• e US Department MAJOR REPAIR AND ALTERATION Of Transportation Federal (Airframe, Powerplant, Propeller, or Appliance) Aviation Administration Form Approved OMB No. 2120-0020 For FAA Use Only Office Identification So- r5DO- 1 INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC43.9-1 (or subsequent revision thereof) for instructions a d disposition of this form. This report is required bylaw (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed $1,000 for ea such violation (Section 901 Federal Aviation Act of 1958). 1. Aircraft Make Boeing Model 727-100 Serial No. 20115 _ Nationality and Registration Mark USA N908JE 2. Owner Name (As shown on registration certificate) J.E.G.E, Inc. = N om Only 3. For FAA Use .. ..• • . OCT Tor, data identified here' pties atoverthInes reqiiFements is approved described aircraft, subject ntorrnity ,uthe dram 43, se 43.7. with applicable for the above I by a person 5 (-1 --f5V 0 — i T Date Sign of Inspector 4. Unit Identificati 5. Type Unit Make Model Serial No. Repair Alteration AIRFRAME (As described in Item 1 above) POWERPLANT PROPELLER APPLIANCE Type Manufacturer 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency C. Certificate No. BANYAN AIR SERVICE •VI NICS DIVISION U.S. Certificated Mechanic Radio Class 1,2,3 Limited Airframe Foreign Certificated Mechanic Certificated Repair Station 0 Manufacturer D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. Date . :,7fr/ C?-7---46 '&/-g_. <71, 0C)Z Signature of Authorized lndi .d4,31) ,/ eeZ Steve Ouellette ( 9/W_ 7. Approval for Retur