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Get FAA 8110-12 2020

Send comments regarding this burden estimate or any other aspect of this collection of information including suggestions for reducing this burden to Information Collection Clearance Officer Federal Aviation Administration 10101 Hillwood Parkway Fort Worth TX 76177-1524 Tear off this cover sheet before submitting this form. FAA Form 8110-12 05-18 Supersedes Previous Edition INSTRUCTIONS FOR COMPLETION OF FAA FORM 8110-12 blocks as follows need to be filled out for each type of certificate. U.S. Department of Transportation Federal Aviation Administration INFORMATION FOR APPLICANT APPLICATION FOR TYPE CERTIFICATE PRODUCTION CERTIFICATE OR SUPPLEMENTAL TYPE CERTIFICATE Privacy Act Statement Information on FAA Form 8110-12 Application for Type Certificate Production Certificate or Supplemental Type Certificate is solicited under the authority of 49 U.S.C. 44103 as implemented by 14 CFR Part 21. The purpose of this information is to evaluate an applicant s application for a Type Certificate is mandatory and will become part of the Privacy Act system of records DOT/FAA 801 Aircraft Registration System* Incomplete submission may result in delay or denial of your request. Information maintained in the Privacy Act system of records is routinely used to 1 provide aircraft owners and operators information about potential mechanical defects or unsafe conditions of their aircraft in the form of airworthiness directives 2 locate specific individuals or aircraft for accident investigation violation or safety related requirements 3 prepare an Aircraft Registry in magnetic tape and microfiche form as required by ICAO agreement containing information on aircraft owners by name address United States Registration Number and type of aircraft and 4 DOT Prefatory Statement of General Routine Uses. Paperwork Reduction Act Statement A federal agency may not conduct or sponsor and a person is not required to respond to nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0018. Public reporting for this collection of information is estimated to be approximately 48 minutes per response including the time for reviewing instructions searching existing data sources gathering and maintaining the data needed completing and reviewing the collection of information* All responses to this collection of information are required to obtain or retain benefits per 14 CFR Part 21. Blocks 1 2 3 4 5 6 and 8 for a TC or Amended TC Block 1. Enter the name of the party corporation or organization to whom the TC Amended TC PC STC or Amended STC will be issued* The name will appear on the certificate exactly as it is entered here. NOTE Only the TC holder can either apply to amend the original TC or apply for an STC. If a person is not the TC holder that person must apply for an STC Refer to 14 CFR 21.

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