1.		Applicant’s organization information 	
1.1.		Applicant’s organization name		
1.2.		Applicant’s organization Legal Address		
1.3.		Applicant’s organization Business (actual) address	(do not fill in if replicates paragraph 1.2)	
1.4.		Application focal point	Title		 Mr    	Ms	
1.1.			Name		
1.1.			Position		
1.1.			Phone		
1.1.			E-mail		
		
2.		Application for	
2.1.			Type Certificate		Type Certificate Restricted Category	
		Supplemental Type Certificate		Major Change Approval

	Minor Change Approval	
			
3.		Aeronautical Product Category	
3.1.			Normal category airplanes		Normal category
	Utility Category
	Acrobatic category
	Commuter Category	
3.2.			Transport category airplane	
3.3.			Normal category rotorcraft	
3.4.			Transport category rotorcraft	
3.5.			Balloon	
3.6.			Engine 		Gas-turbine engine

	Piston engine

	 Other: 	
3.7.			Auxiliary Power Unit	
3.8.			Propeller	
3.9.			Unmanned aviation systems		Aircraft type

	Rotorcraft type	
3.10.		Applicable Airworthiness requirements 		

4.		Data package and associated information on the application	
4.1.		Type Certificate
(in accordance with p. 21.15(c) and 21.502(b) FAR-21)	Type name		
1.1.			Type Certificate Number of primary certification authority		
1.1.			The positions listed below shall be provided to FATA:
	Specifications pack (technical description, principle schemes, basic characteristics, excepted operating conditions and limitations and e. t. c.)
	View of the aircraft in three projections. For engine, propeller, UAV operating and control equipment – common view drawing
	Certification basis 
	Type Certificate and Type Certificate data sheet
	Aviation Authority cover letter	
4.2.		Type Certificate Restricted Category
(in accordance with p. 21.12A, 21.15(c) and 21.502(b) FAR-21)	Type name 		
1.1.			Type of works 		
1.1.			Type Certificate Number of primary certification authority		
1.1.			The positions listed below shall be provided to FATA:
	 Specifications pack (technical description, principle schemes, basic characteristics, excepted operating conditions and limitations and e. t. c.)
	View of the aircraft in three projections. For engine, propeller, UAV operating and control equipment – common view drawing
	Certification basis 
	Type Certificate and Type Certificate data sheet
	Aviation Authority cover letter	
4.3.		Supplemental type certificate 
(in accordance with p. 21.113B and 21.502(b) FAR-21)			
1.1.			Name of the modification		
1.1.			STC Number of primary certification authority		
1.1.			a)	 Single Type design, or	b)	 Multiple Type designs	
1.1.			Modified type/model	(do not fill in if replicates paragraph 4.3.b)	
1.1.			FATA Type certificate number	(do not fill in if replicates paragraph 4.3.b)	
1.1.			TC Holder	(do not fill in if replicates paragraph 4.3.b)	
1.1.			The positions listed below shall be provided to FATA:
	Modification certification basis
	Technical description
	Certification program  
	Copy of agreement between the developer of the modification (Applicant) and Type certificate holder or
	Substantiation of the fact that the applicant has sufficient information regarding the actual type design of the modified aeronautical product in accordance with  paragraph 21.113В(b)(1) FAR-21
	Supplemental Type Certificate
	Aviation Authority cover letter
	Aircraft Model List (AML) (if applicable)	

4.4.		Minor change approval
(for organizations that do not hold the Type Certificate, 
p. 21.91, 21.112B(b) and 21.502 
FAR-21)	a)	 Single modification	b)	 Multiple modifications	
1.1.			Modified Type/Model	(do not fill in if replicates paragraph 4.4.b)	
1.1.			Number of the FATA Type Certificate	(do not fill in if replicates paragraph 4.4.b)	
1.1.			Type Certificate Holder	(do not fill in if replicates paragraph 4.4.b)	
1.1.			Name of the modification	(do not fill in if replicates paragraph 4.4.b)	
1.1.			The positions listed below shall be provided to FATA:
	Technical description of the modification 
	Documents about Classification of changes (with substantiation)
	List of Airworthiness and environmental protection requirements the compliance to be established with
	Certification program 
	Change Approval 
	Attached List of Modification (if applicable)
	Compliance Checklist (the document with provided means of compliance and substantiational data for each applicable airworthiness requirement of the modification )	
	
4.5.		Major change approval
(in accordance with p. 21.93
 FAR-21)	a)	 Single modification	b)	 Multiple modifications	
1.1.			Type of change:	Significant	Non-significant	
1.1.			Modified type/Model	(do not fill in if replicates paragraph 4.5.b)	
1.1.			Number of the FATA Type Certificate	(do not fill in if replicates paragraph 4.5.b)	
1.1.			Name of the modification	(do not fill in if replicates paragraph 4.5.b)	
1.1.			The positions listed below shall be provided to FATA:
	Technical description of the modification 
	Documents about Classification of changes (with substantiation)
	List of Airworthiness and environmental protection requirements the compliance to be established with
	Certification program 
	Approval documents  of primary certification authority
	Aviation Authority cover letter
	Attached List of Modification (if applicable)	

5.		Design organization information 	
5.1.		Design organization approval certificate		Yes (go further)		No (att. p. 5.5)	
5.2.		Terms of Approval match the application area		Yes (go further)		No (att. p. 5.5)	
5.3.		Number of Design organization approval certificate		

6.		Declaration of applicant	
	I hereby certify, that I’m familiarized with the certification procedures, execution timeframe of the certification activities and also that the provided data is correct. 	
	Date 		Signature 		
	Name of the applicant’s head (person entitled)				

7.		Forwarding the application	
	The application can be forwarded to the Federal Air Transport Agency in following ways:
1.	In electronic form to the official e-mail of the Federal Air Transport Agency – rusavia@scaa.ru. While submitting an application in electronic form the application text must be legible and easy to read.
2.	 In hard copy (original, the application must be sent to the following post address:
37 k. 2 Leningradsky prospect,
Moscow, 125993,
Russian Federation.
Each application must be sent to the Federal Air Transport Agency with a cover letter on the company letterhead of the applicant organization.	

Short description of FATA/AR RF validation Process and notes

Modification list of the applications for certification in FATA
A1. General information		
Modified type/model:		
Number of the FATA Type Certificate:		
Type Certificate Holder:		
Initial Aviation Authority documents  		Aviation Authority cover letter 	DOA Certificate
       (The positions listed below shall be provided to FATA)	
A2. Information about modification	
1	2	3	4	5	6	
#	Name of the modification	Significant/
Non-significant	Modification ref. number	Documents describing the modification	Approval documents	

Notes:
1.	In column 5 mentioned documents including the following: Certification basis, certification plan, technical description of the modification, includes classification changes (with substantiation). Documents and files should be provided in the individual folder for each modification. The folder should be titled in accordance with the number from the modification list combined with the unique number of modification, for example 1_MOD123456. These documents shall be providing to m.validation@aviareg.ru or alternatives method after FATA accepted the application. When sending documents, the registration number of the application must be indicated
2.	For the minor change applications the links on the documentation should be provided, the documentation should be provided by the request if needed
3.	In column 6 should be provided links on the approval document issued by the primary certification authority or the direct approval under the authority of DOA. This documents shall be provided to FATA include this application.
4.	Following the documentation should be provided by the request if needed
‐	Analysis, reports, test reports;
‐	Installation drawings;
‐	Service and Engineering bulletins ;
‐	Component approvals (TSO/ETSO);
‐	Operation documentation.