el fr MAJOR REPAIR AND ALTERATION US Dess-rrnm of Tr systukn (Airframe, Powerplant, Propeller, or Appliance) Pram /Matron AthillnlitiliCOO cwa ne.2120402) Ey S414011I neves Tweet wear MA Um One INSTRUCTIONS: Mint or type See Tide 14 CFR Part 43 Append; B, AC 43.9-1 (or subsequent thereof) for as entries. §43.9. and revision instruceons and caposidon of Ws form. Ms report Is rewired by law µ9 U.S.C. §44701). Falun) to report can result in pen" for each such violation. (49U.S.C.§41001(a)) 1. Aircraft NadanalitY and Registrebon Mark N727KB Serial No. RK-260 Make Beech Model 400A Sancta 2. Owner Name (As shown on registraton certincate) PUMPJACK AVIATION LLC Address (As shown on registration certificate) banns 1511 W EPA 91 CA) Caoo. Stab WY LA 026014203 Couruy USA 3. For FM Use Only 4. Type S. Unit Identification Repair Mention Unit Make Made( Serial No. O in AIRFRAME . both (As described fn non? I above) RX. 410 O O POWERPLANT O O PROPELLER O O APPLIANCE Type stsmeaclunar 6. Conformity Statement A. Agency's Name and Address B. Kind of Agency sere ShresiAter a Clones Moon 4 U. S. Ciellfirsiteci ~ado 1 Manufacturer we. Amino* ForrionCernacesso Mechanic C. Certificate No. orr SS Or KS Swoon 3437625 SI 0117 convi 115A ms s; nence Organize:al 0. !entry that the repair and/or alteration made to the unit(s idenefled at tarn 5 above and described on the ravens or attachments hereto have been made in accordance with the requirements of Pan 43 c4 the U.S. Federal Aviation Regulations and that the information furnished heroin es bye and correct to ere bast of my knowledge. per t4 CFR Part 43 K Extended range fuel 91 APP. B of horized Inctrvidual t -1q 4 020 7. Approval for Return to Simko Pursuant to the authority 9 ven persons specked below. the Unit identified in sera 5 wee inspected in the manner ;ascribed by the Administrator of me Federal Aviation Administration and is plA