Order:  8130.21B                                                                                                                              11/7/97

PROCEDURES FOR COMPLETION AND USE OF FAA FORM 8130-3,
AIRWORTHINESS APPROVAL TAG

Distributed to:
		A-W(FS)-2; A-W(IR)-3; A-X(FS/CD)-3;
		A-FFS-7(ALL); A-FAC-0(ALL);
		AMA-220(25 copies)/250(500 copies);
		AVR-20(ALL); AFS-600(3 copies);
		AEU-100; FDR-1D

Initiated by:
		AIR-200

1. PURPOSE. 
  This order revises the procedures for completion and use of Federal Aviation Administration (FAA) Form 8130-3, Airworthiness Approval Tag. The revised procedures provide definition of "direct control" of electronic signatures for Form 8130-3. The order contains procedures concerning the use of Form 8130-3 for airworthiness approval, export approval, conformity determination of prototype products/parts, an indication of approval for return-to-service (RTS). In addition, Form 8130-3 is being expanded to include its use for airworthiness approval domestically, and the split of bulk shipments. For the purposes of this order, the term product, AS IT RELATES TO DOMESTIC USE, applies to aircraft engines and propellers ONLY. 

2. DISTRIBUTION.
   This order is distributed to Washington Headquarters division levels of the Flight Standards Service; to the branch levels of the Aircraft Certification Service; to the branch levels in the regional Flight Standards Divisions and Aircraft Certification Directorates; to all Flight Standards District Offices; to all Aircraft Certification Offices, and all Manufacturing Inspection District and Satellite Offices; to the Aircraft Certification and Airworthiness Branches at the FAA Academy; to the Suspected Unapproved Parts Program Office; and to the Brussels Aircraft Certification Division.

3. CANCELLATION.
   Order 8130-21A, Procedures for Completion and Use of FAA Form 8130-3, Airworthiness Approval Tag, dated January 3, 1994, is canceled.

 4. BACKGROUND.
   The evolution of this order and Form 8130-3 is the result of discussions within the FAA, its counterparts in other jurisdictions, and the aviation industry. Order 8130.21, Procedures for Completion and use of FAA Form 8130-3, Airworthiness Approval Tag, was issued June 21, 1991, as a first step in standardizing U.S. procedures for the export of aviation products/parts. Notice 8130.67, Issuance of a Supplement FAA Form 8130-3, to Split Bulk Shipments of Class II & III Products, dated March 27, 1995, has been incorporated. This revision builds on past experience to facilitate the movement of urgently needed FAA-approved products/parts to the end user for installation on type certificated products. It further enhances our efforts to promote safety of flight and to foster U.S. air commerce, by expanding the use of Form 8130-3 to increase the availability of approved products/parts. 

5. EXPLANATION OF MAJOR CHANGES.
 a.	Many production approval holders maintain an active parts inventory at facilities (also referred to as distribution centers) in the United States and other jurisdictions to provide quick delivery of aircraft products/parts to their customers. Title 14 Code of Federal Regulations (14 CFR) part 21, Certification Procedures for Products and Parts (part 21), restricts the issuance of export airworthiness approvals to parts manufactured and located in the United States. This order contains procedures for the issuance of a supplement Form 8130-3 to split bulk shipments and ship parts that are located at the production approval holder's inventory facility at domestic and international locations.
 b.	This order provides for the domestic use of Form 8130-3 to document the conformity determination of products (aircraft engines and propellers) and parts that are produced in the United States pursuant to an FAA type and production certificate (PC).
 c.	Order 8130.21A included the use of Form 8130-3 for identification of new products/parts produced and shipped within the United States by a Production Approval Holder (PAH) or its supplier. This revision eliminates the term "identification" and incorporates the term "Airworthiness Approval" as its replacement. This refers to products/parts that are produced by a PAH and conform to FAA approved design data.
 d.	Form 8130-3 can be used to document the following:
	(1)	Export airworthiness approvals of Class II and III products;
 	(2)	Conformity determinations;
 	(3)	Airworthiness approval of domestic products (aircraft engines and propellers - domestic shipments);
 	(4)	Airworthiness approval of parts and appliances under section 21.305;
 	(5)	Splitting bulk shipments of previously shipped parts;
 	(6)	RTS after maintenance, preventive maintenance, rebuilding and alterations. 

NOTE: Each of the purposes listed above involve a new product/part certification or maintenance action to determine the serviceability of the product/part in question.

 6. EXPORT AIRWORTHINESS APPROVALS OF CLASS II AND III PRODUCTS.
 a.	General.
	(1)	Part 21, subpart L, contains the procedural requirements for making application for and issuance of export airworthiness approvals. The application for export is made on FAA Form 8130-1, Application for Export Certificate of Airworthiness. However, written applications are not a requirement for Class II products that are manufactured by a PC holder and Class III products that are produced by a PAH. In these cases, oral application or requests may be made to the FAA. Export airworthiness approvals are issued as Form 8130-3 for Class II and III products when a determination has been made that the parts are airworthy.
	(2)	Under section 21.323(b), any manufacturer may obtain an export airworthiness approval for a Class III product if the manufacturer has in its employ a designated representative of the Administrator who has been authorized to issue that approval. The manufacturer must also hold for that product a PC, an Approved Production Inspection System, a Parts Manufacturer Approval (PMA), or a Technical Standard Order (TSO) authorization. Products that are not produced under an FAA production approval are not eligible for issuance of Form 8130-3 for export.

  NOTE: It is the responsibility of the exporter to determine, and the FAA designated representative to confirm, the classification eligibility of Class II & III products prior to issuing Form 8130-3. Exporters sometimes present an application for products claimed to be Class II that are actually Class III products.  

	(3)	Section 21.325(b)(3) states that export airworthiness approvals are issued for Class II and III products that are manufactured and located in the United States. PAH's that have an international manufacturing facilities as part of their PC extension and want to obtain Form 8130-3 for export from these locations would have to be granted an exemption to section 21.325(b)(3).
		(a)	PAH's that have been granted an exemption from section 21.325(b)(3) are authorized to issue an original Form 8130-3 to export new Class II and III products from their production approval extension facilities for the duration of the exemption. Form 8130-3 must be signed by the FAA or an authorized representative of the Administrator.
		(b)	If a PAH has not been granted an exemption from section 21.325(b)(3), the parts must be located in the United States when the original Form 8130-3 is issued.
	(4)	An original Form 8130-3 may only be issued by the FAA or an authorized representative of the administrator from non-U.S. suppliers with direct ship authority from the PAH. The PAH must have been granted an exemption from section 21.325(b)(3) and the form must be signed by the FAA or an authorized representative of the Administrator.
	(5)	PAH international inventory facilities may issue a supplement Form 8130-3 to ship parts to their final destination. The parts must have been manufactured and located in the United States and have been issued an original Form 8130-3 at the U.S. located PAH or supplier. The supplement form must be signed by the FAA or an authorized representative of the Administrator. Refer to paragraph 8c of this order for the procedural requirements. 
		(a)	The PAH must submit a written proposal to its geographic Manufacturing Inspection District Office (MIDO) requesting approval to issue supplement Form 8130-3 to move Class II and III products from their international inventory facilities to the final destination. The proposal shall specify the name and address of the PAH's inventory facilities. It must include the quality system manual, or top level document/procedures detailing how the products/parts will be controlled in accordance with the procedures in this order. The proposal should be provided to the MIDO as soon as possible to determine proposal viability and to allow the MIDO sufficient time to evaluate the proposal and coordinate with the Civil Aviation Authority (CAA) of other countries, if necessary.
		(b)	Upon receipt of the PAH's proposal, the MIDO will notify the applicable CAA in writing of the PAH's intentions and will request a written response (See appendix 1). Upon receipt of the CAA's response, the MIDO will advise the PAH as to whether the CAA will support the proposed activities at the facilities operating within their regulatory system. These activities may include CAA surveillance on behalf of the FAA.
 b.	New and newly overhauled products.
	(1)	Export approvals for newly overhauled Class II products may be issued in accordance with section 21.331. An export approval for a new Class III product may NOT be issued unless the jurisdiction of import has provided written confirmation that they will accept a newly overhauled product as provided under sections 21.333(b), 21.325(c), and 21.327(e)(4).
	(2)	"Newly overhauled" is defined by section 21.321(b)(4) as a product that has not been operated or placed in service, except for functional testing, since having been overhauled, inspected, and approved for RTS in accordance with the applicable CFR. The overhaul must be performed by an appropriately certificated entity, as described in section 21.337. The FAA or its designee, in issuing the approval, must determine compliance with the applicable requirements of subpart L and 14 CFR part 43, Maintenance, Preventive Maintenance, Rebuilding, and Alteration (part 43).
	(3)	Under sections 21.331(a)(1) and 21.333(a)(1), the applicant must show that its Class II and III products conform to the approved design data. In the case of products that are newly overhauled, approved design data refers to data supplied by the holder of the design approval for the product.
 c.	Used products. Export airworthiness approvals are normally issued for new or newly overhauled Class II and III products, unless the importing country CAA specifically agrees to accept used products in accordance with sections 21.325(c) and 21.327(e)(4). These regulations require a written statement from the importing country CAA, submitted by the applicant, acknowledging the status of the products being exported and that such an export approval is acceptable. However, when such a request is made, it should be processed as required by sections 21.325(c), 21.327(e)(4), and 21.331(b) or 21.333(b). 

7. CONFORMITY DETERMINATIONS.
 a.	Under part 21, a conformity determination is made of a product/part to determine that it conforms to the specified data in accordance with the requirements of FAA Order 8110.4, Type Certification Process. Form 8130-3 may be used to record conformity determinations made by the FAA or a CAA of another jurisdiction. The FAA and CAA of other jurisdictions, when requested, may act on behalf of each other for products/parts undergoing type certification pursuant to bilateral agreements and implementing regulations.
 b.	When Form 8130-3 is used to document conformity of prototype products/parts, an FAA Form 8130-9, Statement of Conformity, from the manufacturer or the manufacturer's authorized representative, and an FAA Form 8100-1, Conformity Inspection Record, from either the FAA, CAA or an FAA designee, may be required to document the conformity status. Only the FAA, a Designated Airworthiness Representative (DAR), a Designated Manufacturing Inspection Representative (DMIR), or persons authorized under the PAH's Organizational Designated Airworthiness Representative (ODAR) are authorized to perform this function.

8. DOMESTIC USE OF FAA FORM 8130-3.
  a.	Airworthiness Approval of New Products (Engines and Propellers) including those approved for RTS.
	(1)	Form 8130-3 can be issued for domestic shipments to identify the airworthiness approval status of aircraft products that are produced and located in the United States or products that have undergone maintenance, preventive maintenance, rebuilding or alteration by authorized persons and are located in the United states. The use of Form 8130-3 for this purpose is OPTIONAL.
	(2)	Issuance of Form 8130-3 for domestic shipments to identify airworthiness approval does not constitute an export approval and is not a prerequisite, or substitute, to issuance of FAA Form 8130-4, Export Certificate of Airworthiness. Each exporter must still meet the applicable requirements of part 21, subpart L, including issuance of a Form 8130-4.
 	(3)	FAA DAR's, DMIR's, or persons authorized under the PAH's ODAR are authorized to perform this function for new products. DAR's, DMIR's and persons authorized under the ODAR to issue Form 8130-3 must determine the products conform to the PAH's approved design data and are in a condition for safe operation.
 	(4)	Air agencies certificated under part 145, or the holder of a U.S. air carrier certificate operating under parts 121, or 135 with a continuous airworthiness maintenance program are authorized to perform the approval function for a product that has been maintained or altered under part 43.
 	(5)	A PAH may issue a Form 8130-3 for approval to RTS after rebuilding or altering their product in accordance with section 43.3(j).
	(6)	All requirements of part 21 and 14 CFR part 45, Identification and Registration Marking, continue to apply.
  b.	Airworthiness Approval of New Parts and Appliances.
	(1)	An FAA employee, DAR's, DMIR's, or persons authorized under the PAH's ODAR are authorized to issue the Form 8130-3 for traceability and accountability of new parts and appliances. The DMIR's and persons authorized under the ODAR to issue Form 8130-3 must perform or be directly in charge of inspections that determine the parts or appliances conform to the FAA-approved design data and are in a condition for safe operation. The use of Form 8130-3 for this purpose is OPTIONAL and is not a prerequisite to the domestic issuance of Form 8130-3 for export purposes. 
	(2)	Issuance of Form 8130-3 as an airworthiness approval domestically does not constitute an export approval and the exporter must still meet the applicable requirements of part 21, subpart L. If Form 8130-3 has been issued as an airworthiness approval by the PAH, it cannot also be used as an export airworthiness approval. A new Form 8130-3 must be issued in accordance with the procedures for export airworthiness approvals described in this order. In order to comply with the provisions in sections 21.331 and 21.333, a determination must be made that the special requirements of the importing jurisdiction have been met.

NOTE: It is the exporter's responsibility to meet the requirements of the jurisdiction to which the part is being shipped.

c.	Splitting Bulk Shipments of Previously Shipped Parts.
	(1)	These procedures apply only to:
		(a)	The PAH of new parts that were manufactured and located in the United States and issued a Form 8130-3 in accordance with paragraphs 8b of this order.
		(b)	FAA PAH's (including PC extensions) or inventory facilities (also referred to as distribution centers).
		(c)	PAH's who have in their employ a DAR, DMIR, or a person authorized under the ODAR.
		(d)	Specific parts produced by the PAH under its production approval.

NOTE: Parts brokers or distributors who are not associated with a PAH, as either a supplier, PC extension facility, or inventory facility, are not eligible.

	(2)	 Surveillance of functions performed.
		(a)	Functions performed at PAH inventory facilities regardless of location are subject to the terms, conditions, and surveillance the FAA imposes on a PAH. Facilities that do not meet the "Associate Facility" definition of Order 8120.2, Production Approval and Surveillance Procedures, should not be listed as FAA-approved facilities. The functions performed at these facilities are consistent with the Order 8120.2 definition of a Supplier. Therefore, the procedures in Order 8120.2, Chapter 8, Supplier Control and Surveillance Procedures, will be used to determine appropriate controls for surveillance for these facilities. 
		(b)	When evaluating the PAH's QC procedures for these facilities, the ASI, should consider the limited complexity of the functions being performed. These functions are normally visual inspection, shelf life verification, and issuance of a supplement Form 8130-3 for parts. Delegation of material review board authorization and major inspection authorization are deemed inappropriate for these facilities. 
		(c)	All functions performed by any person under 14 CFR part 183, Representatives of the Administrator (part 183), at PAH facilities regardless of location are subject to the terms, conditions, and supervision of the part 183 authorization. The ASI should consider the limited complexity of the functions being performed when establishing the designee appointment.
	(3)	Eligibility and System Requirements.
		(a)	The parts must be manufactured by a PAH and located in the United States when the original Form 8130-3 was issued.
		(b)	The PAH must ensure that parts that were received without a Form 8130-3 are not co-mingled with those received with the form. For those parts received with a Form 8130-3, the PAH must establish an inventory system documenting each part number and quantity. This is to preclude mixing and shipment of parts under a supplement Form 8130-3 that are not received with an original.
		(c)	As part of the inventory, the serial numbers of critical components specified in section 45.14 must be recorded. When more than one part is listed on a supplement Form 8130-3, the parts do not need to be from the same quantity or shipment as long as they were received with an original airworthiness approval Form 8130-3.
  d.	RTS after Maintenance, Preventive Maintenance, Rebuilding and Alterations - Used Products/Parts. Persons authorized by section 43.7 may approve for RTS aircraft products/parts which have undergone maintenance, preventive maintenance, rebuilding, or alterations provided the applicable record keeping requirements of sections 43.9, 121.380(c), 135.439(c), or 14 CFR section 91.417 are met. The use of Form 8130-3 for this purpose is OPTIONAL. When used for this purpose, the work must be performed by part 121 or 135 certificate holders having a continuous airworthiness maintenance program or an air agency certificated under part 145. This form may also be used by a manufacturer for approval for RTS as set forth in section 43.7(d). In all cases, the authorization for RTS of products/parts must be made by an appropriately authorized representative of the air carrier, air agency, or manufacturer in accordance with part 43. In addition, the maintenance records required by section 43.9 may be required to accompany Form 8130-3.

NOTE: JAA member authorities will normally accept a Form 8130-3 only from a JAA ACCEPTED JAR 145 APPROVED ORGANIZATION or air agency certificated under part 145 appropriately approved for the component in question.

  e.	New Unused Products/Parts. These procedures apply to FAA-approved air agencies or air carriers.
	(1)	New unused products/parts may be inspected and approved for RTS by persons authorized under paragraph 8a above. Form 8130-3 can be used for this purpose, provided the applicable record keeping requirements of sections 43.9, 91.417, 121.380(c), and 135.439(c) are met and the QC system includes the following: 
		(a)	Traceability to an FAA-approved source of manufacture of new products/parts.
		(b)	Monitoring the current status of the product/part in relationship to shelf life, airworthiness directive compliance, and any functional test and/or inspection to determine continued conformity and airworthiness of the product/part.
		(c)	Previous records required by parts 21, 43, 91, 121, 135, or 145 may be necessary to be included as part of the conformity, e.g., life limits, airworthiness directives compliance, damage, leakage, corrosion, etc.
		(d)	Form 8130-3, Block 13 or an attachment that clearly states the process used to determine continued conformity including any reference to invoices, manufacturer maintenance manuals, etc. If removed from a new type certificated product, identification of that product by type and serial number should be annotated.
	(2)	Issuance of Form 8130-3 for this purpose is OPTIONAL. When used for this purpose, the inspection must be accomplished by an air agency or air carrier. In all cases, Form 8130-3 must be signed by the appropriately authorized representative of the maintenance entity in accordance with part 43.
 
NOTE: JAA member authorities will normally accept a Form 8130-3 only from a JAA ACCEPTED JAR 145 APPROVED ORGANIZATION or air agency appropriately approved for the component in question.

9. GENERAL PROCEDURES.
  a.	Form 8130-3 can be folded, put in an envelope, attached to, or included with the shipment. When a supplement Form 8130-3 is issued, the original Form 8130-3 that accompanied each shipment or product/part must be retained on file in its original paper format or a secure database in accordance with paragraph 9j of this order. The supplement forms shall accompany the product/part to its final destination.
   b.	When a Form 8130-3 is issued for approval for RTS, the original Form 8130-3 that accompanies each shipment or product/part must be retained on file in its original paper format in accordance with the record keeping requirements of sections 121.380 and 145.61. These forms should be retained at the facility where the supplement Form 8130-3 is issued. 
  c.	Establishment of a numbering system for the information in Block 3 is required.
  d.	Form 8130-3 may be computer generated for local reproduction but must duplicate the format of the original Government printed form. The overall form as designed cannot be changed nor can any words be added or deleted. It is permissible to preprint the text on the Form 8130-3 that is required by this order. The size of blocks, in relationship to each other, may vary SLIGHTLY, but all blocks must remain in their original location. Form 8130-3 may also be reduced in overall size to facilitate movement of wording on the back to the front, to reduce paper consumption, but not to the extent that it is no longer easily readable and readily recognizable.
  e.	The signature of the person authorized to issue Form 8130-3 can be electronically applied to Block 15, from domestic and international locations, only under the DIRECT CONTROL of the person whose signature is placed on the form. 
	(1)	For the purpose of issuing Form 8130-3, direct control means:
		(a)	An electronic signature can only be applied to Form 8130-3 at the facility where the products/parts are located and physically inspected; and
		(b)	At the time the signature is placed on Form 8130-3, the person signing must have DIRECT access to the products/parts, forms, and other data to monitor the process, perform spot-checks, and ensure the products/parts conform to the approved design data when inspected

NOTE: Issuance of Form 8130-3 is an FAA function that is frequently delegated to designees. Automation of Form 8130-3 does not relieve the designee or person authorized to issue Form 8130-3 within a designated organization from verifying that the product/part conforms to design data and is in a condition for safe operation.

	(2)	A PAH, air carrier, or air agency should develop procedures for managing information systems consistent with Advisory Circular 21-35, Computer Generated/Stored Records. These procedures should include a secured electronic auditing system that will reflect any system changes and a secured monitoring system that will record all transactions by part number, serial number, quantity, etc.
  f.	Procedures in this order refer to several situations where other documents may be attached to Form 8130-3. All attachments should cross reference each other to ensure complete traceability of all work accomplished and actions taken. The Block 3 tracking number, page numbers, and total number of pages should be listed on each page.
  g.	All applicable blocks of Form 8130-3 must contain entries for the document to be valid. All entries must be made in permanent ink and be in the English language. A sample completed Form 8130- 3 (appendix 2) is attached.
  h.	Blocks 14 through 18 are used for conformity determinations; airworthiness approval of products; export airworthiness approvals; and splitting bulk shipments of parts. Blocks 19 through 23 are used for RTS after maintenance, preventive maintenance, and alterations. When Blocks 14 through 18 are used, Blocks 19 through 23 can be shaded or darkened to preclude inadvertent or unauthorized use. Likewise, when Blocks 19 through 23 are used, Blocks 14 through 18 can be shaded or darkened to preclude inadvertent or unauthorized use. In no case will Blocks 14 through 18 and Blocks 19 through 23 be completed on the same form.
  i.	Any Form 8130-3 issued prior to the effective date of this order is still valid. Additional forms may be obtained through normal distribution channels from the Logistics Center, AML-642, P.O. Box 25082, Oklahoma City, OK 73125 or call the priority desk at (405) 954-4088. The Stock Number for Form 8130-3 is 0052-00-012-9003.
  j.	Copies of the original or duplicates of each Form 8130-3 issued should be retained by the issuer for at least 2 years. For air carriers the retention period should be at least 1 year after overhaul unless it is being performed under part 145 which would require 2 years. The copies of the original or duplicates of the Form 8130-3 can be retained in their original paper format or a secure database, provided the database contains ALL of the information required on Form 8130-3, and is available for FAA review upon request. Duplicates of Form 8130-3, including signatures retained in a database, do not need to be graphic images of the original documents. However, when a supplement Form 8130-3 is issued as described by this order, traceability back through a system that assures that parts were received with an original Form 8130-3 must be possible.

10. LINE-BY-LINE INSTRUCTIONS FOR COMPLETION OF FORM 8130-3.
  a.	Block 1. United States. (Preprinted)
  b.	Block 2. Federal Aviation Administration Form 8130-3, Airworthiness Approval Tag, U.S.
	Department of Transportation, Federal Aviation Administration. (Preprinted)
  c.	Block 3. System Tracking Reference Number.
	(1)	Fill in the unique number established by the numbering system (see paragraph 9c).
	(2)	When used to split bulk shipments of previously shipped products by PAH, air carriers, or air agency, the PAH must establish a supplement System Tracking Reference Number for this purpose.
		(a)	Products/parts serialized as required by section 45.14, Identification of Critical Components. Re-enter the system tracking reference number established by the PAH below the supplement System Tracking Reference Number, e.g., S-1. If the PAH, air carriers, or air agency can document and demonstrate to the FAA, that they have a system(s) in place for tracking supplement forms to the original form issued for those products/parts, re-entry of the original System Tracking Reference Number is not required. 
		(b)	Non-Serialized Products. Enter only the supplement System Tracking Reference Number.
  d.	Block 4. Organization.
	(1)	Fill in the full name and address of the FAA-approved organization or individual shipping the product(s)/part(s) as applicable:
		Company name and address
		PAH approval or certificate number, when applicable
	(2)	When a supplier has direct ship authorization from a PAH, the following information should be entered:
		PAH name and address
		PAH approval or certificate number
		c/o Supplier name and address

NOTE: If an individual product/part is produced as a spare by a supplier, the supplier must have either direct ship authority or hold a production approval (PMA/TSO authorization) for all products/parts shipped. If the supplier holds its own production approval, and the products/parts were manufactured and are being shipped under that approval, the information required in paragraph (1) above
should be listed.

  e.	Block 5. Work Order, Contract, or Invoice Number.
	(1)	Fill in the contract, work order, or invoice number related to the shipment list, or maintenance release, and state the number of pages attached to the form, including dates, if applicable. If the shipment list contains the information required in Blocks 6 through 12, the respective blocks may be left blank if an original, or true copy, of the list is attached to the form. In this case, the following statement should be entered in Block 13:
		 "This is the certification statement for the products/parts listed on the attached document 			dated _________, containing pages ______ through ______." 
	(2)	In addition, the shipment list must cross-reference the number located in Block 3. The shipment list may contain more than one item; but it is the responsibility of the shipper to determine if the CAA of the importing jurisdiction will accept bulk shipments under a single Form 8130-3. If the CAA does not permit bulk shipments under a single form, Blocks 6 through 12 of each form must be filled in for each product shipped.
  f.	Block 6. Item. When Form 8130-3 is issued a single item number or multiple item numbers may be used for the same part number. Multiple items should be numbered in sequence. If a separate listing is used, enter "List Attached" (reference 10e for further instructions).
  g.	Block 7. Description. Enter the name or description of the product/part as shown on the design data. For products/parts that do not have design data available, the name as referenced in a part catalog, overhaul manual, etc., can be used.
  h.	Block 8. Part Number. Enter each part number of the product.
  i.	Block 9. Eligibility. State the aircraft, aircraft engine, or propeller make and model on which the PMA part is eligible for installation. If a part is eligible for installation on more than one model enter the words "to be verified by installer or TBV by installer." Where parts are TSO articles, state "TSO Article N/A" since eligibility for installation for TSO articles is determined at the time of installation.

NOTE: For TSO articles Form 8130-3 does not constitute authority to install a product on a particular aircraft, aircraft engine, or propeller. The user or installer is responsible for confirming that the product is eligible for installation by reference to overhaul manuals, service bulletins, etc., as applicable. While the information in Block 9 is optional, it should be filled out whenever possible. When using FAA Form 8130-3 for CONFORMITY of certification program products, enter N/A.

  j.	Block 10. Quantity. State the quantity of each product/part shipped.

NOTE: If a PAH or their inventory facilities require a Form 8130-3 for individual products/parts at a later date, the procedures in paragraph 8c of this order should be used.

  k.	Block 11. Serial/Batch Number. State the serial number or equivalent (identified on the part) on he form for each product/part shipped. If a serial number or equivalent is not required on the part, enter N/A."
  l.	Block 12. Status/work. Enter "NEW" for newly manufactured parts and products (domestic application for engines and propellers). Enter "Newly Overhauled" for those products that have not been operated or placed in service since overhaul. Enter "PROTOTYPE" for products/parts submitted to support type certification programs. Other permissible/appropriate terms to describe the status of the product/part are: "INSPECTED", "REPAIRED," "REBUILT," or "ALTERED."
   m.	Block 13. Remarks. Enter any information or references to support documentation necessary for the user or installer to make a final determination of airworthiness of the products/parts listed in Block 7. Each statement must specify which item identified in Block 6 is related. Examples of information to be supplied are as follows:
 	(1)	Any restrictions (e.g., prototype only).
	(2)	Alternative approved part number.
	(3)	Compliance or noncompliance with airworthiness directives or service bulletins.
	(4)	Information on life-limited parts.
	(5)	Manufacturing, cure, or shelf-life data.
	(6)	Drawing and revision level
	(7)	When used as an export approval, for Class II & III products, the word "EXPORT" must be entered in capital letters. If there has been a supplemental export Form 8130-3 issued and the products arebeing shipped to their final destination the words "SUPPLEMENT EXPORT" must be entered in capital letters. Exceptions to the special requirements of the importing jurisdiction, if any, should be obtained by the exporter and listed together with written acceptance by the importing jurisdiction's CAA. A opy of the original accepting document should be attached to Form 8130-3 and the product being shipped with the original retained by the exporter.
	(8)	When used for conformity the word "CONFORMITY" must be entered in capital letters. In addition, an explanation of the products/parts use, e.g., pending approved data, TC pending, for test only, etc., should be provided. Information concerning a conformity inspection such as design data, revision level, date, project number, and special instructions as shown on FAA Form 8120-10, Request for Conformity, should be entered in this block. Form 8130-9 and Form 8100-1 may be required to document type certification activities.
 	(9)	When used for spare parts identify whether the parts are PMA, TSO authorized. In addition, if the Form 8130-3 is for spare parts or sub components of an FAA approved modification or replacement part, the PMA or TSO authorization should be listed in Block 13.
	(10)	When used for RTS this block should contain the data required by section 43.9. If other documents such as work orders or travelers, FAA Form 337, Maintenance Release Form, are used by the certificate holders to comply with section 43.9, they should be specifically referenced in this block and be cross referenced according to the instructions set forth in paragraph 10(e)(1) above.

NOTE: Issuance of Form 8130-3 for RTS of an engine or propeller does not constitute an export airworthiness approval and is not a prerequisite, or substitute, to issuance of Form 8130-4 (reference paragraph 8 of this order).

	(11)	When used for an airworthiness approval for new products (engines or propellers) the following statement must be entered in capital letters, "AIRWORTHINESS APPROVAL - ENGINE (or PROPELLER). FOR DOMESTIC SHIPMENTS ONLY. THIS FORM IS NOT AN EXPORT APPROVAL" (reference paragraph 8 of this order).
	(12)	When used for airworthiness approval for new parts the following statement must be entered in capital letters, "AIRWORTHINESS APPROVAL - PARTS. THIS FORM IS NOT AN EXPORT APPROVAL" (reference paragraph 8 of this order).
	(13)	When used for export approval for Class II & III used products that have been RTS based on the requirements of part 43, the words "EXPORT, USED PART, SHIPPED PER COUNTRY ACCEPTANCE LETTER OF USED PART" must be entered in capital letters.
 	(14)	When used for non-JAR-145 maintenance in accordance with national regulations then the particular national regulation should be stated.
  n.	Block 14. Check the appropriate box if the product/part is new or newly overhauled. If the product is a used part that has been RTS based on the requirements of part 43, and is now being exported on a 8130-3, do not check new or newly overhauled. 
  o.	Block 15. Signature. Place the signature of the FAA authorized representative who has the authority to perform this function on behalf of the FAA. The approval signature shall be applied at the time and place of issuance, and shall be manually applied except as provided in paragraph 9e of this order.
   p.	Block 16. FAA Authorization Number. Enter the authorization number of the DAR, DMIR, ODAR, of the authorized representative identified in Block 15. If signed by an FAA inspector, the authorization number will be the applicable office identifier. 
  q.	Block 17. Name. The typed or printed name of the FAA designee or inspector identified in Block 15.
  r.	Block 18. Date. Enter the date the Form 8130-3 is signed and the conformity or airworthiness determination is made. This does not need to be the same as the shipping date, which may occur at a later date.
  s.	Block 19. Return to Service. The information is already pre-printed in the block.
  t.	Block 20. Signature. Signature of the individual authorized by the air agency, air carrier, or the manufacturer in accordance with section 43.7(d). The approval signature shall be manually applied at the time and place of issuance.
  u.	Block 21. Certificate number. Enter the air agency, air carrier operating certificate number or the PAH project number, e.g., PQ2122CE, PT3255SW, etc. For manufacturers returning to service after rebuilding products/parts the production approval number should be entered. 
  v.	Block 22. Name. The typed or printed name of the individual identified in Block 20.
  w.	Block 23. Date. The date the Form 8130-3 is signed and the product is returned to service. This does not need to be the same as the shipping date, which may occur at a later date.

11. LOST FAA FORM 8130-3.
  a.	Forms issued, for other than export approval, may be re-issued by the PAH, air carrier, or air agency but only after re-verification of the product's/part's status. Forms issued as export airworthiness approvals may be re-issued by FAA inspectors or designees.
  b.	The applicant must provide a written statement from the importer that Form 8130-3 has been lost and provide evidence of the previous export.
  c.	Once these actions are taken, a file copy of the original form can be provided, if available. Otherwise, a new form can be issued with the words "THIS IS A REPLACEMENT FORM 8130-3, ISSUED ON (the date of original issuance)" typed in Block 13, and the current date applied in Block 18. The replacement form must have an original signature and the same data as the lost Form 8130-3. 

12. INFORMATION CURRENCY.
   Any deficiencies found, clarifications needed, or improvements
to be suggested regarding the content of this order should be forwarded to the Aircraft Certification
Service, Automated Systems Branch, AIR-520, Attention: Directives Management Officer, for
consideration. Your assistance is welcome. FAA Form 1320-19, Directive Feedback Information, is
located on the last page of this order for your convenience. If an interpretation is urgently needed, you
may contact the Production and Airworthiness Certification Division, AIR-200 at (202) 267-8361, but
you should also use Form 1320-19 as a follow-up to the verbal conversation.

/s/

Frank P. Paskiewicz
Manager, Production and Airworthiness
Certification Division

Appendix 1

APPENDIX 1. Sample CAA Letter

Director
Airworthiness & Inspection
Civil Aviation Authority
Department of Transportation
122 2KA South Street
Gatwick, West Sussex RHB-OYR

Dear XXX XXXXXXXXXX:

The ABC Aircraft Company has approached the Federal Aviation Administration (FAA) with a proposal
to perform a certification function in your jurisdiction. The proposal is to issue FAA Form 8130-3,
Airworthiness Approval Tag, from the (name and address) facility in your jurisdiction. Form 8130-3
will be issued to ship parts that were previously shipped by ABC Airplane Company to the (company
name) facility. These individual parts would then be re-shipped for installation on aircraft and related
products.

It is noted that Form 8130-3 will be issued by a FAA Representative of the Administrator, i.e.,
Designated Airworthiness Representative, Designated Manufacturing Inspection Representative, or
Organizational Designated Airworthiness Representative.

A copy of FAA Order 8130.21B, Completion and Use of FAA Form 8130-3, Airworthiness Approval
Tag, is enclosed (enclosure 1) for your review. In consideration of the ABC proposal (enclosure 2) and
the enclosed FAA order, please respond to the following:

a. Does the Government or Civil Aviation Authority of (enter jurisdiction) have any objections to
the issuance of Form 8130-3 from within your jurisdiction?

b. Does the Government or Civil Aviation Authority of (enter jurisdiction) have any objections to
FAA Representatives of the Administrator issuing Form 8130-3 from within your jurisdiction?

c. Are there any Government or Civil Aviation Authority of (enter jurisdiction) requirements that
must be met, or procedures that must be followed, before and during the ABC Airplane Company’s
proposal and implementation?

The FAA appreciates your attention to this matter and is looking forward to your response.
Sincerely,

XXXXX XXXXXXXXXX

Manager, Manufacturing Inspection District Office
Enclosure 1 - FAA Order 8130.21B
Enclosure 2 - ABC Airplane Company proposal
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