Document
United States Department of the Interior
Office of Aviation Services
300 E. Mallard Drive, Suite 200
Boise, Idaho 83706 - 3991
REQUEST FOR FLEET AIRCRAFT EQUIPMENT CHANGE OR MODIFICATION
Requested By: Requesting Agency: Date: Aircraft ‘N’ Number Aircraft Model: Purpose for Change: Description of Change: -ESTIMATED COST- Parts & Material Labor -TYPE CHANGE- Avionics Equipment Change Minor Alteration Major Alteration Other Approval Data: Manufacturer STC DER Other -REQUIRED DOCUMENTATION- Log Book Entry FAA Form 337 Field Approval Wt & Balance POH Supplement Placards -WORK TO BE PERFORMED BY- Facility Past Experience -OAS RECOMMENDATION & COMMENTS- -AGENCY & OAS APPROVAL- *Details of request and/or supporting documentation attached OAS-74 (12/12)