Professional Aviation Services

2152 Astoria Circle # 104
Herndon, VA 20170
Fax 703 657-0340

CUSTOMER INFORMATION
Customer Name
Primary Contact Name
Contact's e-mail
Contact's Business Phone Number
Contact's Cell Phone Number
Contact's Fax Number
Billing Address


Delivery Address


Name on A/C Registration
PERSON RESPONSIBLE FOR MAINTENANCE OPERATIONS
Name
Title
Business Phone Number
Cell Phone Number
Fax Number
E-Mail Address
Delivery Address


AIRCRAFT DETAILS
A/C Make and Model
A/C Year of Manufacture
A/C Registration Number
A/C Serial Number
A/C Base Color and Trim Color
A/C Location (City & ICAO ident)
Engine Type and Dash Number
MTOGW (lbs.)
Zero Fuel Weight (lbs.)
Basic Empty Weight BEW/BOW (lbs.)
Service Ceiling
Maximum Fuel in Pounds
RVSMYes No
RVSM CERTIFICATION INFORMATION
Was A/C Manufactured RVSM Compliant? Yes No if no,
RVSM Completed by:
Vendor or Maintenance Facility
Contact Name
Contact Cell Phone Number
Business Phone Number
Fax Number
Contact E-Mail Address
Facility Website or E-Mail Address
Mailing Address


Date Completed
Comments:

MAINTENANCE OF RVSM EQUIPMENT
Maintenance Facility
Contact Name
Contact Cell Phone Number
Business Phone Number
Fax Number
Contact E-Mail Address
Facility Website or E-Mail Address
Mailing Address


Certified Repair Station Number
RVSM/MNPS EQUIPMENT INFORMATION and LONG RANGE NAVIGATION AND COMMUNICATIONS SYSTEMS
Qty.	Type of Equipment	Manufacturer	Part No.
	Autopilot
	Primary Altimetry (Altimeters and/or EFIS)
	Air Data Computers
	Altitude Alerter
	Transponder
	TCAS
	EGPWS/GPWS
	GPS
	INS
	IRU/IRS
	LORAN
	VHF 8.33 KhzYesNo
	HF
	SATCOM
	SELCAL CODE:
MAINTENANCE DETAILS
Airworthiness Directive's (AD's) *Not* Complied With
Inspections Out of Date
Inspections Due
Additional Comments: