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
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