UNITED STATES OF AMERICA - DEPARTMENT OF TRANSPORTATION 1
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31(019650 Conveyance Recorded Jul/30/2021 08:53
OMB Control No. 2120-0042
UNITED STATES OF AMERICA bp. 0/130/2017
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION
AIRCRAFT BILL OF SALE
FOR AND IN CONSIDERATION OF $ 1.00 + OVC THE
UNDERSIGNED OWNERS) OF THE FULL LEGAL
AND BENEFICIAL TITLE OF THE AIRCRAFT
DESCRIBED AS FOLLOWS:
UNITED STATES
REGISTRATION NUMBER N 722JE
AIRCRAFT MANUFACTURER & MODEL
KEYSTONE HELICOPTER S-76C
AIRCRAFT SERIAL No.
760750
DOES THIS r)th DAY OF May . 2021
HEREBY SELL, GRANT, TRANSFER AND
DEL VER ALL RIGHTS, TITLE, AND INTERESTS
IN AND TO SUCH AIRCRAFT UNTO: Do Not WIN In This Wadi
FOR FM USE ONLY
NAME AND ADDRESS
(IF INDIVIDUAL(S). GIVE LAST NAME. FIRST NAME.MD MIDDLE INMAL)
Industrial Integrity Solutions , LLC
2151 E. Convention Center Way #222
Ontario, Ca 91764
DEALER CERTIFICATE NUMBER
AND TO ITS`SUCCESSORS afr.GLSORS,ADMIMI4TRATORS, AM ASSIGNS TO HAVE ND TO HOLD
SINGULARLY TIE SAO AIRCRAFT FOREVER. WO WARRANTS THE TITLE THEREOF:
IN TESTIMONY WHEREOF I HAVE SET MY Rua AND sag. ram a n t or May, 2021
NAME(S) OF SELLER SIGNATURE(S) TITLE
(TYPED OR PRINTED) (IN INK) (IF EXECUTED FOR (TYPED OR PRINTED)
CO-OWNERSHIP. ALL MUSTSIGN.
Hyperion Air LLC
DIg e0 by LARRY VISOSKI Manager
SPZW04.944103
ACKNOWLEDGMENT NOT REQUIRED FOR PURPOSES OF FM RECORDING: HOWEVER. MAY BE REQUIRED BY LOCAL LAW FOR
VALICC"( OF TIE INSTRUMENT.)
ORIGINAL: TO FM:
AC Fan, 0050-2 (01/12) (NSN 0052-00429-0003)
211331018187
85.00 05/13)2021
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UNITED STATES OF AMERICA - DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION AMINTSTRATION — MIKE INONRONEY AERONAUTICAL CENTER a
AIRCRAFT REGISTRATION APPLICATION a
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AC Form SRN, OTC BI
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EFTA_00249333
EFTA01332777
DocuSIgn Envelope TC2I386F-TOCC-4AISECC14C030CC9F504
FORM APPROVED
OMB NO. 21204042
2•••j1
UNITED STATES OF AMERICA
0
V. S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMNISTRATION
AIRCRAFT BILL OF SALE
FOR AND IN CONSIDERATION OF S THE
UNDERSIGNED OWNER(S) OF THE FULL LEGAL
AND BENEFICIAL TITLE OF THE AIRCRAFT DES-
CRIBED AS FOLLOWS:
UNITED STATES 8
REGISTRATION NUMBER: N722JE
AIRCRAFT MANUFACTURER & MODEL
Keystone (Sikorsky) model S-76C
O
AIRCRAFT SERIAL NO. 760750
0
O
DOES THIS 13 DAY OF June, 2019,
HEREBY SELL, GRANT, TRANSFER AND
DELIVER ALL RIGHTS, TITLE, AND INTERESTS
Do NotWYllo In TMMee
IN AND TO SUCH AIRCRAFT • UNTO: FOR FAA USE ONLY
NAME AND ADDRESS
PURCHASER
IW INDIVIDUAL (B. GIVE LAST NAME. FIRST NAME, AND MIDDLE INITIAL.,)
Hyperion Air, LLC
8100 Red Hook Quarter, B3
St. Thomas, U.S. Virgin Islands 00802
DEALER CERTIFICATE NUMBER
AND TO ITS SUCCESSORS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS TO HAVE AND TO HOLD
SINGULARLY THE SAID AIRCRAFT FOREVER, AND WARRANTS THE TITLE THEREOF.
IN TESTIMONY WHEREOF, THE UNDERSIGNED HAS SET ITS HAND THIS 13 DAY OF St#A- 2019.
NAME(S) OF SELLER SIGNATURE(S) TITLE
(TYPED OR PRINTED) pt4 BLUE INIQ (IF EXECUTED (TYPED OR PANTED)
FOR CO-OWNERSHIP. ALL MUST
SIGN)
SELLER
ASI WINGS LLC Senior Vice President,
r im...row
By: Aetna Inc., Its Managing controller & Chief
Member J"M7t4 ant Accounting Officer
James D. Clark
ACKNOWLEDGEMENT (NOT REQUIRED FOR PURPOSES OF FAA RECORDING: HOWEVER, MAY BE REQUIRED
BY LOCAL LAW FOR VALENTI OF THE INSTRUMENT.)
ORIGINAL TO FAA
AC Form 8050-2 (9/92) (NSN 0052-00429-0003) Supersedes Previous Edition
' and the following described engines: TURBOMECA model ARRIEL 2S2 bearing manufacturers serial numbers 42285
and 42288.
ADMIN 35381002v1 35.00 08/13/2019
SDNY_GM_02762412
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249334
EFTA01332778
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EFTA_00249335
EFTA01332779
OstliCoutn4 Rumba 2120-0729
Boas 04/30/17
Paperwork Reduction Act Statemarm TM information collected an this lam le necessary to mar•aln areal regloration. We estimate Dating take approanatey 30
inhales lo compel, the form. Mee nobs that an agency may not coed:Last or sponsor. and a pirscn a not rcµried to reword lo. a collection Cl Norman wens *displays a
wild CMS coned number. Form Approved, OMB No. 2120-072A Comments concerning the accuraPy or the burden and suggestons for le0Aing the omen shots)) be
areas] to Its FAA at 500 Independence Avenue SW. Washinacn. DC 20591. ATTN. hiamanon Cotocton Clearance War. AES-200.'
FAILURE 70 RENEWREGASTRA RON Mt
DEPARTMENT OF TRANSPORTATION • FEDERAL AVIATION ADMINISTRATION RESULT IN CANCELLATION OF REGISTRATION
AIRCRAFT REGISTRATION RENEWAL APPLICATION ARO REGISTRATION NUMBER ASSIGNMENT
(See 14 CFR §§ 47.15(0, 47.40 and 47.41)
AIRCRAFT REGISTRATION NUMBER SERIAL NUMBER
N 7223E 760750
MANUFACTURER MODEL
KEYSTOtE HELICOPTER S-76C
DATE OF ISSUANCE DATE OF EXPIRATiON TYPE OF REGISTRATION
08/16/2011 06312020 CORPORATION
ENTER REGISTERED OWNER(S) & ADDRESS FROM FAA FILE HELPFUL INFORMATION
(Owner 1) ASI WPIGSLIS Review Aircraft Registration File Information for this aircraft
al: http://renistry.faa.00W8ittalflinnoirY.
(Owner 2)
BS Enter any additional owner names on page two. Assistance may be obtained
151 FARMINGTON AVE at our web page httiXffrengtry.faa.qoyfrenewreoistration
(Address)
by email at fate acraft.rentstryafaa.vev or
(Address) by aleph:no at: (866) 762 - 9434 (loll free). or (405) 954 - 3116
Gay HARTFORD state CT zip 06156-0001
When mailing fees, please use a check or money order made
Country UNITEDSTATES payable to the Federal Avision Administration.
Physical Address: Required Wan mating address is a P.O. Bea or mai drop. Signature and Title Requirements for Common Registration Typos:
(Address) - Individual corner met sign, ale would be 'owner'
• Pannershe general partner signs showing 'general partner as
(Address) title.
ay Stale Zip - Corporation corporate officer or manager signs, slowing full title.
Country - Limited Lasity Co authored member. manager. or &leer idenbied in
the LAC organization document signs. tinning full tots
- Co-owner each co-owner must sign; showing -co-owner as AM.
TO RENEW REGISTRATION: REVIEW aircraft registration ingot-WO,
- Government authorizer] person must so end tow tar full tile
SELECT the aPPnXITile itaterron ENTER any change Y1 addteSS the h
spaces below, ssqL4 DATE, & SEND forrn YAM the 55 renewal fee to te : Note: All signatures must be In Ink, or other permanent media.
FAA Aircraft Registry. PO Box 25509, Oklahoma City OK 73125-0504, a To correct entries: Draw a single sne through error. Make correct entry En
by courier to: 6425 S Denning Rm 118, °Mahone City OK 73169-6937 remaking space. or complete the form orine. An apple-awn loon we be
rejected it any entry is coward try arrection tape Cf sinelany obscured.
a IFOR
(WE) CERTIFY, THE NAME(S) AND ADDRESSES FROM THE FAA FILES
THE OWNER(S) OF THIS AIRCRAFT ARE CORRECT. OWNERSHIP TO CANCEL THE REGISTRATION FOR THIS AIRCRAFT:
CHFCK All amicable blOCKS) below, re/WI FTF Erali gam ea stas.
MEETS CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3, AIRCRAFT IS
NOT REGISTERED UNVER THE LAWS OF ANY FOREIGN COUNTRY. ells form with any fees lo the: FAA Ascraft Registry,
PO Box 25504, Oklahoma City. OK. 73125-0504. or by courier to:
ri UPDATE THE MAILING / PHYSICAL ADDRESS AS SHOWN BELOW.
I (WE) CERTIFY THE: NAME(S)SHOWN ABOVE FOR THE OWNER(S) OF
6425 S Deming Rm. 118, Ckiahoma City OK 73189.6837
THIS AIRCRAFT IS CORRECT. OWNERSHIP MEETS THE CITIZENSHIP O CANCELLATION OF REGISTRATION IS REQUESTED.
REQUIREMENTS OF 14 CFR §47.3. MRCRAFT IS NOT REGISTERED
O THE AIRCRAFT WAS SOLD TO:
UNCER THE LAWS OF ANY FOREIGN COUNTRY.
(Show purchasers name and address.)
NEW MAILING ADDRESS
O THE AIRCRAFT IS DESTROYED OR SCRAPPED.
NEW PHYSICAL ADDRESS: Canoga" if physical oaken has changed, or ❑ THE AIRCRAFT WAS EXPORTED TO:
he new mailing addross s a PO Box a Mail Drop.
O OTHER: Specify
O PLEASE RESERVE NJIUMBER IN THE OWNERS NAME
AND ADDRESS. The S10 reservation fee is enclosed.
SIGNATURE OF OWNER 1 (WNW MM) PRINTEO NAME OF SIGNER (required Said) ilLE (reared Add) OATS
Electronically COI'S by Ragletered Osalsve 32502017
SIGNATURE OF OWNER 2 PRINTED NAME CF SIGNER TITLE DATE
Use page 2 for ado:Nona] signatures.
Fee paid: $5 (201703281152554432N8)
AC Form 8050-113 (04/12)
SDNY_GM_02762414
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249336
EFTA01332780
SDNY_GM_02762415
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249337
EFTA01332781
OMB Cotiaol Ntabes 2120-0729
Eaputs040011/
Note', Twelve (12) owner names may be entered on this page. If you require more, enter the first 12 names and then print
this page by pressing the 'Print Page 2' button below. Next dick the Reset' button to dear the data fields (from page 2
only) to add more names. Repeat action as needed.
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TIME
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
NAME OF OWNER DATE
SIGNATURE PRINTED NAME OF SIGNER TITLE
AC Form 8050-1B (04/12) REF N-NUM: 722JE
SDNY_GM_02762416
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249338
EFTA01332782
SDNY GM 02762417
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249339
EFTA01332783
D
P.
DEBEE GILCH RIST
1116- ATTORNEYS & COUNSELORS
a0
o
August 4, 2014 >o
05.
o
Jana L. Hammer, Manager ri
o
Aircraft Registration Branch 1:
Federal Aviation Administration
P.O. Box 25082
Oklahoma City, Oklahoma 73125
RE: Executive Jet Management;
One (I) Keystone Helicopter S-76C;
Serial Number 760750; U.S.
Registration Number N722JE;
Our File Number: 5502.0015
Dear Ms. Hammer:
On behalf of AS1 Wings LLC, as registered owner (or co-owner) of the above described
aircraft, we hereby request that a duplicate Certificate of Registration be issued for the above
referenced aircraft. The original was inadvertently returned to the FAA for mailing, but the
address listed is not the address where the helicopter is located.
Please deliver the duplicate Certificate of Registration to the attention of the undersigned
in the Public Documents Room.
We are enclosing $2.00, in payment for the duplicate certificate fee.
Very truly yours,
la AinA44/V P4t4t1
(
Brandt S. Sterling
Legal Assistant
142181527010
$2.00 08104/2014
100 North Broadway Ave. • Suite 1500 • Oklahoma City, OK 73102-8609 •
vAvw.debeegilchrist.com
SDNY_GM_02762418
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249340
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SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249341
EFTA01332785
V.S. Department Flight Standards Service P.O. Box 26504
of Transportation Aircraft Registration Branch, Oklahoma City, Oklahoma 731254504
AFS-760 (405) 9544116
Federal Aviation Toll Free: 1.666-762-9434
WEB Address: hltpg/registry.faa.gov
Administration
Date of Issue: August 4, 2014
ASI WINGS LLC
151 FARMINGTON AVE
HARTFORD, a 06156-0001
HAND DELIVERED TO JOIL IN THE PD ROOM
146046 This facsimile must be carried in the Aircraft as a Temporary Certificate of
Registration for
N722JE KEYSTONE HELICOPTER S-76C Serial 760750 and is valid until Sep 03, 2014.
This is not an airworthiness certificate. For airworthiness information, contact the nearest
Federal Aviation Administration Flight Standards District Office.
r
Manager, FAA Atrcra Registry, AFS-750
Federal Aviation Administration
APS-710-FAX-4 (01/14)
SDNY_GM_02762420
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249342
EFTA01332786
SDNY GM 02762421
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249343
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PRINT PAGE 1 PRIVACY ACT STATEMENT
OW ControlNumb 2120-0729
Elpites0S/linOt4
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the FM at. BOO Ireacendenee Avenue SW. Wastingteri.00 20591. ATTN: tedotmatke Collection Clearance Ulcer. AES-2C0.'
FAILURE 70 RENEWREGISTRAnom WILL
DEPARTMENT OF TRANSPORTATION -FEDERAL AVIATION ADMINISTRATION RESULT IN CANCELLATION OP REGISIRADON O
AIRCRAFT REGISTRATION RENEWAL APPLICATION AND REGISTRATION NUMBER ASSIGNIAENT
(SOO 14 C.F.R §§ 47.150), 47.404nd 47.41)
AIRCRAFT REGISTRATION NUMBER SERIAL NUMBER
N 722JE 760750
MANUFACTURER MODEL
Keystone Helicopter S-76C
DATE OF ISSUANCE DATE OF EXPIRATION TYPE OF REGISTRATION
August 16, 2011 August 31. 2014 Corporation
ENTER REGISTERED OWNER(S) & ADDRESS FROM FAA FILE IIFLPFUL INFORMATION
(Owner I) ASI Wines LLC Review Aircraft Registration File Information for this aircraft
at ilitOMORMIN.lea.doviairtraftinduirv.
(Owner 2)
&Jr, Enter any eddidonel owner names on page Teo. Assistance may be Obtained
at our web page: linpfitetretry.raa dovrrenewrecitilmtion.
(Address) 151 Farmington Avenue by a-mar at laa.areraftrealittlESIMI 49X. or
(Address) by telephone at: (866)762 . 9434 (toll Iran or (405) 964 • 3116
Cry Hanford Stale CT zip 06156.0001 Men malting fees, &AM use n then or tretneY order ^Nee
Cooney payable lo the Eager& Avtallol AOmInseaton.
Physical Address: Required when marling address is a P.O. Box or mall *op. Signature and Title Requirements for Common Registration Typos:
- InclMcmis owner must sign. nee would be 'Ownot
(AdCreSt9 PlatnershIp general partner skins showing 'general panne' as 11110.
(AdtesS) - CaPC44.19n ccrporale races or manager signs. sAoMrg AJI tee.
- UMIIo0 LlablIty Co autheeized member, manager, or &Tar Idenolied li the
Ch.y Stele VO LLC erg:minim* document signs. showing lull tine
Country Commer each co-owner must sign: showing 'co-owne? as file.
• Government SNINOC1201 person Moil Mr and shoe' lair full tale
TO RENEW REGISTRATION: SEMI aircraft iwalataticin information. Note: All signatures must be Ni Ink, or other permanent media.
SELECT the aPPMPriele statement. ENTER . any dirge in address in the
spaces below. EIW, DATE. a SEND form with Ete SO renewal lee to the: To correct entries: Drew a single lire through error. Make coned entry In
FM Antra Registry. PO Box 25504, Oklehtere Cay OK 73125-0504, or remaining spook or complete the form on4lre. An oPPIcalle41IONn cede be
by courier to: 6425 $ Canning Room 118. Oklahoma City OK 731694937 *POW I any envy Is Covered by eerreceon tape or sinterly obscured.
E:1 I (WEI CERTIFY, THE NAME(S) AND ADDRESSES FROM THE FM FILES
FOR THE OWNER(S) OF THIS AIRCRAFT ARE CORRECT. OWNERSHIP
TO CANCEL THE REGISTRATION FOR THIS AIRCRAFT:
CHECK all spoked, blocks below. COMPLETE. $.12L MI6 S tal this
MEETS CITIZENSHIP REQUIREMENTS CF 14 CFR/47.3, AIRCRAFT IS
NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY. form with any fern to the: FM Aircraft Registry,
PO Box 25504, Odahoma City, OK, 73125-0504. or by courier to:
El UPDATE THE MAILING! PHYSICAL ADORESS AS SHOWN BELOW. 6425 S Denting Rm. 118. Oldahorna C4Y OR 731694937
I (WE) CERTIFY THE: NAME(S) SHOWN ABOVE FOR THE OWNER(S) OF
THIS AIRCRAFT IS CORRECT. OWNERSHIP MEETS THE CITIZENSHIP O CANCELLATION OF REGISTRATION IS REQUESTED.
REQUIREMENTS OF 14 CFR §47.3.MRCRAFT IS NOT REGISTERED O THE AIRCRAFT WAS SOLD TO:
UNDER NE LAWS OF ANY FOREIGN COUNTRY. (Shore purchaser's name and eddrOSS)
NEW MAILING ADDRESS
. THE AIRCRAFT IS DESTROYED OR SCRAPPED.
NEW PHYSICAL ADDRESS: complete if physical address has changed. or THE AIRCRAFT WAS EXPORTED TO:
the new mailing address is a PO Box or Mall Drop.
OTHER, Specify
PLEASE RESERVE WRONGER IN THE OWNER'S NAME
AND ADDRESS. The S10 reservation fee is enclosed.
SIGNATURE OF I rod fob PRINTED NAME OF SIGNER (requfred fold) TITLE (require* SO DATE i
7 /9 4204
Aswan Careen Seeger, al Anna re,
linda Westbrook "maw re ASWMCS. LLC
. IGNATURE OF OWNER 2 PRINTED NAME OF SIGNER TITLE DATE
Use page 2 for additional signatures.
AC Form 8050-I B (04112)
SDNY_GM_02762422
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249344
EFTA01332788
VINONV1)10
1,110 VIVON71)M
91
. II WU hI 1111' hIPZ
as Nou V31
1. 4 "..103r.
1 1/A 1411M
03113
SDNY_GM_02762423
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249345
EFTA01332789
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE006014974
FFR -1B DOC ID eole 5/1/14
141211307096 15 5/1/14
SONY_CPO_02762424
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249346
EFTA01332790
SDNY_GM_02762425
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249347
EFTA01332791
U.S. Department Flight Standards Service P.O. Box 25504
al Trarsportation Avast Registration Branch. AFS-750 Oldshome City, Oldahoma 73125-0504
(405)954-3118
Federal Aviation Toll Free: 1-880-7824434
Administration WEB Address: httpltregistrytialgov
December II, 2012
AS! WINGS LLC
I5I FARMINGTON AVE
HARTFORD CT 06156-0001
Dear Sirs:
An AC Form 8050-64, Assignment of Special Registration Numbers, was issued on September
16, 2011, as authorization to the change the registration number on a KEYSTONE
HELICOPTER S-76C aircraft, serial number 760750, from N722JE to special number N162AE.
This authorization was good for one year from the form's date of issue. The form was required
to be signed and returned to this office within five days after the special registration number was
permanently affixed to the aircraft. As of the date of this letter, no completed authorization has
been received by this office.
This authorization expired on September 16, 2012. Accordingly, the assignment of special
registration number N162AE to this aircraft was cancelled on December I I, 2012, and returned
to the pool of available N-numbers.
You may apply to reserve any available N-number as a special number in your name, or request
an available N-number be assigned to an aircraft to change that aircraft's registration number.
Information about requesting the reservation or assignment of a special registration number may
be viewed on our web site, httc://registry.faa.gov.
If you have any questions, our toll free telephone number is I (866) 762-9434.
Manager, Aircraft Registration Branch, AI;S-1.)0
AFS-750-REREG-I4 (09/10)
SDNY_GM_02762426
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249348
EFTA01332792
SDNY_GM_02762427
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249349
EFTA01332793
U.S Department FSght Standards Sawa P.O. Box 25504
of Transportation Aircraft Registration Branch AFS-750 Oklahoma City, Oklahoma 73125-0504
(405) 04-3116
Federal Aviation Toe Free: 1-805-762-0434
Administration WEB Address: http:/hegtstry.taa.gov
October 12, 2012
ASI WINOS 11.0
Ill FARACINOTON AVE
HARTFORD CT 04156-000I
Dear Sirs:
The FAA Aircraft Registration Branch (Registry) issued an Assignment of Special Registration
Numbers, AC Form 8050-64, on September 16, 2011. This form authorized a change of
registration number from N722JE to N162AE to be completed within one year of its issue date
for the KEYSTONE HELICOPTER S-76C aircraft with serial number 760750. Within five days
of placing N162AE on the aircraft a signed copy of this form showing the date of the change was
required to be returned to the Registry. The authorization to change registration numbers
expired on September 15, 2012, without a completed copy of the form being received by the
Registry. We ask that you confirm the status of this registration number change so that the
matter may be closed appropriately. If no response is received within 30 days from the date of
this letter, the number change will be cancelled and N162AE returned to the pool of available N-
numbers.
The attached form may be used to confirm the status of this registration number change. If
special registration number N162AE has been placed on this aircraft, then upon receipt of your
notification, the Registry will update our records and issue a revised registration certificate
showing the special registration number.
The attached form also may be used to confirm that the N-Number change was not made, to
request the reservation of the special number in your name, or to make a new request for
N162AE to be assigned as special registration number to change the N-number of this or another
aircraft.
If we may be of any assistance, our toll free telephone number is 1 (866) 762-9434.
anager, Aircra mistra ion ranch, AFS-750
AFS-750-REREG-13 (03/I I)
SDNY_GM_02762428
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249350
EFTA01332794
SDNY_GM_02762429
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249351
EFTA01332795
Directions:
Select and complete the appropriate section below then send, with the indicated fee (if appropriate), to die FAA
Aircraft Registration Branch.
U.S. Postal Service. Regular and Priority Mail Commercial Delivery Seamless:
FAA Aircraft Registration Branch FAA Aircraft Registration Branch
P.O. Box 25504 Registry Building. Rm. 118
Oklahoma City, OK 73125-0504 6425 South Denning
Oklahoma City, OK 731694937
Make fee payment by check or money order payable to the Federal Aviation Administration.
For additional information call toll free 1.866.762.9434. or visit hand egistry.faa,ROY
FAX No: (405) 954.3548
Dear Aircraft Registry:
❑ Special registration number N162AE, was not painted on KEYSTONE HELICOPTER S-76C, serial
number 760750.
❑ 1/We do not wish to reserve this number at this time.
❑ Please reserve this N162AE in our name. The $10.00 special N-number reservation fee is
enclosed.
❑ Please assign N162AE to KEYSTONE S-76C 760750
HELICOPTER
a- .. (Sala' tilmbel
for an N-number change. 520.00 is enclosed to cover both the special number request and
assignment fees.
Or:
❑ Special registration number N162AE, was placed on KEYSTONE HELICOPTER S-76C, serial number
760750 on <„,„,„i.“, Please issue a revised registration certificate.
❑ The completed and signed Assignment of Special Registration Numbers, AC Form 8050-64, is
enclosed.
❑ The Assignment of Special Registration Numbers, AC Form 8050-64, is lost or destroyed. Please
accept this as notice that the authorized N-number change has been completed.
Name of Owner:
&mature/Title Date
AFS-750-REREG-13 (03/11)
SDNY_GM_02762430
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249352
EFTA01332796
SDNY GM 02762431
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249353
EFTA01332797
Special Registration Number
GO ASSIGNMENT OF SPECIAL
REGISTRATION NUMBERS
NI62AE
Present Registration Number
U.S. Department Aircraft Make and Model
or Transpalaticn KEYSTONE HELICOPTER S-76C N722JE
Federal Aviation Serial Number Issue Date:
Administration 760750 Sep 16, 2011
ICAO AIRCRAFT ADDRESS CODE FOR NI62AE - 50174441 This is your authority to change
the United States registration
number on the above described
aircraft to the special
ASI WINGS LLC registration number shown.
151 FARMINGTON AVE
HARTFORD CT 06156-0001 Carry duplicate of this form in the
illunllinoll1lilullulliiilluillinuillkinliinuild aircraft together with the
old registration certificate as
interim authority to operate the
aircraft pending receipt of revised
certificate of registration.
Obtain a revised orctificate of
airworthiness from your near-
est Right Staralards District
Office.
The latest FAA Form 81304,
Application For Airworthiness
on file is dated:
Dec 08, 2008
The airworthiness classification
and category:
STD TRANSP
INSTRUCTIONS:
after the special
SIGN AND RETURN THE ORIGINAL of this form to the Civil Aviation Registry, AFS-750, within 5 days
registration number is placed on the aircraft. A revised certificate will then be issued.
The authority to use the special number expires: Sep 16, 2012
CERTIFICATION: I certify that the special registration number was placed RETURN FORM TO:
on the aircraft described above.
Civil Aviation Registry, AFS-750
P.O. Box 25504
Signature of Owner. Oklahoma City, Oklahoma 73125-0504
Title of Owner:
Date Placed on Aircraft:
AC FORM 005044 (5/2005) Supeniodea PTOVi011• &tidos
SDNY_GM_02762432
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249354
EFTA01332798
SDNY_GM_02762433
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249355
EFTA01332799
D
Q
P
L A I Insured Aircraft Title Service, Inc.
T S P.O. Box 19527
4848 SW 3601Street
Oklahoma City, Ok 73144
Oklahoma City, Ok 73159
o-mail address: ials(40eastilink.net
web site: vawicinstmedaircraft.com
(405) 681-6663
(800) 654-4882
FAX (405) 681.9299
O
FEDERAL AVIATION ADMINISTRATION
CENTRAL RECORDS DIVISION
OKLAHOMA CITY, OKLAHOMA
Date: August 26, 2011
Dear Sir/Madam:
Please Reserve N in NAME ONLY for:
N# Change Request
Please Tteserve N 162AV and assign for the following aircraft:
N 722JE Make Keystone Helicopter Model S-76C Serial # 760750
Which is (1) being purchased by (2) registered to XX
ASI Wings LLC
112381430476
$20.00 08/26/2011
Payment of the required $10.00 fee per number to reserve/assign is attached. If the preferred N number is not
available, please contact the undersigned for a selection of a new number. Please send the confirmation of
reservation/8050-64 form to Insured Aircraft title Service, Inc. in the Public Documents room of the FAA.
Additional Information: • please see attached relinquishment
Requested by: atiakatit-
Aun a Jones
Fe: $10.00
SDNY_GM_02762434
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249356
EFTA01332800
VHOHV1)10
All3 VII0HrDIO
9S T lid 92 HU ILO
tIOILV21.91038 1P030i0V
/43 H I im anid
SDNY_GM_02762435
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249357
EFTA01332801
FORM APPROVED
OMB No. 2120-0042
UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION
scomeAL AVIATOR ADMINISTRATION-MIKE MONRONEY AERONAUTICAL CENTER "(
AIRCRAFT REGISTRATION APPLICATION CERT: ISSUE DATE i
c
UNITED STATES
REGISTRATION NUMBER IN 722JE I
AIRCRAFT MANUFACTURER 8 MODEL -
Keystone (Sikorsky) S -76C (
AIRCRAFT SERIAL No. q
•
76O75O FOR FAA USE ONLY (
TYPE OF REGISTRATION (chock One box)
pl. individual O 2. Partnership al 3. Corporation O 4. Co-Owner O 5. Government
O 8. Non-Citizen Corporation O
9. Non-Citizen Corporation Co- Owner
NAME OR APPLICANT (Person(s) shown on evidence of ownership. If Individual. give last name, first name, and middle initial.)
III ASI Wings, LLC
TELEPHONE NUMBER:
ADDRESS (Permanent mailing address lOt lint app cantOn list) (If P.O. Dos is used. Finnic-al SEEMS, must also be shown.)
Number and street: 151 Farmington Avenue
Rural Route: P.O. Box:
CITY STATE ZIP CODE
Hartford Connecticut O6156
0 CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE OF ADDRESS
ATTENTION! Read the following statement before signing this application.
This portion MUST be completed.
A false or dishonest answer to any question In this application may be grounds for punishment by fine and/or imprisonment
(U.S. Code. Title I g Sec. 1001).
III CERTIFICATION
I/WE CERTIFY:
(1) That the above aircraft is owned by the undersigned applicant. who Is a citizen (including corporations)
Of the United Staten.
(For voting trust, give name of trustee: ) or:
QHEtTiK ONE AS APPROPRIATF'
a. A resident alien, with alien registration (Form 1-131 or Fown 1-551) NO.
0. A non-citizen corporation organized and doing business under the laws of (state)
and said aircraft Is based and primarily used In the United States. Records or flight hours ate available Mr
inspection at
(2) That the aircraft is not registered under the laws of any foreign country: and
(3) That legal evidenceof ownership Is attached or has been filed with the Federal Aviation Administration.
NOTE: It executed for co-ownership all applicants must sign. Use reverse side if necessary.
TYPE OR PRINT NAME BELOW SIGNATURE
S NATURE DATE
AWIstant Corporate
EACH PART OF THIS ecretary of Aetna Inc. ,7210 - 1/
APPLICATION MUST
SIGNA MWAaging Member of DATE
Melinda Westbrook ASI Wings, LLC
BE SIGNED IN I .
SIGNATURE TITLE DATE
NOTE Pending receipt of the Certificate of Aircraft Regis radon. the aircraft may be operated for a period not in excess of 90
days. during which time the PINK copy of this application must be earned In the aircraft.
AC Form 8050-1 (1/09) (NSN 0052-00-628.9007) Supersedes Previous EditiOn
SDNY_GM_02762436
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249358
EFTA01332802
A IT VI:1-1 4
Z; 41 19
1X0
BS TT WU 9Z II0Z
dB HOPI '12f1S1038 IA12:13211\1
V VA F/IPA C1311i
SDNY_GM_02762437
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249359
EFTA01332803
0
-1
0
0
V
a
0
0
3
WARRANTY BILL OF SALE
a
The undersigned, FREEDOM AIR INTERNATIONAL, INC. ("Seller"), is the
owner of the full legal and beneficial title in and to that certain used Keystone (Sikorsky) S•76C
helicopter (sometimes referred to as a S-76C++) bearing Manufacturer's Serial No. 760750 and 0
U.S. Registration No. N722JE, with two (2) Turbomeca Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285 and 42286, together with all avionics, equipment (including
loose equipment), systems, furnishings and accessories installed on, contained in or attached to
said helicopter and engines, all as is more particularly described in that certain Aircraft Purchase 13
Agreement dated as of July I R , 2011, between Seller and Purchaser, and also including all Erl
airframe, engine and accessory logbooks, flight and operation manuals, maintenance and 0
overhaul records, checklists, drawings, any issued FAA Form 337's, warranty documents, and all a
other records and paperwork relating to the above-described helicopter and engines in Seller's 0
possession (collectively, the "Aircraft"); grogftcsi, that the term Aircraft as used herein does not
include airframe maintenance manuals and airframe illustrated parts catalogs as the same are being
retained by Seller.
For and in consideration of the sum of Ten Dollars ($10.00) and other good and
valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Seller
does hereby grant, bargain, sell, convey, transfer and deliver unto ASI WINGS, LLC
("Purchaser"), all of Seller's right, title and interest in and to the Aircraft.
Seller hereby warrants to Purchaser, its successors and assigns, that Seller is the
lawful owner of the Aircraft and that there is hereby conveyed to Purchaser good and marketable
title to the Aircraft, free and clear of any and all liens, claims and encumbrances whatsoever, and
Seller will warrant and defend such title forever, at the sole expense of Seller, against all claims
and demands whatsoever. EXCEPT FOR THE WARRANTIES OF SELLER SET FORTH IN
THE PRECEDING SENTENCE, THE AIRCRAFT IS HEREBY SOLD TO PURCHASER IN
ITS "AS IS, WHERE IS" CONDITION AND "WITH ALL FAULTS."
IN WITNESS WHEREOF, Seller has caused this Warranty Bill of Sale to be
executed by its duly authorized officer, as of this ?t,- day of July, 2011.
FREEDOM AIR INTERNATIONAL, INC.
112071217388
$5.00 07726/2011
SDNY_GM_02762438
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249360
EFTA01332804
VI40)1V 1 )10
Ala VP0V114 XO
RS II al 92 inr LIR
HOI!7615:)721JVt3 61V
V VJ Ogili
SDNY_GM_02762439
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249361
EFTA01332805
FORM APPROVED
OMB No. 2120-0042
UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMIHISTRATION•MIKE MORRONeY AERONAUTICAL CENTER a
AIRCRAFT REGISTRATION APPLICATION CERT: ISSUE DATE ti.
Ffa l A
REGIVIFTA iMBER N - 7 a atz-a-- a
a
Al5CRAFT MANUFACTURSkti MOOEL tIV-ii :57/1) de/ reit cop ter K
a s - 1 >
(S it t) C
AIRCRAFT SERIALSi
No. es
- 7 6 0 - 750 TYPE OF REGIS neck Ono box)
FOR FAA USE ONLY PO
rs
it3
0 1. Individual . Corporation
O 2. Partnership 04. Co-Owner ' 0 5. Government o
_I.
O 8. Non-Citizen Corporation
O 9. Non-Citizen Corporation Co-Owner o
NAME OR APPLICANT PeriSon(s) shown on evidence of ownership. If individual. glve last name. first name. and middle Initial.)
rrae4:90tAn. A4 c ...... -.-% c_ •
....-.4--ein,Let-Ficfrto1/4.0 •
41111
TELEPHONE NUMBER: ( )
ADDRESS (Permanent mailing address for gist applicant On list) (It P.O. Box is used, physical address must also be shown.)
Number and street li 0 S Wo et '<Roca. • so;4-t. ac,...D.
Rural Route: PO. Box:
CITY STATE ZIP CODE
\N) t tAAJtAID)63 ...N. "ble.. I9 203
O CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE OF ADDRESS
ATTENTION! Read the following statement before signing this application.
This portion MUST be completed. -
A false or dishonest answer to any question In this application may be grounds for punishment by line and/or Imprisonment
N.S. Code. Titie 1ii. sec. teat).
ID CERTIFICATION
IAVE CERTIFY:
(t) That the above aircraft is owned by the undersigned appliCant. who is a citizen (including corporations)
of the United States.
(For voting trust. give name of trustee: ) or:
' CHECK ONF AS APPROPRIATF•
a. A resident alien• with alien registration (Form 1-151 or Form 1.551) No.
b.A non-citizen corporation organized end doing business under the laws of (state)
and said aircraft Is based and primarily used in the United States. Records or flight hews are available for
Inspection at
(2) That the aircraft b not registered under the laws of any foreign country; and
(3) That legal evidence of ownership 1 attached or hos been flied with the Federal Aviation Administration.
NOTE: If executed for co-ownership all applicants must sign. Use reverse side If necessary.
TYPE OR PRINT NAME BELOW SIGNATURE
SIGNATURE TITLE DATE
EACH PART OF THIS ....... ,QW. . \I i 11-t r __ g"e-St C 9 re 4-4+ % IQ- I la
SIGNATURE trYt.le3 .c . TITLE DATE
APPLICATION MUST
102280834295
BE SIGNED IN INK.
SIGNATURE TITI-E55. GO 08/18/2010 DATE
.._.....
.
NOTE Pending receipt of the Certificate of Aircraft Regis ration, the aircraft may be operated for • period not In excess of GO
days. during which time the PINK copy of this app 'Catlin, must be earned In the elrerett: • '
AC Form 8050.1 (1/08) (NSN 0052-00-628-9007) Supersedes Previous Edition
SDNY_GM_02762440
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249362
EFTA01332806
SDNY GM 02762441
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249363
EFTA01332807
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE001916668
name change
rev/doi 022709
SDNY_GM_02762442
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249364
EFTA01332808
SDNY_GM_02762443
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249365
EFTA01332809
'RECORDED CONVEYANCE PILED IN:
V.S. DEPARTMENT OF TRANSPORTATION NNUM:
FEDERAL AVIATION ADMINISTRATION SERIAL NUM:
CROSS-REFERENCE—RECORDATION Nom'
moDa.:
AIR CARRIER:
This form is to be used in cases where a conveyance coven several aircraft and engines, propellers, or locations. File original of this farm
with the recorded conveyance and a copy in each aircraft folder invol rid.
TYPE. OF CONVEYANCE DATE EXECUTED
NAME CHANGE FEBRUARY 11, 2010
FROM DOCUMENT NO.
AIR GHISLAINE INC
TO OR ASSIGNED TO DATE RECORDED
SHMITKA AIR INC
MARCH 17, 2010
THE FOLLOWING COLLATERAL IS COVERED BY THE CONVEYANCE:
Total Aircraft: Total Engines: Total Props: Total Sparc Parts:
Ars.n043RWMM
SDNY_GM_02762444
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249366
EFTA01332810
SDNY_GM_02762445
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249367
EFTA01332811
8
Special Registration Number 2
ASSIGNMENT OF SPECIAL N722M
•
a
REGISTRATION NUMBERS
a
Pitsent Regisiratiee Number
Aircraft Make and Model N750A
u.s oeseseme
al Teossediteto KEYSTONE HELICOPTER S76C
Issue Dale:
Fedor& RAS* Serial Number Mar 10, 2010
AdmIMstration 760750 This is your audicery to charge 0
N7223E - 52325707
ICAO. AIRCRAFI ADDRESS CODE FOR the United Styles reitiMadoe
moan Gotha above described
eagle° the special
AIR GHISLARNE INC registaltiou ouster shown.
103 POW( RD
Cony duplicate of ttis fen is the
WILMINGTON DE 19803-3742
ImIliliilliklultikluklita•M emit member "di the
ImillsinlvIiil old registration CaNlifICIAC es
interim 'Amity mosaic the
eiraaft pendia; receipt ofMind
eatiftcaic ofregisoatica.
Obtain . revised°Mega of
Mt from your as
en Flight Standard ;District
OM=
The Moss FAA Porn 81304,
Applirmloo For Mnrorthhens
a Me S dated:
Jan 14.:010
The sienrthinesr dW&rI®
sad category:
EXPERD4Off
INSTRUCTIONS:
the special
RETUR N THE ORIGIN AL of this form to the Civil Aviation Registry, AFS-750, wits 5 drys der
SIGN AND will than be issued.
on the airmail A revised certificat e
regimation number is placed
2011
The solitarily to use the special member mita: Mn 10,
CERTIFICATION: toed* that resittetioe ureter was placed RETURN FORM TO:
on the Sag% described Civil Aviation Registry, AFS-750
for Shmitka Air, P.O. Box 25504
Oldationta City, Oklahoma 73125-0504
Swat= of 1 -Larne
.D rect r of Operations of
Tio,,,,-0„„er.Ohmitke Air, Inc. f/k/a .' '
Air cattie tains, nc..
Dale Placed od AinejlinCULeA r / 5. 2010
AC SORIA MOAN moss) Sepennlai Preview PAM*
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15,
SDNY_ and
GMJ327 62446 17
EFTA_00249368
EFTA01332812
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t'V:1 HUM 03113
SDNY_GM_02762447
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249369
EFTA01332813
AMOMITTMAIMAJW,035 Aero Records & Tide Co.
MWORDMOWMMON P.O. Box 19246
MRIMMIRWORDWORMWDON
February 11, 2010
Hand Delivered
Tm FAA
Oklahoma City, Oklahoma
PORN 8050-64 URGENTLY
a NEEDEDI PLEASE ISSUE AS
Attention:
QUICKLY AS POSSIBLE. THANK YOU! ! !
Gentlemen:
On behalf of our client:
AIR GHISLAINZ INC.
103 Foulk Rd.
Wilmington, DE 19803-3742
Please initiate the following action:
Please ASSIGN special registration number N722JE, which is
reserved for our client, to the following described aircraft which
is registered in their name:
KEYSTONE HELICOPTER S -76C
SERIAL NUMBER 760750
CURRENTLY N750A
PLEASE HAND THE ORIGINAL FORM 8050-64 TO ARTC - P.D. ROOM.
Thank you.
100431322316
$10.00 02/12/2010
0 PLEASE HAND CONFIRIAATION Or RESERVATION LETTER TO *RTC - PUSLIC DOCUMENTS ROOM.
tk PLEASE HAND ORIGINAL rORM S050-114 TO *RTC - PUBLIC DOCUMENTS ROOM.
you,
AERO RECO & TITLE Clk
By. LISA THO S GA
LSIZellenior Administrator, Special Services
/1g
Fee Attached: a 1 ° • 0°
CC: Christopher Shurkus
Sikorsky Aircraft
SONY_GM_02762448
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249370
EFTA01332814
41040HV1NO
Alto Vig0FIVINO
02 T Wci 2I 93J OW
LE NOLLVIIISIO3U JAVelOklIV
"4. ,14,01.03113
SDNY_GM_02762449
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249371
EFTA01332815
FORM APPROVED
OMB No. 2120-0042
UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION
IEDIMAL AWIATKIel Ateleessitimesselete iseesaelen aineilialniCAL CENT=
AIRCRAFT REGISTRATION APPLICATION
co
CERT. ISSUE DATE
UNITED STATES
REGISTRATION NUMBER
AIRCRAFT MANUFACTURER • MOOEL
N 750A
ke st 54one 1-le i;cop-de r
a.
-S-i-kcw-sk,y-435-re-re-ft S-76C-2
AIRCRAFT SERIAL No.
a
760750 FOR FAA USE ONLY
TYPE OF REGISTRATION (Check one boa)
O
CI t InCINKIUM 0 2. Partnership MI 3. COrPOration O 4. Co-owner O 5. GOVT. 0 8. Ner/Catinn
NAME OF APPLICANT (Mamm(e) shown on evidence of ownership. If IndeolduaS give Lest name. ISM name. and middle initial.)
Ill Air Ghislaine, Inc.
TELEPHONE NUMBER: .
ADDRESS (Permanent mailing address les newt applicant listed.) (If P.O. BOX Is used. physical address must also be shown.)
Number end street: 103 Faulk Road
Rural Route: PO. Box:
CITY STATE ZIP CODE
Wilmington DE 19803
O CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE OF ADDRESS
ATTENTION! Read the following statement before signing this application.
This portion MUST be completed.
A false or dishonest answer to any question in this application may be Bounds for Punishment by Ono and r of ImPlitionnvent
(U.S. Cade, ma Ia. See. 1001).
III
INC CERTIFY:
CERTIFICATION
(1) That the above Shoran le owned by the undersigned applicant. who Is a dozen (including corporations)
of the United States.
(For waling bust. give name of truiSlee: ) Or:
CHECK ONE AS APPROPRIATE:
a. O A resident *Min. with alien regiortrMion (Form 1-151 or Form 1-551) No.
b. O A non-ciezen corporation organized and doing business under the laws of (state)
end said semen is based and preneray used In the United States. Records or nigh beta are available for
Inspection al
(2) Thal the aircraft Is not registered under the laws of any torsion Country; and
(9) That legal evidence Of ownership is attached or has been Red with the Federal Aviation Administration.
NOTE: If executed fOr c0-ownership all applicants must sign. Use reverse side If necessary.
TYPE OR PRINT NAME
SIGNATURE
E 7Nar.ATURE
c or TITLE DATE 1
6
gg
2 i MONA E
. I -50st RosegLA- • 4 14112664J k2/.21148
TITLE DATE
LP41O-9 V L 19OSMA.
g SIGNATURE TITLE 090481439131 DATE
g $5.OO 02//7/2000
NOTE Pending receipt of the Certificate of Aircraft Reglsttallon. the ale:sae may be operated for a period not in excess Of SO
days. during Mao, time the PINK copy el Otis agiPlInstiOn must be ankle in the aircraft.
AC Form 8050-1 (5,03) (0052-004284007)
SDNY GM 02762450
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249372
EFTA01332816
•
•
7i1C• 1n0
• ),..610 V: 'V1)10
BO. "Z. Wc1 LI.:93.3 600Z
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SDNY_GM_02762451
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249373
EFTA01332817
0
0
FORM APPROVED
UNITED STATES OF AMERICA OMB NO. 2120-0042 0
V.S. DEPARTMENT OF TRANSPORTATION FEDERAL AvmTION ADMINISTRATION 013131(2006 0
AIRCRAFT BILL OF SALE II
FOR AND IN CONSIDERATION OF $ i+orC THE
UNDERSIGNED OWNER(S) OF THE FULL LEGAL AND I
BENEFICIAL TITLE OF THE AIRCRAFT DESCRIBED AS
FOLLOWS:
8
a
I
UNITED STATES
REGISTRATION NUMBER N750A I
O
AIRCRAFT MANUFACTURER 8 MODEL
Sikorsky Aircraft S-76C-2
AIRCRAFT SERIAL No.
760750
DOES THIS .30
DAY OF December , 2008 a
HEREBY SELL, GRANT. TRANSFER AND
DELIVER ALL RIGHTS, TITLE, AND INTERESTS 3
Do Nor wow in TM Bork T
IN AND TO SUCH AIRCRAFT UNTO: FOR FM USE ONLY y
NAME AND ADDRESS
(IF PrINVIOUAL(9), GIVE LAST NAME. FIRST NAME. AND MDDLEMTIALII
PURCHASER
Air GhislaIne, Inc.,
103 Foulk Rd., #202
Wilmington, DE,
19803
083651547221
$5.00 12/30/2008
DEALER CERTIFICATE NUNOER
Afro TO is steCOOSSOM kt20090203:0001000, 53009 MD ASSIGNS TO HAVE MID TO FOLD
SINOMAALY THE SAID AIRCRAFT FOREVER NC WARRANTS THE WILE THEREOF:
IN TESTIMONY WHEREOF I HAVE SET My MARONE. SEAL TN S go OF 0600000/. 2000
NAME(S) OF SELLER SIGNATURE(S) TITLE
(TYPED OR PRINTED) (IN Par) (IF EXECUTED FOR [TYPED OR PRINTED)
CO.CMAIERSHIP: MAST SIGN,)
Samar Aircraft Corporation S-76 Program Mannar
CC
LL
-J Club Shurkus
_J
LL
ACKNOWLEDGMENT (NOT REQUIRED FOR PURPOSES OF FM RECORDING' HOWEVER. MAY BE REQUIRED SY LOCAL LAW FOR
VALIDITY OF TIE INSTRUMENT
ORIGINAL: TO FM: .
AC From 8050-2 (9/92) (NSN 0052-03-629-0003) Supersoft* Prwkos Milton
SDNY_GM_02762452
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249374
EFTA01332818
As 05 ! Its
coth cocro_:0 4
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SDNY_GM_02762453
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249375
EFTA01332819
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ARE000740071
ORIG DOC ID 80070 FFR 12-30-08 RET TO CiD
SONY GM 02762454
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249376
EFTA01332820
SDNY GM 02762455
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249377
EFTA01332821
I
8
FORM APPROVED
UNITED STATES OF AMERICA OMB NO. 2120-0042 0
0
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION 0813112006 3
0
AIRCRAFT BILL OF SALE
FOR AND IN CONSIDERATION OF siademe
THE 2
UNDERSIGNED OWNER(S) OF THE FULL LEGAL AND
BENEFICIAL TITLE OF THE AIRCRAFT DESCRIBED AS 8
FOLLOWS: a
UNITED STATES
REGISTRATION NUMBER N750A O
0
AIRCRAFT MANUFACTURER 8 MODEL
Keystone Helicopter Corporation S-76C 0
0
AIRCRAFT SERIAL No. 0
760750
DOES THIS 3 U FA- DAY OF bQ C
a
HEREBY SELL, GRANT, TRANSFER AND
DELIVER ALL RIGHTS, TITLE, AND INTERESTS
Do N NANA In MN Block
L ll
IN AND TO SUCH AIRCRAFT UNTO: FOR FAA USE ONLY
DD
NAME AND ADDRESS
(IF INONIOUAL(S), GIVE LAST NAME. FIRST NAME. AND MOLE )
PURCHASER
Sikorsky Aircraft Corporation
6900 Main Street
Stratford, CT 06614
DEALER CERTIFICATE NUMBER
MID TO ITCH MitteSSOIS ar.111-0115. ADWRISTRATONG. AND ASSIGNS TO HAVE AND TO MOLD
SINGULARLY THE SAC AIRCRAFT FOREVER ANO WARRANTS THE TITLE THEREOF:
44,
IN TESTIMONY WIEREOF HAVE SET RAND AND SEAL THIS DAY OF
NAME(S) OF SELLER SIGNATURE(S) TITLE
(TYPED OR PRINTED) OM INK) (F EXECUTED FOR (TYPED OR PRINTED)
COOMERSme, ALL MUST SIGN.)
Keystone Helicopter Corporation preSenl
CC
LLI
David A. Ford
(r)
ACKNOWLEDGMENT (NOT REQUIRED FOR PURPOSES OF FAA RECORDING: HONEvER. MAY BE REQUIRED BY LOCAL LAW FOR
VALIDITY Of TIE INSTRUMENT.)
ORIGINAL TO FM
AC Form 8060.2 (9/92) (NSN 0062 00 a29 0003) Supersedes Previous ErMice
SDNY_GM_02762456
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249378
EFTA01332822
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80 NOLISSIMD3il idV838IV
VV4 1411/A 0316
SDNY_GM_02762457
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249379
EFTA01332823
DOCUMENT LEVEL ANNOTATIONS FOR DOCUMENT ABE000740069
ORIG DOC ID #0068 FFR 12-30-08 RET TO ca.
SONY_CPO_02762458
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249380
EFTA01332824
SDNY_GM_02762459
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249381
EFTA01332825
Dec 22 2008 3:24PM HP LASERJET FAX P•2
Keystone Helicopter 0
A Sikorsky Company 110 E. Stewart Huston Drive, Coatesville PA, 19320
0
0
December 22, 2008
Flight Standards Service
Aircraft Registration Branch, AFS-150
CAR F
PO Box 2550
Oklahoma City, Oklahoma 73125-0504
incorrectly
Keystone Helicopter Corporation is requesting the correction of aircraft that where
that have been registered from oor facility where registered as MODEL: S-76C-2,
registered. Some of the aircraft
the aircraft should have been registered as S-
this is not in accordance with our type certificate data that (HINE); any
manufacturer we are requesting that these please be corrected. We apologize for
76C. As the Aircraft
g N Number are affected
inconvenience this may cause. The following A/C Serial Numbers with the correspondin
by this error, they include:
Aircraft Serial Mugabe: Aircraft N Number
760686 . 718P
' 759
4151'
7
60717 767J
(V760720 720Q
91760723 723Y
760726 753P
6160729 799Y
60731 7817(
607 74
743N
746X
747Y
748A
60750 7504
6075 ' 7$A
C,?5/60753 75311
cpcitegards.
Shaun M. Ge hard
S76 Quality Assurance Production Supervisor
Keystone Helicopter Corporation
110 E. Stewart Huston Or.
Coatesville PA 19320
SDNY_GM_02762460
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249382
EFTA01332826
V1401471)10
A113 7i4O/4V1N0
00 C lid 22 330 800?
SDNY_GM_02762461
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249383
EFTA01332827
MEMORANDUM TO ME FILE
JENNY ROSALES 09/92008
ID DATE
A Prior Record search was performed for ISZYSTONE HELICOPTER CORP S-76C-2. 760730 on 9/9/2008. Search
readts:
No Prior Record
Assigned N730A
SDNY_GM_02762462
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249384
EFTA01332828
SDNY_GM_02762463
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 002493R5
EFTA01332829
U.S. Department Flight Standards Service P.O. Box 25504
of Transportation Aircraft Registration Branch, AFS-750 Oklahoma City, Oklahoma 73125-0504
(405) 954-4208
Federal Aviation Toll Free: 1-B66-704-4715
Administration WEB Address: Mp://registry.faa.gov
September 9, 2008
KEYSTONE HELICOPTER CORP
110 STEWART HUSTON DR
COATESVILLE PA 19320
Dear Sirs:
United States identification mark N750A has been assigned to KEYSTONE HELICOPTER
CORP S-76C-2, serial number 760750, Mode S Transponder Code 52415011 as requested by
you. This manufacturers assignment of special registration number cannot be used as an
authorization for a number change.
If we may be of further assistance, please contact the Aircraft Registration Branch at
(405) 954-4206 or toll free 1-866-704-4715.
Sincerely,
Legal Instruments Examiner
Aircraft Registration Branch
AFS-750-SUPPORT-5 (9/04)
SDNY_GM_02762464
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249386
EFTA01332830
SDNY_GM_02762465
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249387
EFTA01332831
a
•
12
9/4/08 ,
O
Federal Aviation Administration
Civil Aviation Registry
Aircraft Registration Branch
Attention: Central Records
Reference: Request for Manufacturer's
Registration Number AssignMents
Gentlemen/Ladies:
This is written to request reservation 6
assignment of the following special registration
numbers to the aircraft described bolo* which are
presently under manufacture:
ALL ARE KEYSTONE HELICOPTER CORP.,
MODEL S-76C-2
REGISTRATION NO. SERIAL NO.
N74176- 760741
N743N 760743
N7450 760745
N746K 760746
N747Y 760747
N748A 760748 /
N750A 7607501/
N7518 760751
N753V 760753
Thank you.
Sincerely,
KEYSTONE HELICOPTER CORPORATION
By:
Carl Kress
S76 Program Manager
SDNY_GM_02762466
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA_00249388
EFTA01332832
A11:) r!• ug7xo
AA1
I s tv:
Ue
um/
v
uouve.tet
SDNY_GM_02762467
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249389
EFTA01332833
MWMAIMMESIMMMES
Aero Records & Title Co.
RWORWMSUMOM P.O. Box 19248
muntirramommmmvax Oklahoma CIty. OK 73144 a
September 5, 2008
Hand Delivered
To: FAA
Oklahoma aty, Oklahoma
8
Attention: Central Records
Gentlemen: -
On behalf of our client:
KEYSTONE HELICOPTER CORPORATION C :Th
CS
no_ A ft cr_
—
110 East Stewart Huston Drive
Coatesville, PA 19320
Please Initiate the following action:
Please RESERVE and assign the following NINE (9) special
registration numbers to the aircraft listed below which are
presently under manufacture:
ALL ARE KEYSTONE HELICOPTER CORP.,
MODEL 9-76C-2
REGISTRATION NO. SERIAL NO.
I N741A 760741
N743N 760743
N745G 760745
4 N746K 760746
C N7472 760747
N748A 760748
dip N750A 760750
N751E 760751
q N753V 760753
PLEASE ISSUE FORM AFS-750-SUPPORT-5 TO THE MANUFACTURER, KEYSTONE
HELICOPTER CORP., AT THE ADDRESS SHOWN ABOVE. PLEASE HAND COPIES
OF THE MANUFACTURER ASSIGNENT LETTERS TO ARTC - P.D. ROOM.
Note: Enclosed is a "fax" letter by the manufacturer,
confirming their need for these assignments.
Thank you.
082491212072
890.00 00/05)2008
)4 PLEASE NAND CONFIRMATION OF RFSII ATION LETTER TO ARTC - PUBLIC DOCUMENTS ROOM.
cmi
taz eit504m
5
\lti PLEASE NAND TO ARTC - PUBLIC DOCUMENTS ROOM.
Thank you,
AER" RECO
By: LI
/1 THOMAS GASKIN/Senior Administrator, Special Services
9
FeeAttached:0 1'. °G)
CC: Carl Kress
Keystone Helicopter Corp.
SDNY_GM_02762468
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249390
EFTA01332834
VIN0.11)10
Ali3 vs% 'HY1110
IS TT Wki S 43S HOZ
Ufl
vvd HI 131IJ
SDNY_GM_02762469
SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17
EFTA 00249391
EFTA01332835