EFTA00150965.pdf

UNITED STATES OF AMERICA - DEPARTMENT OF TRANSPORTATION FFTPRAI AVIATION ADMINISTRATOR - MIKE MONRONEY AERONAUTICAL CENTER AIRCRAFT REGISTRATION APPLICATION 1 LINOS) STATES N REGISTRATIO N 722JE HUMBER ° 1 InINNS TYRE OF a a PsWorm REGISTRATION O 3. corprom °4 Co-Oryy O 5 Go.yr.-mon, (Choy* as bat) 0 7 Lurid Uabity Canyon (Lit) O a Non-OUnin Corparalart O 9 lionGtoon Capraton Co-Orwr NRCRAFT Sikorsky S-76C NOM. RANUFACTURER AND ASKRAF1 sem 760750 MASER NAILS) OF NVIJCANT(S) (Rwyon(s) -Hyperion Nor on recierce of oinarily 8 rcfroital, Ow SS Air. NV ore RN NoRNI ININI) hi r L-1-t TELEPHONE NUIMER ( -4149. ) RAPoltraR IMAM NUNDER RURAL CITY ACORESS (Power, trading ocktora Ice Ertl NONNI on fist ) "" •I' ' a -- al ANO STREET. ROUTE P O. BOX ZIP -ati-voinineai STATE n IIIIIIMI--___ PHYSICAL IOW DESCRIPTION LOCATION CITY ACCRESSA.00ATION AM) STREET Of STATE- ZIP • CHECK HERE IF YOU ARE Jakr REPORTING A CHANGE OF ADDRESS AVE (1 ) (2) (9) (4) I hereby be isaancelon buena* sods 3571) CERTIFICATION by as tryinagred arbra stomataer ClIEGR ARMOR CC/ METE AN .. 0 CEIRTVY. Thy! Pe rove CA awed Ei • A Yemen a ale UnInd Seen Is dear by 49 USC 40102(15L IS (Ian I .551) Na . a A neliard a wen Son El a An:04=r ocoTorser to trod at prmstty sad crowned and axis business way the tee n te Weed Shan Records al SRN hoes of (Mae aid end fl ea tot troctione(provId• are ANSON aNIIINolo POPININ 440• 42N CI 41 A carp:ratan Nylny a meg (nal toga* Enter rein, fa mates Sta. c or d sow a drat seek sant rejleaton albeies Ted es antler°, rogror Red IN* aware al clonsra ANY MID ALL SICIPIATORIES A SIGRAIURE TO DOS catty that to clormatm dm inaladpe aid betel la meal regetraton and %arty tisane, came& I. 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NN elocted or has been Med .e, Woe Federal OF THIS APPLICATION MUST READ DOCUMENT, THEY ARE SUBJECT TO THE proyekil hem archn any atladrrents to the I ,,need Oa Me a NirrnaL01 proeded by I urderslird Mai raver, marry manes aim a oilmen up (by any tick scheme a deice) entry, rray balled up 0)3250000 or martsonel realticnally p-onde any nocasnate alike ail andkants must by are ancacmt suftanzobon Are Nanrnanexn THE FOILOINDIO REFEIZENCED appbabon me el be rated tie prischaton a mama' not rime town atom. to eve °Inn* `barn cd b e yowls( ARO ISICIEItSTAND THAT BY APPLYING STATUTES AND ASSOCIATED PEN ALTIES- for naafi rays:mt.:0 a true, accurffie and and to the at by te FM atatratrator n Maher detennreton of of any departnant a mesa of to UnCed Sates, tact or eft makes any tease, rntileatbrip a handy:Ent ten Ina (5) yeas or bolt (18 USCSectcre 1001 aid of tie nand emit may bo revoked next page and add pagers) it necessary. a n up. ass Luanne or I irdersend that should NOTE a aoudad ern ann.. regelyaban sign. Use 1 , SIGNATURE: DATE: (0_ ill- i 111 TYPED/PRINTED NAME: Lawrence P. Visoski..1r. TIRE Manager 2 SIGNATURE: DATE TYPED/PRINTED NAME MU - 1107£ Except at., the most newt narlstrabri of the sictiNet abash S expired of amcaleck 14 CFR 47 31(c) rides for en .heat, Masa to te operated for up to 93 drys ran the United States when a cow of the tared applkstIon for IS mien/km S casrkd N the tbtrell while inning Issuance and roosts at the my ragistrrion mei:a 0 0 D AC Form Kcal none) EFTA00150965 FILED-WITH FAA AIRCRAFT REGISTRATION BR 1014 JUN I 3 AN 12 OKLAHOMA CITY , OKLAHOMA EFTA00150966 OocuSign Envelope ID: 7C21388F-7DCCA,O6B-9CC1-7C830CC9F594 FORM APPROVED OMB NO. 2120-0042 UNITED STATES OF AMERICA U. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION AIRCRAFT BILL OF SALE Do Not Witte In This Block FOR FAA USE ONLY FOR UNDERSIGNED AND CRIBED AND IN CONSIDERATION OF $ THE OWNER(S) OF THE FULL LEGAL BENEFICIAL TITLE OF THE AIRCRAFT DES- AS FOLLOWS: UNITED STATES REGISTRATION NUMBER: N722JE AIRCRAFT MANUFACTURER & MODEL Keystone (Sikorsky) model S-76C AIRCRAFT SERIAL NO. 760750 DOES THIS l3 DAY OF June, 2019, AND INTERESTS HEREBY SELL, GRANT, TRANSFER DELIVER ALL RIGHTS, TITLE, AND IN AND TO SUCH AIRCRAFT • UNTO: PURCHASER NAME AND ADDRESS (IF INDIVIDUAL (S). GIVE LAST NAME. FIRST NAME. AND MIDDLE INITIAL ) DEALER CERTIFICATE NUMBER AND TO ITS SUCCESSORS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS TO HAVE AND TO HOLD SINGULARLY THE SAID AIRCRAFT FOREVER, AND WARRANTS THE TITLE THEREOF. IN TESTIMONY WHEREOF, THE UNDERSIGNED HAS SET ITS HAND THIS t3 DAY OF "SLASA- 2019. SELLER NAME(S) OF SELLER (TYPED OR PRINTED) SIGNATURE(S) (IN BLUE INK) (IF EXECUTED FOR CO-OWNERSHIP, ALL MUST SIGN) TITLE (TYPED OR PRINTED) ASI WINGS LLC By: Aetna Inc., its Managing Member DocuSigned by: Ejo.skt-S a,,t ?IC 7.OO072EMSI Senior Vice President, controller & Chief Accounting Officer James D. Clark ACKNOWLEDGEMENT (NOT REQUIRED FOR PURPOSES OF FAA RECORDING: HOWEVER, MAY BE REQUIRED BY LOCAL LAW FOR VALIDITY OF THE INSTRUMENT.) ORIGINAL: TO FAA AC Form 8050-2 (9/92) (NSN 0052.00-629.0003) Supersedes Previous Edition • and the following described engines: TURBOMECA model ARRIEL 2S2 bearing manufacturers serial numbers 42285 and 42286. ADMIN 35381002v1 191641014476 55.00 06/13/2019 O O 0 0 0 0 a 0 O O CO 0 (.4 EFTA00150967 FILED WITH FAA AIRCRAFT REGISTRATION BR 1019 JUN 13 AU 10: 12 OKLAHOMA CITY OKLAHOMA EFTA00150968 OMB Control Number 21204729 apices 04/30/1 7 Paperwork Reduction Act Statement: The information collected on this lam is necessary to maintain aircraft registration. We estimate that 4 will take approximately 30 minutes to complete the form. Please note that an agency may not conduct or sponsor, and a person is not requited to respond to. a cOrection of information unless it displays a valid OMB control number. Form Approved, OMB No. 2120,0774 'Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800 Independence Avenue SW. Washington. DC 20591. ATTN: Information Collection Clearance Officer, AES-200.- DEPARTMENT OF TRANSPORTATION - FEDERAL AVIATION ADMINISTRATION AIRCRAFT REGISTRATION RENEWAL APPLICATION FAILURE FAILURE 7O RENEW REGISTRATION WILL W CANCELLATION OF REGISTRATION AND REGISTRATION NUMBER ASSIGNMENT (See Id C.F.R. §§ 47.15(0, 47.40 and 47.49 AIRCRAFT REGISTRATION NUMBER N 722JE SERIAL NUMBER 760750 MANUFACTURER KEYSTONE HELICOPTER MODEL S.76C DATE OF ISSUANCE 08/16/2011 DATE OF EXPIRATION 08/31/2020 TYPE OF REGISTRATION CORPORATION ENTER REGISTERED OWNER(S) & ADDRESS FROM FAA FILE (owner 1) ASI WINGS LLC HELPFUL INFORMATION Review Aircraft Registration File Information for this aircraft at: http://reeistry.faa.cmyfaircraftinouirv. (Owner 2) Assistance may be obtained at our web page: htID:HreCliSIFV.faa.CIDWrefleWregiStratiOn 1' fl Enter any additional owner names on page two. (Address) by e-mail at: taa.aircraftreoistrvefaa.ciov. or (Address) by telephone at:: (866) 762 - 9434 (toll free), or (405) 954 - 3116 When mailing tees, please use a check or money order made payable to the Federal Aviation Administration. Signature and Title Requirements for Common Registration Types: - Individual owner must sign, title would be 'owner'. - Pannership general partner signs showing 'general partner' as title. • Corporation corporate officer or manager signs, showing full title. - Limited Liability Co authorized member, manager, or officer identified in the LLC organization document signs. showing full title. - Co-owner each co-owner must sign: showing *co .owner" as brie. - Government authorized person must sign and show their full title. Note: All signatures must be In Ink, or other permanent media. To correct entries: Draw a single line through error. Make correct entry in remaining space, or complete the form on-line. An application form will be rejected if any entry Is covered by correction tape or similarly obscured. City State Zip Country UNITED STATES Physical Address: Required viten mailing address is a P.O. Box or mai drop. (Address) (Address) City State ZIP Country TO RENEW REGISTRATION: REVIEW aircraft registration Information. SELECT the appropriate statement, f ,NTER any change in address in the spaces below SIGN.DATE. & auji form with the $5 renewal fee to the: FAA by courier i O NEW Aircraft Registry, PO Box 25504. Oklahoma City OK 73125-0504. or to: 6425 S Denning Rm 118, Oklahoma City OK 73169-6937 I (WE) CERTIFY. THE NAME(S) AND ADDRESSES FROM THE FAA FILES FOR THE OWNER(S) OF THIS AIRCRAFT ARE CORRECT, OWNERSHIP MEETS CITIZENSHIP REQUIREMENTS OF 14 CFR 947.3. AIRCRAFT IS NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY. UPDATE THE MAILING I PHYSICAL ADDRESS AS SHOWN BELOW. I (WE) CERTIFY THE: NAME(S) SHOWN ABOVE FOR THE OWNER(S) OF THIS AIRCRAFT IS CORRECT. OWNERSHIP MEETS THE CITIZENSHIP REQUIREMENTS OF 14 CFR 947.3. AIRCRAFT IS NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY. MAILING ADDRESS TO CANCEL THE REGISTRATION FOR THIS AIRCRAFT: CHECK All applicable bloats) below. cOMPIFTF SIGN_ MIES MIL this form with any fees to me: FM Aircraft Registry. PO Box 25504, Oklahoma City, OK, 73125-0504, or by courier to: 6425 S Denning Rm. 118, Oklahoma City OK 73169-6937 CANCELLATION OF REGISTRATION IS REQUESTED. THE AIRCRAFT WAS SOLD TO: (Show purchaser's name and address.) THE AIRCRAFT IS DESTROYED OR SCRAPPED. THE AIRCRAFT WAS EXPORTED TO: NEW PHYSICAL ADDRESS: complete if physical address has changed, or the new mailing address is a PO Box a Mall Drop. OTHER, Specify PLEASE RESERVE N-NUMBER IN THE OWNER'S NAME AND ADDRESS. The 510 reservation fee is enclosed. SIGNATURE OF OWNER 1 (required field) Electroncally Certified by Registered Owners PRINTED NAME OF SIGNER (required field) TITLE 111.t., I'd field) DATE 3/28/2017 SIGNATURE OF OWNER 2 PRINTED NAME OF SIGNER TITLE DATE Use page 2 for additional signatures. Fee paid: $5 (201703281I52554432NB) ..1( • Form 5051 - B (04)12) EFTA00150969 EFTA00150970 OMB Control Number 2120-0729 apices 04/30/I 7 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 click the 'Reset' button to clear the data fields (from page 2 only) to add more names. Repeat action as needed. NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE I PRINTED NAME OF SIGNER TITLE AC Form 8050-113 (04/12) REF N-NUM: 122.IE EFTA00150971 EFTA00150972 > DEBEE GILCH RIST E 6 g V. ATTORNEYS IR COUNSELORS fb a co August 4, 2014 c 9. c) V2 Manager N o Aircraft Registration Branch t Federal Aviation Administration RE: Executive Jet Management; One (1) Keystone Helicopter S-76C; Serial Number 760750; U.S. Registration Number N722JE; Our File Number: 5502.0015 Dear 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, A SrPKA417 Brandt S. Sterling Legal Assistant 1421131527019 $2.00 08/04/2014 EFTA00150973 FILED WITH FAA 4IRM%Fr ;.ECISTRATION BR 2014 RUG 4 PITI 3 26 OKLAHOMA CITY OKLAHOMA EFTA00150974 S Deparf• of Tia•spooation Federal Aviation Administration Date of Issue: August 4, 2014 II l I I I I I... II Flight Standards Service Aircraft Registration Branch, AFS-750 HAND DELIVERED TO 'GIL IN THE PD ROOM WEB Address: http://registry.faa.gov T146046 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. Manager, FAA Aircraft Registry, AFS-750 Federal Aviation Administration AFS-750-FAX4 (01/14) EFTA00150975 EFTA00150976 PRINT PAGE 1 r PRIVACY ACT STATEMENT] OMB Contra Numact 2120-0/29 F-xpats 05/31/2014 Paperwork Reduction Act Statement: Tne information COSeCted on this form is necessary to maintain aircraft registration. Wo estimate that it ma lake approximately 30 minutes to complete the form. Please note that an agency may not conduct or sponsor. and a person is 'Cl required to respond 10. a collection of information unless II displays a valid OMB motto) number. Form Approved. OMB No. 2120-0729 'Comments concerning ine accuracy of this burden and suggestions for aoluaina the burden should be directed to the FAA at: BOO Independence Avenue SW. Washington. DC 20591. ATTN: Information Collection Clearance Officer. AES-200.' DEPARTMENT OF TRANSPORTATION • FEDERAL AVIATION ADMINISTRATION AIRCRAFT REGISTRATION RENEWAL APPUCATION FAILURE TO RENEW REGISTRATION WILL RESULT IN CANCELLATION OF REGISTRATION AND REGISTRATION NUMBER ASSIGNMENT (See 14 C.F.R. §§ 47.15(9, 47.40 end 47.41) AIRCRAFT REGISTRATION NUMBER N 722JE MANUFACTURER Keystone Helicooter DATE OF ISSUANCE August 16.2011 SERIAL NUMBER 760750 MODEL S-76C DATE OF EXPIRATION August 31, 2014 ENTER REGISTERED OWNER(S) & ADDRESS FROM FAA FILE (Owner 1) ASI Wings LLC (Owner 2) Was Enter an additional owner names on o two. (Address) (Address) City State Zip Country Physical Address: Required when mating address is a P.O. Box or mail drop. (Address) (Address) City State Zip Country TO RENEW REGISTRATION: REVIEW aircraft registration information. SELECT the appropriate statement. FRIER any change in address in the spaces below. WO. DATE & SENO form with the $5 renewal fee to the: FAA Aircraft Registry, PO Box 25504, Oklahoma City OK 73125-0504, or by courier to: 6425 S Denning Room 118, Oklahoma City OK 73169.6937 a I (WE) CERTIFY, THE NAME(S) AND ADDRESSES FROM THE FM FILES FOR THE OWNER(S) OF THIS AIRCRAFT ARE CORRECT, OWNERSHIP MEETS CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3. AIRCRAFT IS NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY. El UPDATE THE MAILING I PHYSICAL. ADDRESS AS SHOWN BELOW. I (WE) CERTIFY THE: NAME(S) SHOWN ABOVE FOR THE OWNER(S) OF THIS AIRCRAFT IS CORRECT. OWNERSHIP MEETS THE CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3. AIRCRAFT IS NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY. NEW MAILING ADDRESS NEW PHYSICAL ADDRESS: Complete if physical address has changed, or the new mailing address is a PO Box or Mail Drop. TYPE OF REGISTRATION Corporation HELPFUL INFORMATION Review Aircraft Registration File Information for this aircraft at: htto://reoistry.faaoov/aireraftinouifv. Assistance may be obtained at our web page: htterarechstry laa ativirenearrealaaati0n by telephone a-mail at: SINIMOMMI by al: When mailing fees, please use a check or money order made payable 10 the Fedora; Aviatkin Administration. Signature and Title Requirements for Common Registration Types: • Individual owner must sign, title would be 'owner. Partnership general panne( signs showing 'general partner as Geo. Corporation corporate officer or manager signs, showing full title. - Limited Liability Co authorized member, manager, or officer identified in the LLC organization document signs, showing full title. • Co-owner each co-owner must sign: showing 'co-owner es title. • Government authorized person must sign and show their fun title. Note: All signatures must be in Ink, or other permanent media. To correct entries: Draw a single line through error. Make correct entry In remaksase space. or complete the form on-line. An application form will be rejected If any entry is covered by correction tape or similarly obscured. TO CANCEL THE REGISTRATION FOR THIS AIRCRAFT: gitscK all applicable Mocks below, COMPLETE, Eat!. DATE a may this loan with any fees to the: FAA Aireseft Registry. PO Box 25504, Oklahoma City. OK, 73125-0504, or by courier to: 6425 S Denning Rm. 118, Oklahoma City OK 73169-6937 a CANCELLATION OF REGISTRATION IS REQUESTED. a THE AIRCRAFT WAS SOLO TO: (Show purchaser's name end address.) K THE AIRCRAFT IS DESTROYED OR SCRAPPED. K THE AIRCRAFT WAS EXPORTED TO: o OTHER, Specify PLEASE RESERVE N-NUMBER IN THE OWNER'S NAME AND ADDRESS. The SIO reservation fee is enclosed. SIGNATURE OF OWt 1 puked field) PRINTED NAME OF SIGNER Melinda Westbrook (required field) TITLE (required held) Ass Man Corporals SoCreNIN 01 Aetna Inc.. Minn.( of AS! WINGS, LLC DATE SIGNATURE OF OWNER 2 PRINTED NAME OF SIGNER TITLE DATE Use page 2 for additional signatures. 8 S V m m L C R.1 O A AC Form 8050-I B (04/12) EFTA00150977 FILED WITH FAA IIRCF!ar PEGISTRATION 6R NH JUL 14 FYI 11 16 I OKLAHOMA CITY OKLAHOMA EFTA00150978 DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE006014974 FFR -1B DOC ID 8018 5/1/14 141211307096 $5 5/1/14 EFTA00150979 EFTA00150980 V S Department of Transportation Federal Aviation Administration December 11, 2012 Dear Sirs: Flight Standards Service Aircraft Registration Branch. AFS-750 WEB Address: httpfiregistry.faa.gov 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 11, 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 http://registry.faa.gov. If you have any questions, our toll free telephone number is I anger, rcra egistranon Branch. AFS-750 AFS-750-RE1tEG-14 (09/10) EFTA00150981 EFTA00150982 V S Department of Transportation Federal Aviation Administration October 12, 2012 Dear Sirs: Flight Standards Service Aircraft Registration Branch. AFS-750 WEB Address: ettp:firegistry.faa.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 Manager, Aircraft Registration Branch, AFS-750 AFS-750-REREG-13 (03/11) EFTA00150983 EFTA00150984 Directions: Select and complete the appropriate section below then send. with the indicated fee (if appropriate), to the FAA Aircraft Registration Branch. U.S. Postal Service. Regular and Priority Mail Commercial Delivery Sonic:es: FAA Aircraft Registration Branch FAA Aircraft Registration Branch Make fee payment by check or money order payable to the Federal Aviation Administration. For additional information call toll free or visit hurrfirerristrv.faa.aov . FAX No: Dear Aircraft Registry: K Special registration number N162AE. was not painted on KEYSTONE HELICOPTER S-76C serial number 760750. K I/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 (Mate) Maki I Saul Number) for an N-number change. $20.00 is enclosed to cover both the special number request and assignment fees. On K Special registration number N162AE, was placed on KEYSTONE HELICOPTER S-76C serial number 760750 on ,„„„.1„,. Please issue a revised registration certificate. K The completed and signed Assignment of Special Registration Numbers. AC Fonn 8050-64. is enclosed. K The Assignment of Special Registration Numbers. AC Fonn 8050-64. is lost or destroyed. Please accept this as notice that the authorized N-number change has been completed. Name of Owner: Signature/Title Date AFS-750-REREG-13 (03/11) EFTA00150985 EFTA00150986 0 U.S. Department of Transporlation Federal Aviation Administration ASSIGNMENT OF SPECIAL REGISTRATION NUMBERS Special Registration Number N162AE 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 N162AE - 50174441 ASI WINGS I.I.0 Illmiliiiiiillilikilhillinlimlliiiiiiiiiiiiililiiiiiiii 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 certificate of airworthiness from your near- est Flight Standanls District Office. The latest FAA Form 8130-6, 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 Title of Owner Date Placed on Aircraft: AC FORIN 8050-64 (5/2005) Supersedes Pen ion, Edition EFTA00150987 EFTA00150988 LI Insured Aircraft Title Service, Inc. FEDERAL AVIATION ADMINISTRATION CENTRAL RECORDS DIVISION OKLAHOMA CITY, OKLAHOMA Date: August 26, 2011 Dear Sir/Madam: Please Reserve N in NAME ONLY for: Please Reserve N 162AE• 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 112381430478 $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: Nikala Aun a Jones Fee: $10.00 EFTA00150989 FILED WITH FAA AIRCRAFT RECISTRATI011 DR 2011 AUG 26 NI 1 56 OKLAHOMA CITY OKLAHOMA EFTA00150990 FORM APPROVED OMB No. 2120-0042 UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION-MIKE MONRONEY AERONAUTICAL CENTER AIRCRAFT REGISTRATION APPLICATION I I1 CERT: ISSUE DATE j i i ' UNITED STATES REGISTRATION NUMBER N 722JE AIRCRAFT MANUFACTURER & MODEL Keystone (Sikorsky) S-76C AIRCRAFT SERIAL No. 760750 FOR FAA USE ONLY TYPE OF REGISTRATION (Chock One box) I i O1. Individual O 2. Partnership eg 3. Corporation 0 4. Co-Owner 0 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.) ID ASI Wings, LLC TELEPHONE NUMBER: ADDRESS Number Rural Route: (Permanent mailing address for first applicant on list) (If P.O. Box is used, physical address must also be shown.) and street: P.O. Box: CITY STATE ZIP CODE O A false 11 1 I/WE CERTIFY: (1) That of the (For CHECK CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE ATTENTION! Read the following statement before signing This portion MUST be completed. or dishonest answer to any question In this application may be grounds for punishment (U.S. Code. Title 18. Soc. 1001). CERTIFICATION OF ADDRESS this application. by fine and/or Imprisonment corporations) ) or: the above aircraft is owned by the undersigned applicant, who Is a citizen (Including United States. voting trust, give name of trustee: ONE AS APPROPRIATE: or Fonn 1-551) No. a. b. (2) That (3) That TYPE A resident alien, with alien registration (Form 1-151 A non-citizen corporation organized and doing and said aircraft is based and primarily used in inspection at business under the laws of (state) the United States. Records or flight hours are available for the aircraft is not registered under the laws of any foreign country: and legal evidence of 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 it necessary. OR PRINT NAME BELOW SIGNATURE EACH PART OF THIS APPLICATION MUST BE SIGNED IN I . SI NATURE- Allstant Corporate ecretary of Aetna Inc. DATE ,7 -..210- 0 SIGNA Melinda Westbrook MaAaging Member of ASI Wings, LLC DATE SIGNATURE TITLE DATE NOTE Pending receipt of the Certificate of Aircraft Regis ration, 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 carried In the aircraft. AC Form 8050-1 (1/09) (NSN 0052-00-628-9007) Supersedes Previous Edition EFTA00150991 FILED WITH FA A AIRCR t.FT REGISTRATION BR 2011 JUL 26 811 11 58 OK L A HOP1A CITY OK I A FCOMA • go EFTA00150992 WARRANTY BILL OF SALE 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-H-) bearing Manufacturer's Serial No. 760750 and U.S. Registration No. N722JE, with two (2) Turbomcca 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 IR , 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"); provided, 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 THE PRECEDING SENTENCE, THE AIRCRAFT IS HEREBY SOLD TO PURCHASER 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 )(,. day of July, 2011. FREEDOM AIR INTERNATIONAL, INC. By: flAJC.0-.A.V . ,, Name: O. O...t Title: Vi .te ci 112071217388 $5.00 07/26/2011 0 O N a CO 0 0 3 3 0 ro a EFTA00150993 FILED WITH FAA AIRCRAFT RLc STR ATION BR 2011 JUL 26 RIl 11 58 OXLAHOOA CITY OKLAHOMA EFTA00150994 FORM APPROVED OMB No. 2120-0042 UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION FEDERAL. AVIATION ADMINISTRATION-MIKE MONRONEY AERONAUTICAL CENTER AIRCRAFT REGISTRATION APPLICATION CERT: ISSUE DATE 6 ft) -0 Er a. a > c co N cn i1.) O-. O UNITED STATES REGISTRATION NUMBER N —7 a e-- Al • RAFT MANUFACTUR 5c (S i Vows Vti 8 MODEL +ode lie/ copkr Cam- -7 AIRCRAFT SERI No. -7 6 C -7 SO FOR FAA USE ONLY TYPE OF REGISTRA O1. Individual O 2. Partnership 0 8. Non-Citizen Corporation heck One box) . Corporation 04. Co-Owner ' 0 5. Government Co-Owner NM 9. Non-Citizen Corporation NAME OR APPLICANT (Person(s) shown on evidence of Ferec a o,,,,_ Ai r TELEPHONE NUMBER: ( ) ownership. If individual, give last +--tv-vtecf-iobtct.( name. first name, and middle initial.) ..... k ran c • mar, ADDRESS (Permanent mailing address for first applicant on list) (If P.O. Box is used, physical address must Number and street: Rural Route: P.O. Box: also be shown.) CITY O CHECK HERE ATTENTION! Read A Nese or dishonest answer to I/WE CERTIFY: (1) That the above aircraft is owned of the United States. (For voting trust, give name " CHECK ONE AS APPROPRIATF• STATE IF YOU ARE ONLY REPORTING A CHANGE the following statement before signing This portion MUST be completed. any question In this application may be grounds for punishment (U.S. Code, Title 18. Sec. 1001). CERTIFICATION ZIP • • OF ADDRESS this application. - by fine and/or imprisonment corporations) 1. Or: by the undersigned applicant, who is a citizen (including of trustee: or Form 1-551) No. a. b. (2) That (3) That TYPE A resident alien, with alien registration (Form 1-151 A non-citizen corporation organized and doing and said aircraft is based and primarily used in inspection at business under the laws of (state) the United States. Records or flight hours are available for the aircraft is not registered under the laws of any foreign country; and legal evidence of ownership Is attached or has been filed with the Federal Aviation Administration. NOTE: If executed for co-ownership all applicants must sign. Use reverse side if necessary. OR PRINT NAME BELOW SIGNATURE EACH PART OF THIS APPLICATION MUST BE SIGNED IN INK. SIGNATURE \ TITLE \A re SPv ac,i cke 4 - DATE a io SIGNATURE .c_ TITLE 102280834295 DATE SIGNATURE TITLES& DO 0-8/16/2010 DATE NOTE Pending receipt of the Certificate of Aircraft Regis ration, 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 carried in the aircraft. . AC Form 8050-1 (1/09) (NSN 0052.00.628-9007) Supersedes Previous Edition EFTA00150995 . . • EFTA00150996 DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE001916668 name change rev/doi 022709 EFTA00150997 EFTA00150998 U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION CROSS-REFERENCE—RECORDATION RECORDED CONVEYANCE FILED IN: NNUM: SERIAL NUM: MFR: MODEL: MR CARRIER: This form is to be used in cases where a conveyance covers several aircraft and engines. propellers, or locations. File original of this form with the recorded conveyance and a copy in each aircraft folder involved. TYPE OF CONVEYANCE NAME CHANGE DATE EXECUTED FEBRUARY 11, 2010 FROM AIR OHISLAINE INC DOCUMENT NO. TO OR ASSIGNED TO SHMITKA AIR INC DATE RECORDED MARCH 17. 2010 THE FOLLOWING COLLATERAL IS COVERED BY THE CONVEYANCE: Total Aircraft: Total Engines: Total Props: Total Spare Pans: tES-750-23R (ODOR) EFTA00150999 EFTA00151000 0 u.s. OfeatenWat a vasosoortioon Federal Aviation Administration ASSIGNMENT OF SPECIAL REGISTRATION NUMBERS Special Registration Number N7221E Aircraft Make and Model KEYSTONE HELICOPTER S-76C Present Registration Number N750A Serial Number 760750 Issue Date: Mar 10, 2010 ICAO AIRCRAFT ADDRESS CODE FOR N722JE - 52325707 AIR GHISLAINE INC i.,. ID il i toe i it' I 8' to s I to ilitelsIll This is your authoriy to change the United States miss:scion number on the above described admit to the special C registratioo number shown. t arly duplicate or bi ram in the aircraft together wi-h the old registration certificate as interim authority tooperate the aircraft pending receipt of revised certificate of regishatica Obtain a revised ectificate of airworthiners from your nue- est Flight Standard :District Office. The latest FAA Form 81304, Application For Airworthiness on file is dated: Jan 14, 2010 The airworthiness classification sad category: FJCPERIMENU INSTRUCTIONS: SIGN AND RETURN THE ORIGINAL of this form to the Civil Aviation Registry, AFS-750, van= 5 days atter lute special registration number is placed on the aircraft. A revised certificate will then be issued. The authority to use the special number expires: Mar 10, 2011 CERTIFICATION: I certify on the groan desaibed abo Signature of that rehisiwii00 minter was Plated for Shmitka Air, 1 Jac- RETURN FORM TO: ivil Aviation Re i , AFS-750 D reel TidedOmml Shmitka —Ktr—shisIaineffnc. ,..T r of Operations of Air, Inc. f/k/a - ' Date Placed on Aircraft: 2A . I 5, 20/0 AC FORM ileSci-64 (5/2005) Stspenede Previous FAIden 8 0 0 a 0 N EFTA00151001 FILED WITH FAA AIRCRAFT RECISTRATICq CR 2010 f9118 16 Pfl 1 15 OKLAHOMA CITY OKLAHOMA EFTA00151002 AMCRAFTnme SEARCHES RECORDING SERVICES AIRMEN RECORD INFORMADON February 11, 2010 Hand Delivered To: FAA Oklahoma City. Oklahoma Attention: Gentlemen: On behalf of our client: AIR GHISLAINE INC. Please initiate the following action: Aero Records & Title Co. FORM 8050-64 URGENTLY NEEDED! PLEASE ISSUE AS QUICKLY AS POSSIBLE. THANK YOU!!! Please ASSIGN special registration number N7223E, which is reserved for our client, to the following described aircraft which is registered in their name: KEYSTONE HELICOPTER 8-76C SERIAL NUMBER 760750 CURRENTLY N750A PLEASE HAND THE ORIGINAL FORM 8050-64 TO ARTC - P.D. ROOM. Thank you. 100431322316 $10.00 02/1212010 o PLEASE HAND CONFIRMATION OF RESERVATION LETTER TO ARTC - PUBLIC DOCUMENTSROOM. \li llh PLEASE HAND ORIGINAL FORM 6060-64 TO ARTC - PUBLIC DOCUMENTS ROOM. ankyOU. AERO RECORDS &TITLECC ek. L--Sijleka By: LISA THOMAS GASKIN/Senior Administrator, Special Services /1g Fee Attached' $10.00 CC: Christopher Shurkus Sikorsky Aircraft O a 3 ?, 7:4 O EFTA00151003 FILED.WITWIFAA AIRCRAFT REGISTRATION aR 2010 FEB 12 P19 1 20 OKLAHOMA CITY OKLAHOMA EFTA00151004 FORM APPROVED OMB No 2120-0042 UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION AtialeleSTRATION-ISKE IIIONNOINEV JuDIONAUNICAL CENTER AIRCRAFT REGISTRATION APPLICATION CERT. ISSUE DATE UNITED STATES SI REGISTRATION NUMBER 750A AIRCRAFT MANUFACTURER & MODEL Key 54 o n e 14 e /.<0 p -pie (- --5 -444e -r-s -k-1, — A -4- rertrFt S-76C-2 AIRCRAFT SERIAL No. 760750 FOR FAA USE ONLY TYPE OF REGISTRATION (Check one box) 0 1. Individual O 2. Partnership 19 3. Corporation O 4. Co-owner O 5. Gov't. O 8." °^Calizert Corperallon NAME OF APPLICANT (Person(s) shown on evidence of ownership. If individueJ, give last name, first name, end middle Initial.) Air Ghislaine, Inc. TELEPHONE NUMBER: ADDRESS Number Rural (Permanent missing address lot first applicant Meted.) (If P.O. BOX is used, physical address must also be shown.) and street: Route: P,O. Box CITY O A false (U.S. ID SANE (1) That of (For CHECK STATE CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE ATTENTION! Read the following statement before signing This portion MUST be completed. or dishonest answer to any question in th-s application may be grounds for punistamont Code, The 18, Sec 1001). CERTIFICATION this application. by fine corporations) ZIP CODE OF ADDRESS and i or I mpensonment ) or CERTIFY: the above Wendt is owned by the undersigned applicant, who is a citizen (including the United States. voting trust, give name of trustee: ONE AS APPROPRIATE: 1-151 or Form 1.551) No. a. b. (2) That (3) That TYPE O A resident alien, with ration registration (Form 0 A non-citizen corporation organized end doing and Saki aircraft is based and primarily used In inspection at business under the laws ol (state) the United States Records or 'tight hours ate Administration. side if available for necessary. GATE i 10242451 0 8 . the aircraft Is not registered under the laws of legal evidence of ownership is attached or has NOTE: II executed for co-ownership all OR PRINT NAME E SI NATURE any foreign country: and been filed with the Federal Aviation applicants must sign. Use reverse TITLE IteCAA- 7 bi 4491 160 EACH PART CF THIS APPLICATION MUST BE SIGNED IN INK SeGNATURE ca r J5051(11 . SIGNATURE L.P44 1-9 vt5OSN 4A. TITLE DATE SIGNATURE TITLE Ciatialfr43 ia 131 $5.00 02/17/2009 an NOTE Pending receipt of the Cereffable of Aircraft Registration, Me aircraft may be operated for a period not in excess of 90 days, during which lime the PINK copy of this application must be carried in the aircraft. 0 0 tD -cs CD CD IS 1%..) 0 0 AC Form 80661 (5/03) (0052-00-828-9007) EFTA00151005 ••• '711, C• • "In • !vimo 130. "?: Wd Ll-'933 8002 31)%"...; 1.O1,220UIV \WA ad EFTA00151006 UNITED STATES OF AMERICA U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION AIRCRAFT BILL OF SALE FOR AND IN CONSIDERATION OF $ THE UNDERSIGNED OWNER(S) OF THE FULL LEGAL AND BENEFICIAL TITLE OF THE AIRCRAFT DESCRIBED AS FOLLOWS: UNITED STATES REGISTRATION NUMBER N 750A AIRCRAFT MANUFACTURER 8 MODEL Sikorsky Aircraft S-76C-2 AIRCRAFT SERIAL No. 760750 DOES THIS 304.4- DAY OF December 2008 HEREBY SELL. GRANT. TRANSFER AND DELIVER ALL RIGHTS, TITLE, AND INTERESTS IN AND TO SUCH AIRCRAFT UNTO: FORM APPROVED OMB NO 2120-0042 08/31/2008 Do Not Write In This Block FOR FM USE ONLY PURCHASER NAME AND ADDRESS (IF INDIVIDUAL(S). GIVE LAST NAME. FIRST NAME. AND MIDDLE INITIAL.) Air Ghislaine. Inc. 083651547221 $5.00 12/30/2008 DEALER CERTIFICATE NUMBER AND TO its successors gnetaltibesIeS. AND ASSIGNS TO HAVE ANO TO HOLD SINGULARLY THE SAID AIRCRAFT FOREVER AND WARRANTS THE TITLE THEREOF: IN TESTIMONY WHEREOF r HAVE SET MY HAND AND SEAL THIS DAY OF December. 2008 LU -1 -1 U) NAME(S) OF SELLER (TYPED OR PRINTED) SIGNATURE(S) (IN INK) (IF EXECUTED FOR CCI-OWNERSHIP, MUST SIGN ) Sikorsky Aircraft Corporation TITLE (TYPED OR PRINTED) S-76 Program Manager Chns Shurkus ACKNOwLEDGPAENT (NOT REQUIRED FOR PURPOSES OF FM RECORDING: HOWEVER. MAY BE REQUIRED BY LOCAL LAW FOR VALIDITY OF THE INSTRUMENT.) ORIGINAL TO FAA AC Form 8050-2 (9/92) (NSN 0052-00.629.0003) Supersedes Previous Edition 0 O a N 0 7 7 n 8 a L. co 0 8 A EFTA00151007 FILED WITH FAA AIRCRAFT REGISTRATION BR 2008 DEC 30 HI 3 40 OKLAHOMA CITY OKLAHOMA ocis Ir n 1s S. sa too'. "0\ Neo \co ovofreu, .430 01:0 1)° ;1.‘de3 EFTA00151008 DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE000740071 ORIG DOC ID #0070 FFR 12-30-08 RET TO C&D EFTA00151009 EFTA00151010 UNITED STATES OF AMERICA U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION AIRCRAFT BILL OF SALE FOR AND IN CONSIDERATION OF $1fiatre THE UNDERSIGNED OWNERS) OF THE FULL LEGAL AND BENEFICIAL TITLE OF THE AIRCRAFT DESCRIBED AS FOLLOWS: UNITED STATES REGISTRATION NUMBER N 750A AIRCRAFT MANUFACTURER & MODEL Keystone Helicopter Corporation S-76C AIRCRAFT SERIAL No. 760750 DOES THIS J u HEREBY SELL, GRANT, TRANSFER AND DELIVER ALL RIGHTS, TITLE, AND INTERESTS IN AND TO SUCH AIRCRAFT UNTO: DAY OF ( • . FORM APPROVED OMB NO. 2120-0042 08/31/2008 Do Not Write In This Block FOR FM USE ONLY PURCHASER NAME AND ADDRESS (IF INDWIDUAL(S), GIVE LAST NAME. FIRST NAME. AND MIDDLE INITIAL.) Sikorsky Aircraft Corporation DEALER CERTIFICATE NUMBER AND TO StateSSOLS LUCA/TOWS monnorMtmleR6. AND ASSIGNS TO HAVE AND TO HOLD SINGULARLY THE SAID AIRCRAFT FOREVER AND WARRANTS THE TITLE THEREOF: IN TESTIMONY WHEREOF HAVE SET my HAND ANO SEAL THIS O DAY OF L.CC. 211U LU -1 LLI C/) NAME(S) OF SELLER (TYPED OR PRINTED) SIGNATURE(S) (IN INK) (IF EXECUTED FOR CO-OWNERSHIP. ALL MUST SIGN ) TITLE (TYPED OR PRINTED) Keystone Helicopter Corporation fraC7.74 President David A Ford ACKNOWLEDGMENT (NOT REQUIRED FOR PURPOSES OF FM RECORDING HOWEVER. MAY RE REQUIRED BY LOCAL LAW FOR VALIDITY OF THE INSTRUMENT.) ORIGINAL' TO FM: AC Form 8050-2 (9(92) (NSN 0052-00-829-0003) Supersedes Previous &MICR B- '0 O O UI 0 0 a CD L EFTA00151011 FILED WITH FAA AIRCRAFT REGISTRATION BR 2008 DEC 30 HI 3 40 OKLAHOMA CITY OKLAHOMA EFTA00151012 DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE000740069 ORIG DOC ID #0068 FFR 12-30-08 RET TO C&D EFTA00151013 EFTA00151014 Dec 22 2008 3:24PM HP LASERJET FAX P • 2 Keystone Helicopter A Sikorsky Canpany December 22, 2008 Flight Standards Service Aircraft Re 'suasion Branch, AFS-I SO fel re blif FIMA Keystone Helicopter Corporation is requesting the correction of aircraft that what incorrectly registered. Some of the aircraft that have been registered from our facility where registered as MODEL: S-76C-2, this is not in accordance with our type certificate data sheet (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 Number Aircraft N Number u2760686 718P C011,760690 759P g2760704 23W 4151' 7571' 714F 767.1 (,760720 720G 723Y 753P 799V 781X 741A 743N 7456 746K 747Y 748A 750A 75 E 753V Regards, Shaun M. Gebhard S76 Quality Assurance Production Supervisor g/760704...a> e 60711 760714 60717 cq,I60723 Q11760726 G760729 W/760731 ,760741 60743 60745 60746 1'760747 60748 (6760750 7W,60751 Ce,760753 EFTA00151015 EON DEC 22 IT( 3 00- OKLAHOMA CITY • • OKLAHOMA EFTA00151016 MEMORANDUM TO THE FILE JINNY ROSALES 09/9/2008 ID DATE A Prior Record search was performed for KEYSTONE HELICOPTER CORP S-76C-2, 760750 on 9/9/2008. Search results: No Prior Record Assigned N25DA EFTA00151017 EFTA00151018 V S Department of Transportation Federal Aviation Administration September 9, 2008 Il Iu uullunlliuli 11tH iilrri Dear Sirs: Flight Standards Service Aircraft Registration Branch. AFS-750 WEB Address: httpfiregistry.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 manufacturer's assignment of special registration number cannot be used as an authorization for a number change. If w m ffrthr i n l ntact the Aircraft Registration Branch at Sincerely, Legal Instruments Examiner Aircraft Registration Branch AFS-750-SUPPORT-5 (9/04) EFTA00151019 EFTA00151020 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 & assignment of the following special registration numbers to the aircraft described below which are presently under manufacture: ALL ARE KEYSTONE HELICOPTER CORP., MODEL S-76C-2 REGISTRATION NO. SERIAL NO. N741A 760741 N743N 760743 N745G 760745 N746K 760746 N747Y 760747 N748A 760748 / N750A 760750j N751E 760751 N753V 760753 Thank you. Sincerely, KEYSTONE HELICOPTER CORPORATION By: S76 Program Manager CP3;\ COPY EFTA00151021 VIVOL:V13/0 ADO yr 1V1)10 TS IT Wb S d3S SOO? as NOI.MIC •.; 1.1VUOUIV EFTA00151022 AIRCRAFT TITLE SEARCHES RECORDING SERVICES AIRMEN RECORD INFORMATION September 5, 2008 Hand Delivered To: FAA Oklahoma City, Oklahoma Attention: Central Records Gentlemen: On behalf of our client: KEYSTONE HEL Please initiate the following action: 4: a 117,4,.. IfiC.e7 • 4l.fr taivairxtir- -7 le- CTION Please RESERVE and assign the following NINE (9) special registration numbers to the aircraft listed below which are presently under manufacture: ALL ARE KEYSTONE HELICOPTER CORP., MODEL S-76C-2 REGISTRATION NO. I N741A A N743N 1 N745G 4 N746K N747Y N748A N750A N751E q N753V SERIAL NO. 760741 760743 760745 760746 760747 760748 760750 760751 760753 PLFACE ISSUE FORM AFS-750-SUPPORT-5 TO THE MANUFACTURER, KEYSTONE HELICOPTER CORP., AT THE ADDRESS SHOWN ABOVE. PLEASE HAND COPIES OF THE MANUFACTURER ASSIGMENT LETTERS TO ARTC - P.D. ROOM. Note: Enclosed is a "fax" letter by the manufacturer, confirming their need for these assignments. Thank you. 0824g1212072 590.00 CO/05120W XI PLEASE HAND CONFIRMATION OF RESERVATION LETTER TO ARTC - PUBLIC DOCUMENTS ROOM. CC`r:72 - co- — tctett-- 9(--0 - \X5 PLEASE HAND OR401 -050-e4 TO ARTC - PUBLIC DOCUMENTS ROOM. Thank you. AERO RECO By: LI THOMAS GASKIN/Senior Administrator, Special Services /19 • FeeAUSOMW:$94),‘";) CC: Carl Kress Keystone Helicopter Corp. ro L Ay 0 § EFTA00151023 FILE!: .8 11.1 FAA AIRCRAFT E .: V.;TRATICM RR 2008 SEP 5 API 11 51 OKLAH . ..IA CITY OKLAFIUMA EFTA00151024