Federal Aviation Administration, DOT

Figure C4F

Attachment 4 to Appendix C to Part 60Sample Statement of Qualification; Configuration List
INFORMATION

Visual System Manufacturer
and Type:

Motion System Manufacturer
and Type:

FSTD Seats
Available:

Engine Instrumentation:
EICAS 0 FADEC
Other:

Flight Instrumentation:
0 EFTS 0 HUD 0 HGS 0 EFVS
0 TCAS 0 GPWS 0 Plain View
0 GPS 0 FMS Type:
0 WX Radar 0 Other: _

Engine Type(s):

Aircraft Equipment:

Pt. 60, App. C

Airport Models:

3.6.1

Circle to Land:

Air ort Desi nator
3. 7.1
Ai ort Desi nator

Visual Ground Segment

3.8.1

0
0

Air ort Desi nator

Section 2. Sunnlementarv Information
0 POI 0 TCPM 0 Other:

FAA Training Program Approval Authority:
Name:

Office:

Tel:

Fax:

-

Section-

Email:

I

I

.SectionSection

FSTD Scheduling Person:
Name:
Address 1:

Address 2

City:

State:

ZIP:

Email:

Tel:

Fax:

-

FSTD Technical Contact:
Name:
Address 1:

Address 2

City:

State:

ZIP:

Email:

Tel:

Fax:

Section 3~
Train~.t,

Testin~.

and Checkinf! Considerations

Area/Function/Maneuver

Requested

Private Pilot- Training I Checks: (142)

0
0
0
0
0

Commercial Pilot- Training /Checks:(l42)
Multi-Engine Rating- Training I Checks (142)
Instrument Rating -Training I Checks (142)

SectionSectionSectionSection=-

-

415

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kpayne on VMOFRWIN702 with $$_JOB

Type Rating -Training I Checks (135/121/142)

Remarks