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RVSM or International Operations Application:
The information you provide on the application will be used to produce your RVSM Manual. Please fill out the application as accurately and completely as possible, as this information is critical to the certification process. Once complete, your RVSM Manual will be shipped to you via FEDEX 2nd Day Air. This typically will assure your RVSM Manual will arrive within five (5) business days of order placement. (Please note: We cannot ship via FEDEX to a P.O. Box Address) If you have any questions with regard to this application please call us toll free at 877-GOT-RVSM (877-468-7876) or email inquiries to sales@flyrvsm.com. We will promptly address your questions or concerns.
Referred By (if any):
   
  Airspace certification you are applying for:

RVSM-Reduced Vertical Separation Minimum ($1495.00)
MNPS - Minimum Navigation Performance Specification
RNP-5-Required Navigation Performance
RNP-10-Required Navigation Performance

International Operations Manual (additional $1495.00 charge)
  If International Operations application, what country/countries do you wish to operate in? (If All, write "World-Wide")
   
Owner/Operator Information:
Full Name:
(required)
Address:
(required)
City:
(required)
State:
 (required)
Zip Code:
(required)
Phone Number:
(required)
Fax Number:
Email:
(required)
 
Shipping Information:
(if different from above)
Full Name:
Address:
City:
State:
Zip Code:
Phone Number:
Fax Number:
Email:
 
RVSM Representative Information:
Name of person responsible for flight crew operations
(Must be U.S. Citizen):
Phone Number:
Crew Training Conducted by:
Certifying Government Office
(CAA, INAC, DGAC, FSDO, IFO):

Government Inspector Contact: (if known):
   
Aircraft Information:
Make/Model:
Registration Number (N-number):
Serial Number:
Aircraft Color:
Operating Under:
Part 91
Part 135
Both Part 91 & 135
 
Aircraft Base of Operation (ICAO):
Base of Operation Address
(where certifying FSDO is located):
RVSM modification completed under which method?:
-SB (Service Bulletin)
-STC (Supplemental Type Certificate)
-TCDS (Type Certificate Data Sheet) if equipped from factory
What date was RVSM modification completed (STC or Service Bulletin) or what date did your aircraft come from the factory RVSM Compliant (Airworthiness Date-falls under TCDS (Type Certificate Data Sheet)?:
 
Maintenance Facility:
(must be FAA Part 145 repair station)
Name of business/facility:
Name of main point of contact (if known):
Address:
City:
State:
Zip Code:
Phone Number:
Fax:
Repair Station Number (if known):
   
  RVSM Equipment List:

QTY

UNIT

MANUFACTURER

MODEL NUMBER

PART NUMBER

Air Data Computer

Autopilot

Altitude Alerter

Transponder

DME
ADF

*TCAS II (if installed)

Flight Management System (FMS) (with GPS)

VHF Nav. Unit

VHF Comm. Unit

**HF Comm.

  * If TCAS II installed must have Version 7.0 or later software upgrade. (After March 31, 2002, unless otherwise authorized by the Administrator, if you operate an aircraft that is equipped with TCAS II in RVSM airspace, it must be a TCAS II that meets TSO C-119b (Version 7.0), or a later version.)
** If provisional HF Comm. install only and applying for MNPS, please complete all columns
 
TERMS:
  • Owner/Operator is aware FLY RVSM SERVICES, LLC is a third party vendor and is available for unlimited technical consultation should Owner/Operator or certifying FSDO require.
  • Owner/Operator is aware he/she is first point of contact with certifying FSDO.
  • It is recommended Owner/Operator begin the Manual certification process at minimum (60) days in advance of needed certification.
  • Signing/Submitting this application authorizes FLY RVSM SERVICES, LLC to begin RVSM Manual/International Operations Manual preparation for above referenced Owner/Operator.
  • Owner/Operator is aware cost of FLY RVSM SERVICES RVSM, LLC Manual preparation fee is $1495.00, which includes 2 identical copies for desk and onboard reference.
  • Owner/Operator is aware cost of FLY RVSM SERVICES, LLC International Operations Manual preparation fee is $1495.00, which includes 2 identical copies for desk and onboard reference.
  • Owner/Operator is aware RVSM Manual balance due ($1495.00) upon receipt of prepared RVSM Manual.
  • Owner/Operator is aware International Operations Manual balance due ($1495.00) upon receipt of prepared International Operations Manual.
I have read and agree to these terms.
 

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Credit Card Information:
Card Type:
Card number:
Expiration date:
3 digit security code
(located on the back of the card):

Credit Card Address
(if different from owner address):
Name (as it appears on your card):
Address:
City:
State:
Zip Code:
Please note: Your credit card will not be charged until your receipt of documents has been confirmed.

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