O 4. Co-Owner
O 5. Government
O 8. Non-Citizen Corporation
O 9. Non-Citizen Corporation Co-Owner
NAME OR APPLICANT (Person(s) shown on evidence of ownership. If Individual. give last name, first name, and middle initial.)
III
ASI
Wings,
LLC
ADDRESS (Permanent mailing address lOt lint app cantOn list) (If P.O. Dos is used. Finnic-al SEEMS, must also be shown.)
Number and street:
151
Farmington
Avenue
Rural Route:
P.O. Box:
CITY
Hartford
STATE
Connecticut
ZIP CODE
O6156
0
CHECK
HERE
IF YOU ARE ONLY
REPORTING
A CHANGE
OF ADDRESS
ATTENTION!
Read the following
statement
before
signing
this application.
This portion
MUST be completed.
A false or dishonest answer to any question In this application may be grounds for punishment by fine and/or imprisonment
(U.S. Code. Title I g Sec. 1001).
III
CERTIFICATION
I/WE CERTIFY:
(1) That the above aircraft is owned by the undersigned applicant. who Is a citizen (including corporations)
Of the United Staten.
(For voting trust, give name of trustee:
) or:
QHEtTiK ONE AS APPROPRIATF'
a.
A resident alien, with alien registration (Form 1-131 or Fown 1-551) NO.
0.
A non-citizen corporation organized and doing business under the laws of (state)
and said aircraft Is based and primarily used In the United States. Records or flight hours ate available Mr
inspection at
(2) That the aircraft is not registered under the laws of any foreign country: and
(3) That legal evidenceof ownership Is attached or has been filed with the Federal Aviation Administration.
NOTE: It executed for co-ownership all applicants must sign. Use reverse side if necessary.
S NATURE
AWIstant
Corporate
ecretary
of
Aetna
Inc.
DATE
,7210
- 1/
SIGNA
Melinda
Westbrook
MWAaging
Member
of
ASI
Wings,
LLC
DATE
SIGNATURE
TITLE
DATE
NOTE Pending receipt of the Certificate of Aircraft Regis radon. the aircraft may be operated for a period not in excess of 90
days. during which time the PINK copy of this application must be earned In the aircraft.
AC Form 8050-1 (1/09) (NSN 0052-00-628.9007) Supersedes Previous EditiOn
SDNY_GM_02762436
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249358
EFTA01332802
A
IT
I V:1-14Z;
41 191X0
BS TT WU
9Z
II0Z
dB HOPI '12f1S1038 IA12:13211\1
V VA F/IPA C1311i
SDNY_GM_02762437
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249359
EFTA01332803
0
-1
0
0
V
a
The undersigned, FREEDOM AIR INTERNATIONAL, INC. ("Seller"), is the
owner of the full legal and beneficial title in and to that certain used Keystone (Sikorsky) S•76C
helicopter (sometimes referred to as a S-76C++) bearing Manufacturer's Serial No. 760750 and
U.S. Registration No. N722JE, with two (2) Turbomeca Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285 and 42286, together with all avionics, equipment (including
loose equipment), systems, furnishings and accessories installed on, contained in or attached to
said helicopter and engines, all as is more particularly described in that certain Aircraft Purchase
Agreement dated as of July I R , 2011, between Seller and Purchaser, and also including all
airframe, engine and accessory logbooks, flight and operation manuals, maintenance and
overhaul records, checklists, drawings, any issued FAA Form 337's, warranty documents, and all
other records and paperwork relating to the above-described helicopter and engines in Seller's
possession (collectively, the "Aircraft"); grogftcsi, that the term Aircraft as used herein does not
include airframe maintenance manuals and airframe illustrated parts catalogs as the same are being
retained by Seller.
For and in consideration of the sum of Ten Dollars ($10.00) and other good and
valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Seller
does hereby grant, bargain, sell, convey, transfer and deliver unto ASI WINGS, LLC
("Purchaser"), all of Seller's right, title and interest in and to the Aircraft.
Seller hereby warrants to Purchaser, its successors and assigns, that Seller is the
lawful owner of the Aircraft and that there is hereby conveyed to Purchaser good and marketable
title to the Aircraft, free and clear of any and all liens, claims and encumbrances whatsoever, and
Seller will warrant and defend such title forever, at the sole expense of Seller, against all claims
and demands whatsoever. EXCEPT FOR THE WARRANTIES OF SELLER SET FORTH IN
ITS "AS IS, WHERE IS" CONDITION AND "WITH ALL FAULTS."
IN WITNESS WHEREOF, Seller has caused this Warranty Bill of Sale to be
executed by its duly authorized officer, as of this ?t,- day of July, 2011.
112071217388
$5.00 07726/2011
SDNY_GM_02762438
0 0
3
a
0
13
0
Erl
0
a
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249360
EFTA01332804
Ala
VI40)1 V
14
1 )10
VP0V1 XO
RS II al 92 inr LIR
HOI!7615:)721 JVt3 61V
V VJ
Ogili
SDNY_GM_02762439
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249361
EFTA01332805
FORM APPROVED
OMB No. 2120-0042
FEDERAL AVIATION ADMIHISTRATION•MIKE MORRONeY AERONAUTICAL CENTER
a
ti.
REGIVIFTAFfa
llAiMBER N - 7 a atz-a--
a
a
Al5C
(S
RAFT MANUFACTUR
a
Skti MOOEL tIV-ii
:57/1) de/
reit
cop ter
it
t)
s
-
1
K
>
C
AIRCRAFT SERIALSi
No.
es
- 7 6 0 - 750
PO
rs
TYPE OF REGIS
neck Ono box)
it3
0 1. Individual
O 2. Partnership
. Corporation
04. Co-Owner '
0
5. Government
o
_I.
O 8. Non-Citizen Corporation
O 9. Non-Citizen Corporation Co-Owner
o
NAME OR APPLICANT PeriSon(s) shown on evidence of ownership. If individual. glve last name. first name. and middle Initial.)
rrae4:90tAn.
A4 c
....-. 4--ein,Let-Ficfrto1/4.0 ......
•
-.-% c_ •
41111
)
ADDRESS (Permanent mailing address for gist applicant On list) (It P.O. Box is used, physical address must also be shown.)
Number and street
li 0
S
Wo
et '<Roca. • so; 4-t. ac,...D.
Rural Route:
PO. Box:
CITY
\N)
t tAAJtAID)63 ...N.
STATE
"ble..
ZIP CODE
I9 203
O
CHECK
ATTENTION! Read the following statement before signing this application.
This portion MUST be completed.
-
A false or dishonest answer to any question In this application may be grounds for punishment by line and/or Imprisonment
N.S. Code. Titie 1 ii. sec. teat).
ID
CERTIFICATION
IAVE CERTIFY:
(t) That the above aircraft is owned by the undersigned appliCant. who is a citizen (including corporations)
of the United States.
(For voting trust. give name of trustee:
) or:
'
CHECK ONF AS APPROPRIATF•
a.
A resident alien• with alien registration (Form 1-151 or Form 1.551) No.
b.
A non-citizen corporation organized end doing business under the laws of (state)
and said aircraft Is based and primarily used in the United States. Records or flight hews are available for
Inspection at
(2) That the aircraft b not registered under the laws of any foreign country; and
(3) That legal evidence of ownership 1 attached or hos been flied with the Federal Aviation Administration.
NOTE: If executed for co-ownership all applicants must sign. Use reverse side If necessary.
SIGNATURE
.......
,QW.
TITLE
\I
i 11-tr __ g"e-St
C 9 re 4-4+
DATE
% IQ- I la
.
SIGNATURE
trYt.le3
.c .
TITLE
102280834295
DATE
SIGNATURE
TITI-E55. GO 08/18/2010
DATE
.._.....
.
NOTE Pending receipt of the Certificate of Aircraft Regis ration, the aircraft may be operated for • period not In excess of GO
days. during which time the PINK copy of this app 'Catlin, must be earned In the elrerett:
•
'
AC Form 8050.1 (1/08) (NSN 0052-00-628-9007) Supersedes Previous Edition
SDNY_GM_02762440
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249362
EFTA01332806
SDNY GM 02762441
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249363
EFTA01332807
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE001916668
name change
rev/doi 022709
SDNY_GM_02762442
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249364
EFTA01332808
SDNY_GM_02762443
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249365
EFTA01332809
CROSS-REFERENCE—RECORDATION
'RECORDED CONVEYANCE PILED IN:
NNUM:
SERIAL NUM:
Nom'
moDa.:
AIR CARRIER:
This form is to be used in cases where a conveyance coven several aircraft and engines, propellers, or locations. File original of this farm
with the recorded conveyance and a copy in each aircraft folder invol rid.
NAME CHANGE
DATE EXECUTED
FEBRUARY 11, 2010
FROM
DOCUMENT NO.
SHMITKA AIR INC
DATE RECORDED
MARCH 17, 2010
Total Aircraft:
Total Engines:
Total Props:
Total Sparc Parts:
Ars.n043RWMM
SDNY_GM_02762444
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249366
EFTA01332810
SDNY_GM_02762445
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249367
EFTA01332811
a
u.s oeseseme
al Teossediteto
Fedor& RAS*
AdmIMstration
Sp
N722M
ecial Registration Number
Aircraft Make and Model
KEYSTONE HELICOPTER S76C
Pitsent Regisiratiee Number
N750A
Serial Number
760750
Issue Dale:
Mar 10, 2010
ICAO. AIRCRAFI ADDRESS CODE FOR N7223E - 52325707
103 POW( RD
WILMINGTON DE 19803-3742
ImillsinlvIiil
ImIliliilliklultikluklita•M
This is your audicery to charge
the United Styles reitiMadoe
moan Gotha above described
eagle° the special
registaltiou ouster shown.
Cony duplicate of ttis fen is the
emit member "di the
old registration CaNlifICIAC es
interim 'Amity mosaic the
eiraaft pendia; receipt of Mind
eatiftcaic of regisoatica.
Obtain . revised °Mega of
Mt
from your as
en Flight Standard ;District
OM=
The Moss FAA Porn 81304,
Applirmloo For Mnrorthhens
a Me S dated:
Jan 14.:010
The sienrthinesr dW&rI®
sad category:
EXPERD4Off
INSTRUCTIONS:
SIGN AND RETURN THE ORIGINAL of this form to the Civil Aviation Registry, AFS-750, wits 5 drys der the special
regimation number is placed on the airmail A revised certificate will than be issued.
The solitarily to use the special member mita: Mn 10, 2011
CERTIFICATION: toed* that
resittetioe ureter was placed
on the Sag% described
for Shmitka Air,
Swat= of
1
RETURN FORM TO:
Civil Aviation Registry, AFS-750
P.O. Box 25504
Oldationta City, Oklahoma 73125-0504
-Larne
.D rect
r of Operations
of
Tio,,,,-0„„er.Ohmitke Air,
Inc.
f/k/a
.'
'
Air
cat tie tains,
nc..
Dale Placed od AinejlinCULeA r / 5. 2010
AC SORIA MOAN moss) Sepennlai Preview PAM*
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10,
SDNY_GMJ32762446
15, and 17
8
2 • a
0
EFTA_00249368
EFTA01332812
VV;OHV1NO
A.1IO VYWHV1NO
SI I lid 91 BBL] 010?
FIG h:ttonliS133k1 .1.3VIIOUW
t'V:1 HUM 03113
SDNY_GM_02762447
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249369
EFTA01332813
AMOMITTMAIMAJW,035
MWORDMOWMMON
February 11, 2010
Hand Delivered
Tm
FAA
Oklahoma City, Oklahoma
PORN 8050-64
URGENTLY
Attention:
a
NEEDEDI
PLEASE ISSUE AS
QUICKLY AS POSSIBLE. THANK YOU! ! !
Gentlemen:
Aero Records & Tide Co.
P.O. Box 19246
On behalf of our client:
103 Foulk Rd.
Wilmington, DE 19803-3742
Please initiate the following action:
Please
ASSIGN special
registration
number
N722JE,
which
is
reserved for our client, to the following described aircraft which
is registered in their name:
KEYSTONE HELICOPTER S -76C
SERIAL NUMBER 760750
CURRENTLY N750A
PLEASE HAND THE ORIGINAL FORM 8050-64
TO ARTC -
P.D.
ROOM.
Thank you.
100431322316
$10.00 02/12/2010
0 PLEASE HAND CONFIRIAATION Or RESERVATION LETTER TO *RTC - PUSLIC DOCUMENTS ROOM.
tk
PLEASE HAND ORIGINAL rORM S050-114 TO *RTC - PUBLIC DOCUMENTS ROOM.
you,
AERO RECO
& TITLE Clk
By. LISA THO S GALSIZellenior Administrator, Special Services
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Fee Attached: a 1 ° • 0°
CC:
Christopher
Shurkus
Sikorsky
Aircraft
SONY_GM_ 02762448
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249370
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SDNY_GM_02762449
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249371
EFTA01332815
FORM APPROVED
OMB No. 2120-0042
IEDIMAL AWIATKIel Ateleessitimesselete iseesaelen aineilialniCAL CENT=
UNITED STATES
REGISTRATION NUMBER N 750A
AIRCRAFT MANUFACTURER • MOOEL
ke st 54one
1-le i;cop-de r
-S-i-kcw-sk,y-435-re-re-ft S -76C -2
AIRCRAFT SERIAL No.
760750
TYPE OF REGISTRATION (Check one boa)
Ner/Catinn
CI t
InCINKIUM
0
2. Partnership MI 3. COrPOration
O
4. Co-owner
O
5. GOVT.
0
8.
OF
If IndeolduaS
Lest name. ISM name. and middle initial.)
NAME
APPLICANT (Mamm(e) shown on evidence of ownership.
give
Ill
Air Ghislaine, Inc.
.
ADDRESS (Permanent mailing address les newt applicant listed.) (If P.O. BOX Is used. physical address must also be shown.)
Number
103 Faulk Road
end street:
Rural Route:
PO. Box:
CITY
Wilmington
STATE
DE
ZIP CODE
19803
O
ATTENTION! Read the following statement before signing this application.
This portion MUST be completed.
A false or dishonest answer to any question in this application may be Bounds for Punishment by Ono and r of ImPlitionnvent
(U.S. Cade, ma Ia. See. 1001).
III
CERTIFICATION
INC CERTIFY:
(1) That the above Shoran le owned by the undersigned applicant. who Is a dozen (including corporations)
of the United States.
(For waling bust. give name of truiSlee:
) Or:
a. O A resident *Min. with alien regiortrMion (Form 1-151 or Form 1-551) No.
b. O A non-ciezen corporation organized and doing business under the laws of (state)
end said semen is based and preneray used In the United States. Records or nigh beta are available for
Inspection al
(2) Thal the aircraft Is not registered under the laws of any torsion Country; and
(9) That legal evidence Of ownership is attached or has been Red with the Federal Aviation Administration.
NOTE: If executed fOr c0-ownership all applicants must sign. Use reverse side If necessary.
E
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SIGNATURE
c or
TITLE
RosegLA- • 4 14112664J
DATE
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TITLE
DATE
SIGNATURE
TITLE
090481439131
$5.OO 02//7/2000
DATE
NOTE Pending receipt of the Certificate of Aircraft Reglsttallon. the ale:sae may be operated for a period not in excess Of SO
days. during Mao, time the PINK copy el Otis agiPlInstiOn must be ankle in the aircraft.
AC Form 8050-1 (5,03) (0052-004284007)
SDNY GM 02762450
co
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a
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SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249372
EFTA01332816
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SDNY_GM_02762451
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249373
EFTA01332817
V.S. DEPARTMENT OF TRANSPORTATION FEDERAL AvmTION ADMINISTRATION
FOR AND IN CONSIDERATION OF $ i+orC
THE
FOLLOWS:
UNITED STATES
N 750A
AIRCRAFT MANUFACTURER 8 MODEL
Sikorsky Aircraft S-76C-2
AIRCRAFT SERIAL No.
760750
DOES THIS
.30
DAY OF
December
, 2008
FORM APPROVED
OMB NO. 2120-0042
013131(2006
Do Nor wow in TM Bork
FOR FM USE ONLY
PURCHASER
(IF PrINVIOUAL(9), GIVE LAST NAME. FIRST NAME. AND MDDLEMTIALII
Air GhislaIne, Inc.,
103 Foulk Rd., #202
Wilmington, DE,
19803
083651547221
$5.00 12/30/2008
Afro TO is steCOOSSOM
kt20090203:0001000,53009 MD ASSIGNS TO HAVE MID TO FOLD
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CC
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HAVE SET
My
go OF 0600000/. 2000
SIGNATURE(S)
TITLE
(IN Par) (IF EXECUTED FOR
[TYPED OR PRINTED)
CO.CMAIERSHIP:
MAST SIGN,)
(TYPED OR PRINTED)
Samar Aircraft Corporation
Club Shurkus
S-76 Program Mannar
ACKNOWLEDGMENT (NOT REQUIRED FOR PURPOSES OF FM RECORDING' HOWEVER. MAY BE REQUIRED SY LOCAL LAW FOR
.
AC From 8050-2 (9/92) (NSN 0052-03-629-0003) Supersoft* Prwkos Milton
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SDNY_GM_02762452
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249374
EFTA01332818
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SDNY_GM_02762453
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249375
EFTA01332819
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE000740071
ORIG DOC ID 80070 FFR 12-30-08 RET TO CiD
SONY GM 02762454
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249376
EFTA01332820
SDNY GM 02762455
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249377
EFTA01332821
FOR AND IN CONSIDERATION OF siademe THE
FOLLOWS:
UNITED STATES
N 750A
AIRCRAFT MANUFACTURER 8 MODEL
Keystone Helicopter Corporation S-76C
AIRCRAFT SERIAL No.
760750
3 U FA-
DOES THIS
DAY OF
bQ C
PURCHASER
(IF INONIOUAL(S), GIVE LAST NAME. FIRST NAME. AND MOLE
)
Sikorsky Aircraft Corporation
6900 Main Street
Stratford, CT 06614
I
8
FORM APPROVED
OMB NO. 2120-0042
0
0813112006
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HAVE SET
(TYPED OR PRINTED)
Keystone Helicopter Corporation
ACKNOWLEDGMENT (NOT REQUIRED FOR PURPOSES OF FAA RECORDING: HONEvER. MAY BE REQUIRED BY LOCAL LAW FOR
VALIDITY Of TIE INSTRUMENT.)
ORIGINAL TO FM
AC Form 8060.2 (9/92) (NSN 0062 00 a29 0003) Supersedes Previous ErMice
SIGNATURE(S)
COOMERSme, ALL MUST SIGN.)
David A. Ford
DAY OF
TITLE
(TYPED OR PRINTED)
preSenl
SDNY_GM_02762456
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249378
EFTA01332822
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80 NOLISSIMD3il idV838IV
VV4 1411/A 0316
SDNY_GM_02762457
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249379
EFTA01332823
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ABE000740069
ORIG DOC ID #0068 FFR 12-30-08 RET TO ca.
SONY_CPO_02762458
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249380
EFTA01332824
SDNY_GM_02762459
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249381
EFTA01332825
Dec 22 2008 3:24PM
HP LASERJET FAX
Keystone Helicopter
A Sikorsky Company
December 22, 2008
Flight Standards Service
Aircraft Registration Branch, AFS-150
PO Box 2550
Oklahoma City, Oklahoma 73125-0504
110 E. Stewart Huston Drive, Coatesville PA, 19320
CAR F
Keystone Helicopter Corporation is requesting the correction of aircraft that where incorrectly
registered. Some of the aircraft that have been registered from oor facility where registered as MODEL: S-76C-2,
this is not in accordance with our type certificate data that (HINE); the aircraft should have been registered as S-
76C. As the Aircraft manufacturer we are requesting that these please be corrected. We apologize for any
inconvenience this may cause. The following A/C Serial Numbers with the corresponding N Number are affected
by this error, they include:
Aircraft Serial Mugabe:
Aircraft N Number
760686
. 718P
'
759
4151'
7
cpcitegards.
Shaun M. Ge hard
S76 Quality Assurance Production Supervisor
Keystone Helicopter Corporation
110 E. Stewart Huston Or.
Coatesville PA 19320
60717
767J
(V760720
720Q
91760723
723Y
760726
753P
6160729
799Y
60731
7817(
607
74
743N
60750
6075
746X
747Y
748A
7504
'
7$A
C,?5/60753
75311
P • 2
SDNY_GM_02762460
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
0
0
0
EFTA_00249382
EFTA01332826
V1401471)10
A113 7i4O/4V1N0
00 C lid 22 330 800?
SDNY_GM_02762461
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249383
EFTA01332827
JENNY ROSALES
09/92008
ID
DATE
A Prior Record search was performed for ISZYSTONE HELICOPTER CORP S-76C-2. 760730 on 9/9/2008. Search
readts:
No Prior Record
Assigned N730A
SDNY_GM_02762462
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249384
EFTA01332828
SDNY_GM_02762463
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 002493R5
EFTA01332829
U.S. Department
of Transportation
Federal Aviation
Administration
September 9, 2008
110 STEWART HUSTON DR
COATESVILLE PA 19320
Dear Sirs:
Flight Standards Service
Aircraft Registration Branch, AFS-750
P.O. Box 25504
Oklahoma City, Oklahoma 73125-0504
(405) 954-4208
Toll Free: 1-B66-704-4715
WEB Address: Mp://registry.faa.gov
United States identification mark N750A has been assigned to KEYSTONE HELICOPTER
CORP S-76C-2, serial number 760750, Mode S Transponder Code 52415011 as requested by
you. This manufacturers assignment of special registration number cannot be used as an
authorization for a number change.
If we may be of further assistance, please contact the Aircraft Registration Branch at
(405) 954-4206 or toll free 1-866-704-4715.
Sincerely,
Legal Instruments Examiner
Aircraft Registration Branch
AFS-750-SUPPORT-5 (9/04)
SDNY_GM_02762464
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249386
EFTA01332830
SDNY_GM_02762465
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249387
EFTA01332831
9/4/08 ,
Federal Aviation Administration
Civil Aviation Registry
Aircraft Registration Branch
Attention: Central Records
Reference: Request for Manufacturer's
Registration Number AssignMents
Gentlemen/Ladies:
This is written to request reservation 6
assignment of the following special registration
numbers to the aircraft described bolo* which are
presently under manufacture:
MODEL S-76C-2
SERIAL NO.
N74176-
760741
N743N
760743
N7450
760745
N746K
760746
N747Y
760747
N748A
760748 /
N750A
7607501/
N7518
760751
N753V
760753
Thank you.
Sincerely,
By:
Carl Kress
S76 Program Manager
SDNY_GM_02762466
a
•
12
O
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249388
EFTA01332832
r!• ug7xo
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A11:)
s tv:
um/
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SDNY_GM_02762467
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249389
EFTA01332833
MWMAIMMESIMMMES
RWORWMSUMOM
muntirramommmmvax
September 5, 2008
Hand Delivered
To:
FAA
Oklahoma aty, Oklahoma
Attention:
Gentlemen:
On behalf of our client:
Central Records
110 East Stewart Huston Drive
Coatesville,
PA
19320
Please Initiate the following action:
Aero Records & Title Co.
P.O. Box 19248
Oklahoma CIty. OK 73144
-
:CS
C
Th
—
no_ A ft cr_
Please
RESERVE
and
assign
the
following
NINE
(9)
special
registration
numbers
to
the
aircraft
listed
below
which are
presently
under manufacture:
MODEL 9-76C-2
SERIAL NO.
I N741A
760741
N743N
760743
N745G
760745
4 N746K
760746
C N7472
760747
N748A
760748
dip N750A
760750
N751E
760751
q N753V
760753
PLEASE ISSUE FORM AFS-750-SUPPORT-5 TO THE MANUFACTURER, KEYSTONE
Note: Enclosed is a "fax" letter by the manufacturer,
confirming their need for these assignments.
Thank you.
082491212072
890.00 00/05)2008
)4 PLEASE NAND CONFIRMATION OF RFSII
cmitaz
eit504m
5
\lti PLEASE NAND
Thank you,
AER" RECO
By: /1
LI
THOMAS GASKIN/Senior Administrator,
Special Services
9
FeeAttached:0
1'.
°G)
CC:
Carl Kress
Keystone Helicopter
Corp.
SDNY_GM_02762468
a
8
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249390
EFTA01332834
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IS TT Wki S 43S HOZ
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vvd HI
131IJ
SDNY_GM_02762469
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249391
EFTA01332835