UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION AOMPiU IHAIHJH-IBKE MONRONEY AERONAUTICAL CENTER AIRCRAFT REGISTRATION APPLICATION UNITED STATES REGISTRATION NUMBER N AIRCRAFT MANUFACTURER & MODEL Hneywell Internatinal AIRCRAFT SERIAL N. 07020323 grav TYPE OF REGISTRATION (Check ne bx) FORM APPROVED 0M8 N. 2120-0042 CERT. ISSUE DATE FOR FAA USE ONLY > 0 0 (D T3 f+ (t a c_ c 1. Individual 2. Partnership g 3. Crpratin 4. C-wner 5. Gvt. 8. NAME OF APPLICANT (Persn(s) shwn n evidence f wnership. If individual, give last name, first name, and middle initial.) Hneywell Internatinal TELEPHONE NUMBER: (505 ) 828~5000 ADDRESS (Permanent mailing address fr first applicant listed.) (If P.O. BOX is used, physical address must als be shwn.) Number and street: 9201 San MateO Blvd NE Rural Rute: CITY Albuquerque STATE NM P.O. Bx: ZIP CODE B7113-2227 CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE OF ADDRESS ATTENTION! Read the fllwing statement befre signing this applicatin. This prtin MUST be cmpleted. A false r dishnest answer t any questin in this applicatin may be grunds fr punishment by fine and I r imprisnment (U.S. Cde, Title 18. Sec. 1001). l/we CERTIFY: CERTIFICATION (1) That the abve aircraft is wned by the undersigned applicant, wh is a citizen (including crpratins) f the United States. (Fr vting trust, give name f trustee: CHECK ONE AS APPROPRIATE: a. A resident alien, with alien registratin (Frm 1-151 r Frm 1-551) N. b. A nn-citizen crpratin rganized and ding business under the laws f (state). and said aircraft is based and primarily used in the United States. Recrds r flight hurs are available fr inspectin at (2) That the aircraft is nt registered under the laws f any freign cuntry; and (3) That legal evidence f wnership is attached r has been filed with the Federal Aviatin Administratin. _). r: NOTE: If executed fr c-wnership all applicants must sign. Use reverse side if necessary. TYPE OR PRINT NAME BELOW SIGNATURE S2h-vi E3É z - Epiu fg I_i5> sin SIGNATURE Vaughn Fultn TITLE UAS Prgram Manager TITLE DATE ^/zz/ôt DATE 7 / U / NOTE Pending receipt f the Certificate f Aircraft Registratin, the aircraft may be perated fr a perid nt in excess f 90 days, during which time the PINK cpy f this applicatin must be carried in the aircraft. AC Frm 8050-1 (5/03) (0052-00-628-9007)
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Paperwrk Reductin Act Statement: The infrmatin cllected n this frm is necessary t ensure applicant eligibility. The infrmatin is used t determine that the applicant meets the necessary qualificatins as wner f an amateur built aircraft. We estimate that it will take apprximately 30 minutes t cmplete the frm. The infrmatin cllectin is required t btain a benefit. The infrmatin cllected becmes part f the aircraft registratin system. Please nte that an agency may nt cnduct r spnsr, and a persn is nt required t respnd t, a cllectin f infrmatin unless it displays a currently valid OMB cntrl number. OMB 2120-0042. Cmments cvering the accuracy f this burden and suggestins fr reducing the burden shuld be directed t the FAA at 800 Independence Avenue SW, Washingtn, DC 20591. ATTN: Infrmatin Cllectin Clearance Officer, ABA-20. U. S. Identificatin AFFIDAVIT OF OWNERSHIP FOR EXPERIMENTAL AIRCRAFT INCLUDING AMATEUR-BUILT AIRCRAFT AND OTHER NON-TYPE CERTIFICATED AIRCRAFT (des nt include light-sprt) Name f Amateur built builder OR Name f Nn TC'd manufacturer Mdel qmav Class (airplane, rtrcraft, glider, weight shift cntrl, pwered-parachute, etc.) Hneywell Internatinal Serial Number 07020323 VTOL Ducted Fan Type f Engine Installed (reciprcating, turbprpeller,2 r 4 cycle, etc.) Number f Engines Installed 1 Manufacturer, Mdel and Serial Number f each Engine Installed 2 cycle reciprcating 3W mdel CS-56iB2 c u 0 < ra < 0) 0 ra J> ra -i a ra a c_ c u w 00 (D en Built fr Land r Sea Operatin MUST CHECK ONE Land Number f Seats 0 n > n Mre than 50% f the abve-described aircraft was built frm miscellaneus parts and I am the wner. (This ptin is fr amateur-built aircraft.) I~1 Mre than 50% f the abve-described aircraft was built frm a kit (prefabricated parts) and I am the wner. The bill f sale frm the kit manufacturer is attached. (This ptin is fr amateur-built aircraft.) 171 I certify that the abve-described aircraft is a newly manufactured nn-type certificated aircraft and is nt currently registered in anther cuntry. (This ptin is fr manufacturers nly.) ~I I certify that the abve-described aircraft is a previusly manufactured (used) nn-type certificated aircraft and is nt currently registered in anther cuntry. Siis ptin is fr wners f previusly manufactured aircraft nly.) Evidence f wnership frm the aircraft manufacturer thrugh any intervening wners is attached (chain f wnership). [ Unable t btain cmplete chain f wnership. Statement as t wnership histry and whereabuts f aircraft is attached. Name f Owner: Hneywell Internatinal Signature f Owner: /r//(/r)/y\ y ^ Title f Signer (If Apprpriate): UAS Prgram Manager Address 9201 San Mate Blvd NE City: Albuuergue State: New Mexic Zip: 87113-2227 Telephne: 505-828 - 5000 Ntary Public: i a Subscribed and swrn t befre me this State f: Cunty f: : f\lúm)i^vp lyrcmmissin Expires: / P f e / z p n êôujtj/ (Signature f Ntary Public) OFFICIAL SEAL NANCY HENDRY BARKELL AC FORM 8050-88 (01/07) _ Ntary Public State f New «1. 1 My Cmmissin Expire; day f Q ^ j, Zôy 082111D35QS9 nn n7»/>nnñ
FILED WITH FAA AIRCRAFT REGISTRATION BR 2008 JUL 29 fin 10 39 OKLAHOMA CITY OKLAHOMA,
Aerspace Electrnic Systems Hneywell Defense Avinics Systems 9201 San Mate Blvd., N.E. Albuquerque, New Mexic 87113-2227 505 828-5000 Hneywell 22 July 2008 Federal Aviatin Administratin Civil Aviatin Registry P.O. Bx 25504 Oklahma City, OK 73125 Subject: Request fr Aircraft Registratin Number Dear Sir/Madam, Hneywell Internatinal, 9201 San Mate Blvd. NE, Albuquerque, NM 87113, is requesting an Aircraft Registratin Number fr ur unmanned aerial vehicle (mdel gmav, serial number 07020323) assciated with ur Unmanned Aerial Vehicles (UAV) prgram. Hneywell Internatinal has been granted a Dealer's Aircraft Registratin Certificate (D002987) n Jun 28, 2008, but we are requesting assignment and registratin f the next available "N" number under frm 8050-1. ^) Please find enclsed a cmpleted frm 8050-1 (Aircraft Registratin Applicatin), a cmpleted frm 8050-88 (Affidavit f Ownership), and a mney rder fr $5.00 fr the recrding fee. Shuld yu need any additinal infrmatin r if yu have any questins, please cntact the fllwing individuals: (1) fr technlgy matters, cntact Nader Tubbeh, Chief Engineer (505-828- 6624); (2) fr peratinal matters, cntact Sctt Hdgsn, Flight Test Directr (505-828-7608); (3) fr registratin and certificatin matters, cntact Ragn Michael, FAA Liaisn (505-828-5526). Thank yu fr yur attentin t this request, Vaughn Fultn PMP Hneywell Unmanned Aerial Systems Prgram Manager 505-828-7895 (ffice) 505-307-8380 (cell) vaughn.fultn@hneywell.cm Enclsure(s) FAA Frm 8050-1 FAA Frm 8050-88 $5 Mney Order Prgram Letter - Registratin Number Request 07020323 1
FILED WITH FAA AIRCRAFT REGISTRATION E! 2008 JUL 29 fin 10 39 OKLAHOMA CITY
MEMORANDUM TO THE FILE NELL VENABLE 07/30/2008 ID DATE AIRCRAFT: N220AW AIRCRAFT DESCRIPTION N-number: 220AW Serial number: 07020323 Make: HONEYWELL INTERNATIONAL Mdel: GMAV (MMSC) 061001Z Reasn: O N number change Other: FAA 8130-6 A Prir Recrd search was perfrmed fr HONEYWELL INTERNATIONAL GMAV, 07020323 n 7/30/2008. Search results: N Prir Recrd Assigned N220AW