rn.Pipponi COO No. 2110001,04/1 141/2611 ill ............... Application for Export Certificate of Airworthiness Export Certificate No. Est 3 7_5(ge redonl Adak. Ailsoints. INSTRUCTIONS - This application is to be submitted to an authorized FM representative (one copy) when the aircraft to be exported is (are) presented for inspection. This application may be used, but is not required. for aircraft engines, propellers, and articles. Use Part I for products and Part II for articles. For complete aircraft, execute items 1 through 11, as applicable. For engines and propellers, omit item 5A. Part III is for FM use only. Part I - Application for Export Certificate of NrworthIness (Complete Mims 1.11) 1. Application is made n export certificate NEW hiness to cover the product(s) described below which (are): USED 2. Name and address of exporter Summit Aviation, Inc. 4200 Summit Bridge RD Middletown, DE 19709-9340 3 Name and address of foreign purchaser Greenwich Aerogroup Brazil Leasing Inc 4200 Summit Bridge RD Middletown, DE 19709-9340 4. Country of destination Brazil 5. Description of products) Type (a) Transport Helicopter Make and Model (b) Identification No. Serial Nos. (c) FAA T.C. or Spec. No. (d) Operating time (Hours) (e) Since Overhaul Tout A. AIRCRAFT Sikorsky S-76C N162AD 760472 Hi NE 1.3 49 c4. 03 B. ENGINES Turbomeca Arriel 2S1 P/N 02920053 10 #1 eng: 20040 #2 eng: 20533TEC E00054 EN #1:09g7 #2:2368.3 51.94.: zma. 3 C. PROPELLERS N/A N/A N/A N/A N/A N/A 8. Does the product I comply with all applicable Federal Aviation Regulations. Airworthiness Directives, and other FAA requirements? YES NO (Explain In "Remarks" 7. Nave ay.e.abliti special rWents of the importing country been complied with? LJYES 11.1.-INO (Explain In "Remarks") 8. Date title passed or is expected to pass to foreign purchaser: 10-Apr-2013 9. For overseas shipment, preservation and packaging methods used to pro