Pt. 60, App. D

14 CFR Ch. I (1-1-19 Edition)

Attachment 4 to Appendix D to Part 60Figure D4B- Sample Letter, Request for Initial, Upgrade, or Reinstatement Evaluation
Attachment: FSTD Information Form

INFORMATION
Engine Type(s):

Aircraft Equipment:

Engine Instrumentation:
0 EICAS 0 FADEC
OOther:_

Airport Models:
Circle to Land:
Visual Ground Segment

Section 2. SuppJementanrJnformation
0 POI 0 TCPM 0 Other:

FAA Training Program Approval Authority:
Name:

Office:

Tel:

Fax:

Email:

I

l

FSTD Scheduling Person:
Name:
Address l:

Address 2

City:

State:

ZIP:

Email:

Tel:

Fax:

FSTD Technical Contact:
Name:
Address 1:

Address 2

City:

State:

ZIP:

Email:

Tel:

Fax:

Section 3. J'raining, Tesdng andCheckine Considerations
Area/Function/Maneuver

Requested

:g

Private Pilot - Training I Checks: ( 142)
Commercial Pilot - Training /Checks:( 142)

0
0
0
0
0

Multi-Engine Rating- Training I Checks (142)
Instrument Rating -Training I Checks ( 142)
Type Rating -Training I Checks (135/1211142)
Proficiency Checks (1351121/142)

-

-

480

VerDate Sep<11>2014

16:30 Jun 25, 2019

Jkt 247047

PO 00000

Frm 00490

Fmt 8010

Sfmt 8006

Q:\14\14V2.TXT

PC31

ER09MY08.056</GPH>

kpayne on VMOFRWIN702 with $$_JOB

CAT I: (RVR 2400/1800 ft. DH200 ft)

Remarks