-;:? - :_sr - RECORD OF OWNERSHIP. 1-d-Y-?~ (CITY & STATE. ( TY & STATE) (CITY & STATE) (STREET A DRESS) (DATE PURCHASED) (DATE SOL D) (STREET ADDR
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2 RECORD OF OWNERSHP ( TY & STATE) (STREET A DRESS) ;:? :_sr (DATE PURCHASED) (DATE SOLD) (OWNER) (STREET ADDR r 1dY? (CTY & STATE. (DATE PURCHASED) (DATE SOL D) (STREET ADDRESS) (CTY & STATE) d;) / Y (DATE PURCHASED) (DATE S LD)
3 ( /o... MANU (DATE PURCHASED) () 3 S/ (DATE SOL D)?d7./S7 REG S...: 3:_d. j ;1.D:...::.:::RSS t; Y J 1 MAXl1\1l (DATE PURCHA D) (DATE SOLD) ENGNE (OWNER) (STREET ADDRESS) fcty & ST ATE) (DA TE PURCHASED). (DA TE SOLD) PROPELJ
4 ARCRAFT DAT A (THS PAGE MU ST BE FLLED OUT COMPL ETELY) MA UFACTURER MODEL _5. st SER AL NO. S REGSTRATON NO. DATE MANUFACTU RED MAX l taua WEGHT TYPE ENG1t1E MAKE 0 {.. \:> ) PROPELLER: WlAKE MODEL BLADE tv\odel
5 ARCRAFT LOG EA ;"4 DAY RECORDNG TACH. READNG TME TH S FL GHT SGNATURE YEA MO \ \ \. TS T CARRY TOTAL TME TO TOP OF NEXT PAGE
6 ARCRAFT LOG MO. DAY DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certificated mechanics or repair facilities must endorse al inspections and repairs with name re1ting & Cert. No. CERTFY AT THS ARCRAT HAS BEENr N ARWORTHY CONDTON. Ali.AN HATZ
7 kj\(\ $: SER. NO (t?.! v... TYPE q.. NSPECTONS ARE DUE EVERY 12 CALENDER MONT HS
8 SGNATURE YEA MO ClJ STOMER l. } h JV\ S.... ADDRESS NST.../J! R..S.f.{.(.Ja.... SER. NO. / G. NO.. fl. :e..ct.j. r. ). A.f. ( TYPE?(. <? i " q N SPECT ONS ARE DUE EVERY 12 CALENDER MONTHS
9 A RCRAFT LOG MO. DAY REC ORDNG TACH. READNG TME THS FLGHT.. TOTAL TME \ of REMARKS S1GNATURE? t. t Jr 1 f 1 hl/c z CARRY TOTAL TME TO TOP OF NEXT PAGE
10 ... ARCRAFT LOG YEAR... ( l MO. DAY etif1catd m echanics or redair facilities must endorse al 1 1 nsect1o n s and repairs with name rating & Cert. No. "1.. ( i /.f.?/" JJ y Cl /!l rt?=:) ;:::ii: JJ..vl./... /r V.". J J L / 1 /..td./ l 7 /./.. / (i....;:i ). t K... j 11 4 f 1". 7 7 ff ; t.; / t. i /.. _.. J ;. rij_ o / l. "... l ) 7 A3 /) q (J?" " 1 X aj.e t TfA :; 19.3 / / e h../.o... 1vz avikua. 1 o r.. ((.; 9 /1 e LVrik /4 p 13 foc( 0 [ ff(.. frvi f J o K uf kj ; 5 l 111/\ e. re Fno v er d.. t. c..k 1 0 (A. Jf j Y..e1? /Ja..41/2 O<V J ( ( la t J c : : +o i/ 4u f<... O : H E /. /" p t.... ti( Ct 1...e tr. / / / Ye Jaifl LJ e 2 a lk.cli. rviat../.e..ia ""c e "Ci. _..) af (// 0 l.j i\ l tt A v/( JA ). s a f o )< 11 Jt ( Lt+ Ex ok 74) 1 11 {(_"tj r... T. /) r_ t.. e 1rf.i /; + h. C<. ; "C lrw ft hu s v l e 0 V"l a 1 h.(l.. A " r r... / A. G/ct n/ r. t J / ) cc. + (() /) a h. Pf 1../ l. J +v. " / "Z_ { (. 1V "i:... a c rfv(..._f /u. ; J V\.vli l1. /#/7 : :: 1 7b «NSPECTONS ARE DUE EVERY 12 CALENDER MONTHS
11 ARCRAFT LOG YEAR RECO RD NG TACH. MO. DAY READNG TME THS FLGHT SGNATURE YEAR MO. f f/. tt::..r 7 C.!!=:;::(_) ":...# 1 t CARRY TOTAL TME TO TOP OF NEXT PAGE
12 ARCRAFT LOG YEAR MO. DAY DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certificated mechanics or recair facilities must endorse all inspections and repairs with name rating & Cert. No.! ;; t r.1.:.1. 1 r r! ". : "" :: v :. l M!NED TO Be ( ":r._.. _J TON.. p.. t0"th\;... CALENDER MONTHS
13 ARCRAFT LOG YEAR f MO. DAY RECORDNG TACH. READNG TME THS FLGHT TOTAL TME REMARKS SGNATURE YEAR MO. DAY
14 = t ARCRAFT LOG YEAR M O DAY DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certi fi coted mechanics or redair foci ities must endorse al inspections and repairs with name rating & Cert. No. a =;:;;:. :n Q CERTFY THAT THS AlCRAFT WAS NSPECTED N ACCORD A" CE WlTH A l.p.i.._... l..j j_ TON. NSP. A UTTOR NSPECTONS ARE DUE EVERY 12 CALENDER MONTHS
15 ARCRAFT LOG YEAR MO. DAY RECORDNG TACH. READNG TME THS FLGHT J l.r.. 2KL CARRY TOTAL TME TO TOP OF NEXT PAGE
16 ARCRAFT LOG YEAR MO. DAY eta acatd mechanics or recair tacilities must endorse al inspections and repairs with name rc1ting & Cert. No. p" AL /.U! p. TME.A.J... HOURS TOTAL TME.HOU 4!J$Ctt. OU UVA:L. lf4!:4> t<.tl3n ANO FOUND lt F At<.... liy<.. :Ti:; e: tt:jf a"/ "1f../b? / L4$L/... "5 R. {( " " //ZL./.. Pl&? s.. Al L ti {.U t:::: 1 NSPECTONS ARE DUE EVERY 12 CALENDER MONTHS
17 YEAR MO. 1:Y.i DAY RECORD NG TACH. READ NG TME TH S FLGH T <;?. r 5 z... " ). j.. J. e. TOTAL TME Al RCRAFT LOG REMARKS "1 A e 7. /.1L./. _)if : /1 c _. \.5 "" /)" L t } //(_ r :;.. A " $ 5 ; r f 7 ic1 r... ; / :Pitolt 1 S G A m K4/Js t. 7 (.!. ( _ CARRY TOTAL TME TO TOP OF NEXT PAGE
18 E YEAR MO DAY ARCRAFT LOG DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certificated mechanics or redair facilities must endorse all inspections and repairs with name roting & Cert. No. / L c:;ej 6 /72/17/J tv!1 r G:Ek 0/.SC::. RAKt ( NSPECTONS ARE DUE EVERY 12 CALENDER MONTHS
19 YEAR _)6&fo RECORD NG TACH. MO. DAY READNG ME THS FLGHT TOTAL TME REMARKS SGNATUP.E YEA tlo (J f e_ ;J ) f J r 14 ; /J " e l i.._ Cl l e \ 6 L 5 L vl>. s u.f L Q "" y J f Co \;.P r (..U.c:) "..... CARRY TOTAL TME TO TOP OF NEXT PAGE
20 YEAR MO. DAY. A RC RAFT LOG DESC RPTON OF NSPECTONS REPARS AND ALTERATONS Cert ifi c ated mechanics or repair facilities must endorse al l inspec tions and repairs with name rating & Cert. No. NSPECTONS ARE DUE EVERY 12 CALENDER MONTHS
21 A RCRAFT LOG r YEAR RECORDNG TME TOTAL TACH. TH S T ME MO. DAY uwe Lf READNG rrad FL GHT o"ldi......a..... REMARKS j j1 b SGNATURE J ". 7 l r1 /... A L " ( 1 (._ /""" C. <._ j > i} \_ v.._ /} Vii f" 4 N1:>1 v f: v \.. ( r la.) A C f1 r : h r J /. 4 A { / / /) u c.u J?.n ; n /). /. J... t f :... J A/C 11 / YL. J lj r.... r y " "" r kl.. _....) / f ;1J.. \ / Li j /... \ _ /). et: J.r " l 71_.. (j/ J f j _? A. A C r " t \ r ) _.. 1 L J /...Q ( (/< v t{_ 1... /; !\" /? A c... \ l/ {>. CARRY TOTAL T ME TO TOP OF NEXT PAGE _...
22 YEAR ;)CJo < ARCRAFT LOG z MO. DAY DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certificated mechanics or redair faci lities must endorse al inspections and repairs with name rating & Cert. No. JJt.te... i r. AJ ccor c 0 (.(). Y EVERY 12 CALENDER MONTHS
23 ARCRAFT LOG YEAR RECORDNG T ME TOTAL TACH. TH S TME REMARKS SGNATURE MO. DAY READNG FLGHT " Yt?Ft> 0 i/t c :z_ D CP1frt.CO 701 t{.. 7;4; N" l rt/r6 ; fc P1?z :> l i Lo Cc LZ k / "i _ s. {. r1 Ml;._ ii L /j0 ). l. HA4 :is...)j ; t (O>l}tQ_... C.c "; y ;H/f; /./15 _. r.rt5. tz" \. 1lo l F)/6f E 4>1 /J.H.tL {. \ fls V) lie < W.. i ft1?bz...rtvy Z) is i }10y &..if/y. C.l/1. i _2. Jt}/!: :> "J. < vo " 35 (/ 3..iti "... ) CARRY TOTAL TME TO TOP OF NEXT PAGE
24 ARCRAFT LOG YEAR MO. DAY DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certificated mechanics or reoair facilities must endorse all inspections and repairs with name rc1ting & Cert. No.... J A r _ 1t a T29_:! [LU::U \ c. L.... AJ " ==::::"" o...:.... (2_ ec
25 ARCRAFT LOG YEAR 1 = RECORDNG TACH. READNG TME THS FLGHT "TOTAL TME REMARKS SGNATURE YE Mi a L w l.... s l }(o Prr< rll \ \ CARRY TOTAL TME TO TOP OF NEXT PAGE
26 YEAR MO. DAY ARCRAFT LOG DESCRPTON OF NSPECTONS REPARS AND ALTERATONS Certificated mechanics or reoair facilities must endorse all inspections and repairs with name rating & Cert. No..L:...:.L; ( \o \ 1 \ il_ c_ t p C _!loc;vcl:::_ji"t::. =.: = < " D 1\l lor b / DUE EVERY NSPECTONS ARE 12 CALENDER MONTHS
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