MAJOR REPAIR AND ALTERATION US Department  of Transportation  (Airframe, Powerplant, Propeller, or Appliance) Federal Aviation Administration OMB No. 2120-0020  Exp:  5 /31/201 8 Electronic Tracking Number  For FAA Use Only INSTRUCTIONS: Print or type all entries. See Title 14 CFR §43.9, Part 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for  instructions and disposition of this form. This report is required by law (49 U.S.C. §44701). Failure to report can result in a civil penalty for each  such violation. (49 U.S.C. §46301(a))   $_{1. Aircraft}$$_{ }$ Nationality and Registration Mark  Serial No.  Make  Model  Series   $_{2. Owner}$$_{ }$ Name  (As shown on registration certificate) Address  (As shown on registration certificate) Address  City  State  Zip  Country  3. For FAA Use Only 4. Type 5. Unit Identification Repair  Alteration  Unit  Make  Model  Serial No.  $^{ }$AIRFRAME  (As described in Item 1 above) $^{ }$$_{POWERPLANT }$  $^{ }$PROPELLER   $_{APPLIANCE }$ Type  Manufacturer  6. Conformity Statement A. Agency's Name and Address  B. Kind of Agency  Name  Address City  State Zip  Country U. S. Certificated Mechanic  Manufacturer  Foreign Certificated Mechanic  C. Certificate No.  Certificated Repair Station  Certificated Maintenance Organization  D. I certify that the repair and/or alteration made to the unit(s) identified in item 5 above and described on the reverse or attachments hereto  have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information  furnished herein is true and correct to the best of my knowledge.  Extended range fuel  per 14 CFR Part 43  App. B  Signature/Date of Authorized Individual  7. Approval for Return to Service Pursuant to the authority given persons specified below, the unit identified in item 5 was inspected in the manner prescribed by the  Administrator of the Federal Aviation Administration and is  Approved  Rejected   $_{BY }$ FAA Flt. Standards  Inspector  Manufacturer  Maintenance Organization  Persons Approved by Canadian  Department of Transport  FAA Designee  Repair Station  Inspection Authorization  Other  (Specify) Certificate or  Designation No.  Signature/Date of Authorized Individual  FAA Form 337 (10/06)  Figure 4-173.  FAA Form 337, Major Repair and Alteration (Airframe, Powerplant, Propeller, or Appliance). 4-95