051-lsa-aircraft-data-sheet

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document_type=form entity=format:application/pdf entity=language:ar language=en taxonomy_l1=transport taxonomy_l2=aviation taxonomy_l3=aircraft_certification validity=valid validity_confidence=0.6

GACA
الطبيه العامه للطيران المدني
General Authority of Civil Aviation
[Non-Text]
LSA - AIRCRAFT DATA SHEET
(1) All Certificates, AD's and life limited equipment installed on the aircraft will have a minimum calendar life of 90 days remaining, prior to expiry from the date of application submitted to the GACA, otherwise all applications will be rejected and returned to the applicant for resubmission.
(2) Any changes/corrections to this form after signature/stamp by the NCAA of Aircraft Registry will null and void the form.
(3) Original copy of this form should be submitted to GACA with application.
1. Aircraft Information
<table><tr><td>Registration Mark</td><td></td><td>Serial No.</td><td></td><td>Type Cert. No.</td><td></td></tr><tr><td colspan="6">Aircraft Owner / Operator Name</td></tr><tr><td colspan="2">Max. Gross Weight (kg)</td><td>TT (hours)</td><td></td><td>TC (Cycles)</td><td></td></tr><tr><td colspan="2">Aircraft Manufacturer</td><td>Model/Series</td><td></td><td>Date of Mfr.</td><td></td></tr><tr><td colspan="3">Engine Manufacturer</td><td>Model/Series</td><td colspan="2"></td></tr><tr><td colspan="3">Propeller Manufacturer</td><td>Model/Series</td><td colspan="2"></td></tr></table>
2. Approved Manuals (Check applicable only)
<table><tr><td>#</td><td>Type</td><td>Revision No.</td><td>Revision Date</td></tr><tr><td>1</td><td>Airplane Flight/Operating Manual (AFM)</td><td></td><td></td></tr><tr><td>2</td><td>Pilot&#x27;s Operating Manual (POH)</td><td></td><td></td></tr><tr><td>3</td><td>Aircraft Operating Instructions (AOI)</td><td></td><td></td></tr></table>
3. Last Airworthiness Directives Complied with (If applicable only)
<table><tr><td>FAA AD&#x27;s No.</td><td>Date</td><td>EASA AD&#x27;s No.</td><td>Date</td></tr><tr><td></td><td></td><td></td><td></td></tr></table>
4. Last Aircraft Inspections Performed
<table><tr><td>Type</td><td>Date</td><td>Total Time</td><td>Location</td><td>Certificate No.</td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr></table>
5. Emergency Equipment and Systems Status
<table><tr><td colspan="2">Description</td><td>Number Installed</td><td>Next Due or Expiry Date</td><td>Remarks</td></tr><tr><td>1</td><td>ATC Transponder Test &amp; Inspection (91.453)</td><td></td><td></td><td></td></tr><tr><td>2</td><td>Altimeter System Test &amp; Inspection (91.451)</td><td></td><td></td><td></td></tr><tr><td>3</td><td>Emergency Loc. Transmitter Battery (91 App ‘C’)</td><td></td><td></td><td></td></tr><tr><td>4</td><td>Portable Fire Extinguisher/s</td><td></td><td></td><td></td></tr><tr><td>5</td><td>First Aid kit</td><td></td><td></td><td></td></tr><tr><td>6</td><td>Mass (Weight) &amp; Balance last check</td><td></td><td></td><td></td></tr></table>
6. Statement of Undertaking
<table><tr><td colspan="3">I do herby certify that the above information and attached documents are true and correct and that the aircraft is in a condition for safe operation</td></tr><tr><td>Name</td><td>Company</td><td>Stamp</td></tr><tr><td></td><td></td><td rowspan="3"></td></tr><tr><td>Date</td><td>Signature</td></tr><tr><td></td><td></td></tr></table>
GACA-AVSES-AIR-F051
Rev: 2, Date: 07 Sep 25
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