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FORM ACA 349 (REV. 8-1-11) UNITED STATES OF AMERICA DEPARTMENT OF COMMERCE CIVIL AERONAUTICS ADMINISTRATION WASHINGTON CERTIFICATE NO.: _ DATE: __ APPROVED: (Inspector's signature) __ DISAPPROVED:1 (Inspector's signature) __ PILOT APPLICATION FOR: □ AIRCRAFT TYPE RATING □ AIRPLANE CLASS AND HORSEPOWER RATING TO THE CIVIL AERONAUTICS ADMINISTRATION: APPLICATION IS MADE FOR RATING ON (MAKE) (MODEL) (TYPE) (HORSEPOWER) AIRCRAFT. 1. NAME 2. PERMANENT MAILING ADDRESS 3. HOURS IN AIRCRAFT OF THIS CATEGORY LAST 60 DAYS: DUAL__ SOLO__ 4. NAMES OF INSTRUCTORS 5 TOTAL SOLO HOURS IN AIRCRAFT OF THIS CATEGORY 6. I HAVE NOT BEEN EXAMINED FOR THIS RATING WITHIN THE LAST _ DAYS. 7. IF ANY APPLICATION, CERTIFICATE OR RATING, SUBMITTED BY OR ISSUED YOU PURSUANT TO THE PROVISIONS OF THE CIVIL AIR REGULATIONS HAS BEEN DENIED, SUSPENED OR REVOKED WITHIN THE PAST 2 YEARS, GIVE DETAILS AS TO: (KIND OF APPLICATION) (PLACE AND DATE OF EXAMINATION) I CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE. FLIGHT TEST REPORT (FOR INSPECTOR'S USE ONLY) SINGLE-ENGINE AIRCRAFT GRADE 1. KNOWLEDGE AND HANDLING OF CONTROLS AND DEVICES _ 2. TAXIING (OR SAILING AND DOCKING) _ 3. TAKE-OFFS AND ACCURACY LANDINGS _ 4. FIGURE EIGHTS _ 5. COORDINATION MANUEVERS _ 6. CLIMBING TURNS AND MAXIMUM PERFORMANCE CLIMBS _ 7. STEEP GLIDING TURNS _ 8. STALLS AND RECOVERS (WITH AND WITHOUT POWER) _ 9. 60° BANK, 720° PRECISION TURNS (RIGHT AND LEFT) _ 10. SIMULATED FORCED LANDINGS _ 11. SPINS (IF APPROPRIATE) _ 12. JUDGEMENT _ MULTI-ENGINE AIRCRAFT GRADE 1. KNOWLEDGE AND HANDLING OF CONTROLS AND DEVICES _ 2. KNOWLEDGE OF FUEL AND IGNITION SYSTEMS _ 3. TAXIING (OR SAILING AND DOCKING) _ 4. TAKE-OFFS AND ACCURACY LANDINGS _ 5. CLIMBS AND CLIMBING TURNS _ 6. GLIDES AND GLIDING TURNS _ 7. 60° BANK, 360° TURNS (RIGHT AND LEFT) _ 8. APPROACHES TO STALLS (WITH AND WITHOUT POWER) _ 9. 45° BANK, 180° TURNS AND RECOVERY WITH BOTTOM ENGINE(S) FULLY THROTTLED 10. 45° BANK, 180°TURNS AND RECOVERY WITH TOP ENGINE(S) FULLY THROTTLED) _ 11. JUDGMENT _ REMARKS 30209