F006 Gyroplane Registration

AUSTRALIAN SPORT ROTORCRAFT ASSOCIATION INC
F006 GYROPLANE REGISTRATION, RENEWAL & TRANSFER FORM 2017
(APPLICATION PERIOD JULY 2016 – ENDING JUNE 2017)
Regulations state that only current financial ASRA members
are permitted to fly and register a Gyro
ASRA
Membership No:
Owner
Given
Names:
Gyroplane
Registration No:
A
Airframe
Serial No:
G
Owner
Family Name:
Address:
Phone No:
Town:
State:
P/Code:
Email:
Annual Renewal with no changes
Go to page 2, sign the signature and no changes box and submit fee.
Annual Renewal with changes
Complete the whole form. Sign at the bottom of page 2 and submit photo & fee.
New Registration
Complete the whole form. Sign at the bottom of page 2 and submit photo & fee.
Submit F022A or F024A as applicable
The seller must advise ASRA of a change of ownership and enter the buyer details below. The registration is
suspended until the buyer submits the transfer fee and a completed F006 with the TA inspection signed.
Transfer:
ASRA
No:
Buyer
Name:
A
Phone No:
Address:
State:
Cockpit:
Places:
Aircraft Status:
Open Frame
Semi Enclosed
Fully Enclosed
Empty weight
including rotors:
One
Two Side by Side
Two Tandem
MTOW:
Registered
Unregistered
Hang Test: 1 UP
Degrees
Nose up
Hang Test: 2 UP
Degrees
Nose down
Fore/Aft
Angle:
P/Code:
kg
kg
Gyroplane Primary
Destroyed
Colour:
Total
Side/Side
Teeter
Angle:
Angle:
Degrees
Manufacturer:
Model:
Model No:
Main Frame
Material:
Size:
mm
Mast Material:
Size:
mm
Frame Plates
Material:
Thickness:
mm
Vertical Tail
Type & Area:
Pitch Stabiliser
Location & Area:
Rudder & Fin
Full Flying
Total Vertical
Tail Area:
m
2
Twin Tail
Horizontal Distance from C of G:
In propeller slipstream
Stabiliser Area:
Rotor Head
Manufacturer:
Rotor Blade
Manufacturer:
Propeller
Manufacturer:
Engine
Manufacturer:
Redrive Make:
Fuel Tank
Manufacturer:
Tri Tail
m
Outside propeller slipstream
m
2
Horizontal Distance from C of G
m
Serial No:
Type:
Hub Bar Serial
No:
Length:
ft
Serial No:
Diameter:
in
Engine No:
Engine
Capacity:
cc
Serial No:
Ratio:
:1
Capacity:
LTS
Continue over
ASRA Form F006
Gyroplane Registration
Revision 022 JUN 2016
Page 1 of 2
Mandatory Instruments
ASI
Altimeter
Fuel Indicator
Compliant Gyroplanes
Mandatory Instruments
Hour Meter
Oil Pressure (4 stroke)
Engine tacho
Compass
Volts (Battery Ignition)
Temperature
Significant Extras
GPS
Transponder
EPIRB
Yaw Indicator
VHF
UHF
TO BE COMPLETED BY AN ASRA TECHNICAL ADVISER FOR ALL NEW REGISTRATIONS, ALL
TRANSFERS AND FOR ALL CHANGES TO COMPLIANT GYROPLANES ONLY.
I declare that I have inspected the above Gyroplane and checked that all the control movements are normal as specified
in the applicable ASRA Inc. F022 or F024 registration protocols. The Gyroplane complies with all the compliance
requirements and the Safety Directives issued by ASRA. Safety Directives can be accessed at
http://www.asra.org.au/news/airworthiness-directives-ads/. I take no responsibility for any modifications carried out after
this date unless approved by me. I do not take any responsibility for the accuracy of the owner or manufacturer’s
statements, or the manner in which the Pilot operates the Gyro. This is an Application for Registration or Renewal and is
not indicative of the flight readiness or performance of this aircraft
Single Seat
The Gyroplane qualifies
for registration under
the following category:
Provisional
Basic
Two Seat
Registration Protocols Form
F 006 submitted
If Compliant select one
of the following:
Form correctly filled in
Provisional
Compliant
Compliant
Manufacturers Type
Approved No:
Annual photo necessary to complete registration
Technical
Adviser’s Name:
Membership No:
Signature:
Date:
A
Technical Adviser’s Comments:
Owner’s Signature:
I confirm there are no changes since last years registration
Side on photo supplied (Mandatory for all registrations)
Date:
2017 Gyro Registration Fees (Tick appropriate box) DO NOT SEND CASH
Note:
Current financial members
Annual registration renewal
$60
Transfer - Purchaser
$60 (TA inspection required)
New Registration 2016 & 2017
(Registration expires 31st Dec
2017)
$90 (includes Gyroplane maintenance logbook)
Please make a copy of this form or alternatively download the PDF from the online database to keep in
the Gyroplane Maintenance Logbook.
Return form and photo (digital or print) with Cheque or Money Order made payable to ASRA Inc.
EFT payment details BSB 032524 ACC 165988
Address: ASRA Registrar, PO Box 3070 Mandurah East WA 6210. [email protected]
All documentation can downloaded from the ASRA Website www.asra.org.au/
ASRA Form F006
Gyroplane Registration
Revision 022 JUN 2016
Page 2 of 2