Entry Date	JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberNovemberOctober1234567891011121314151617181920212223242526272829303120062007200820092010
Purchase Date	JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberNovemberOctober123456789101112131415161718192021222324252627282930312005200620072008200920042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961
Date  Ship Certified	JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberNot Yet Certified12345678910111213141516171819202122232425262728293031N/A2005200620072008200920042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961N/A
Aircraft Year, Make & Model:
Registration Number:
Frame Serial Number
Engine Serial Number
Original Builder/s
Hobbs Hours
Main Drive Type	Factory ChainPro-DriveOther
Clutch Type	FactoryOtherPro-Drive
Swing Arm Manufacturer	Factory 1st VersionFactory 2nd VersionPro-DriveOther
Swing Arm Breakage (type & hours at time of breakage)
Secondary Shaft	30mm 3 bearing30mm double bearing30mm spherical35mm sphericalPro-Drive 40mmEPI 40mmother
Shaft Problems/Breakages
Current Owner Name:
Address:
City:
State:	Zip:
Country:
Email:
Website Address:
Home Phone:
Cell Phone:
Comments: