# S

- 76 ® 

# HELICOPTER
ALERT SERVICE
BULLETIN

N OTICE TO A LL P ERSONS R ECEIVING T HIS D OCUMENT :

W ARNING : T HIS DOCUMENT , OR AN EMBODIMENT OF IT IN ANY MEDIA , DISCLOSES INFORMATIO N WHICH IS PROPRIETA RY , IS THE PROPERTY OF S IKORSKY AIRCRAFT COR PORATION AND / OR ITS SUBSIDIARIES , IS AN UNPUBLISHED WORK PROTECTED UNDER APPL ICABLE COPYRIGHT LA WS , AND IS DELIVERED ON THE EXPRESS CONDITIO N THAT IT IS NOT TO BE USED , DISCLOSED , REPRODUCED , IN WHOLE OR IN PART ( INCLUDING REPRODUCTI ON AS A DERIVATIVE W ORK ), OR USED FOR MANUFACT URE FOR ANYONE OTHER THAN SIKORSKY AIRCRA FT CORPORATION AND / OR ITS SUBSID IARIES WITHOUT ITS W RITTEN CONSENT , AND THAT NO RIGHT IS GRANTED TO DISCLOSE OR SO USE ANY INFORM ATION CONTAINED HERE IN

. A LL RIGHTS RESERVED

. A NY ACT IN VIOLATION OF APPLICABLE LAW MA Y RESULT IN CIVIL AN D CRIMINAL PENALTIES

.
E XPORT W ARNING : T HESE COMMODI TIES , TECHNICAL DATA OR SO FTWARE ARE SUBJECT T O THE EXPORT CONTROL OF EITHER THE I NTERNATIONAL T RAFFIC IN A RMS R EGULATIONS (ITAR) OR THE E XPORT A DMINISTRATION R EGULATIONS (EAR) AND CANNOT BE EXPORT ED WITHOUT THE PRIOR AUTHORIZATION OF EIT HER THE D EPARTMENT OF S TATE OR THE D EPARTMENT OF C OMMERCE

. T HE TERM “E XPORT ” INCLUDES ANY DISCLOS URE AND / OR PROVISION OF ACCE SS TO COMMODITIES , TECHNICAL DATA OR SO FTWARE TO OR BY FORE IGN NATIONALS ( WHETHER LOCATED IN T HE U NITED S TATES OR A BROAD ). T HIS REQUIREMENT ALSO AP PLIES TO FOREIGN NAT IONAL EMPLOYEES OF U.S. C OMPANIES AND THEIR F OREIGN SUBSIDIARIES

.

S

- 76 ® IS A REGISTERED TRAD EMARK OF SIKORSKY AI RCRAFT CORPORATION

. ASB 76

- 66

- 52
Basic Issue ▪ April 1 / 14

SUBJECT: POWERTRAIN

– Tail Drive Shaft

– One

- Time Inspection and Torque Verification of Tail Drive Shaft (TDS) Flange Bolt

Section 3. P LANNING INFORMATION

A. Effectivity All S

- 76 A through D model heli copters up to and including serial number 76 1 051 including spares

. Component: All S

- 76 TDS

, with Part Numbers (P/N) 76361

- 04004 (al l dash numbers) with serial numbers prior to A127

- 01093, and 76361

- 04604 (all dash numbers) with serial number prefixes A240 (all serial numbers) , B240 (all serial numbers) , and C240 all serial numbers up to and including 00880

.
B. Purpose To perform a one

- time inspection of TDS flange

- to

- shaft attachment hardware for proper installation and torque.
There were instances where TDS flange

- to

- shaft attachment hardware has been found loose or fractured.

C. Description Helicopter is prepared for ma intenance. TDS is removed. TDS flange

- to

- shaft attachment hardware is inspected for movement, torque stripe misalignment, and correct assembly. If movement, misalignment of torque stripe, or misassembled hardware is found, TDS flange

- to

- shaft attachment ha rdware is removed, returned to Sikorsky along with attached Return for Sikorsky Engineering Evaluation form and Torque Verification of TDS Flange Bolt Data Sheet, and replaced with Sikorsky Aircraft Corporation

6900 Main Street P.O. Box 9729 Stratford, Connecticut 06615

- 9129 (203) 386

- 4000

Page 1 of 17 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 1. P LANNING l NFORMATION (Continued)

serviceable TDS flang e
- to

- s haft attachment hardware. Helicopter is returned to service.

D. Compliance Compliance is essential. The instructions outlined herein shall be accomplished no later than November 30, 2014.

E. Approval Inspection item

.
F. Manpower (Estimated)

Task No. of Men No. of Hours Man

- Hours *
Remove Driveshaft 1 0.75 0.75 Inspect TDS Flange Attachment Hardware

. 1 0.50 0.50

Install Driveshaft (*Existing assembly or new if unit is found to be unserviceable). 1 1 .0 0 1

. 0 0

Total Man

- Hours 2

. 25
*Estimate does not include time required to prepare helicopter or return it to flight status.

G. Tooling

Qty Nomenclature Part No. Source

1 Locally Fabricated Special Tool Modified McMaster Carr P/N 5543A35 or equivalent (1)

1 Torque Wrench (30

- 150 inch

pounds) Commercially Available or equivalent (2)

1 Caliper Commercially Available or equivalent (2)

(1) Available from McMaster Carr. Website: www.mcmaster.com
(2) Procure through local supply.

H. Weight and Balance

Not affected.

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Basic Issue ▪ April 1 /14 

### SERVICE BULLETIN

Section 1. P LANNING l NFORMATION (Continued)

I. Electrical Load Data

Not affected

.
J. Software Load Data

Not changed.

K. References

(1) Maintenance Manual SA 4047

- 76

- 2, Chapter/Section 20

- 04

- 00.

(2) Maintenance Manual SA 4047

- 76B

- 2, Chapter/Section 20

- 04

- 00

. (3) Maintenance Manual SA 4047

- 76C

- 2, Chapter/Section 20

- 04

- 00

. (4) Maintenance Manual SA S76D

- AMM

- 000, Chapter/Section 20

- 04

- 00.

(5) Maintenance Manual SA S76D

- AMM

- 000, Chapter/Section 65

- 11

- 01.

(6) Maintenance Manual SA S76D

- AMM

- 000, Chapter/Section 65

- 11

- 02.

(7) Maintenanc e Manual SA S76D

- AMM

- 000, Chapter/Section 65

- 11

- 04.

(8) Maintenance Manual SA S76D

- AMM

- 000, Chapter/Section 65

- 13

- 02.

(9) Maintenance Manual SA 4047

- 76

- 2, Chapter/Section 66

- 40

- 00.

(10) Maintenance Manual SA 4047

- 7 6B

- 2, Chapter/Section 66

- 40

- 00.

(11) Maintenance Manual SA 4047

- 76C

- 2, Chapter/Section 66

- 40

- 00.

L. Publications Affected

(1) Temporary Revision No. 66

- 28 again st Maintenance Manual, SA 4047

- 7 6B

- 2, Chapter/Section 66

- 40

- 00 is issued concurrently with this ASB

. (2) Temporary Revision No. 66

- 29 against Maintenance Manual, SA 4 047

- 76C

- 2, Chapter/Section 66

- 40

- 00 is issued concurrently with this ASB

. (3) Temporary Revision No. 66

- 52 against Maintenance Manual, SA 4047

- 76

- 2, Chapter/Section 66

- 40

- 00 is issued concurrently with this ASB

. (4) Temporary Revision No. 65

- 02 against Maintenance Manual, SA S76D

- AMM

- 000, Chapter/Section 65

- 13

- 0 2 is issued concurrently with this ASB.

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 2. M ATERIAL INFORMATION

A. Attachment
Return for Sikorsky Engineering Evaluation form

.
B. Basis for Material Data

Per helicopter

.
C. Bill of Material

None

.
C. Consumable Material

Qty Nomenclature Part No. Source
A/R Corrosion Preventive Compound MIL

- C

- 81309 Type 2
, 3 or equivalent (1)
A/R Epoxy Polyamide Primer MIL

- PRF

- 23377 or equivalent (1) Epoxy Primer (Alternate) MIL

- PRF

- 85582 or equivalent (1)

(1) Procure through local supply.

Section 3. A CCOMPLISHMENT INSTRUCTIONS

A. Prepare helicopter for maintenance :
(1) Turn off all helicopter electrical and hydraulic power.

(2) Engage rotor brake.

(3) Remove driveshaft from helicopter . (Refer to applicable Maintenance Manual )

. OBSERVE ALL CAUTIONS AND WARNINGS ON CONTAINERS WHEN USING CONSUMABLES. WHEN APPLICABLE, WEAR NECESSARY PROTECTIVE GEAR DURING HANDLING AND USE. IF A CONSUMABLE IS FLAMMABLE OR EXPLOSIVE, MAKE CERTAIN CONSUMABLE AND ITS VAPORS ARE KEPT AWAY FROM HEAT, SPARK AND FLAME. MAKE CERTAIN FIREFIGHTING EQUIPMENT IS READILY AVAILABLE PRIOR TO USE. FOR ADDITIONAL INFORMATION ON TOXICITY, FLASHPOINT AND FLAMM ABILITY OF CHEMICALS, CONSULT YOUR MEDICAL PEOPLE OR THE MANUFACTURER OF THE CONSUMABLE.

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Basic Issue ▪ April 1 /14 

### SERVICE BULLETIN

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

B. Inspect TDS as follows :

NOTE: This inspection must be performed for all TDS’s listed in effectivity section.

(1) Inspect TDS flange attachment hardware at all four locations (four locations for each drive shaft) (Figure s 1 and 2 ) for evidence of movement or torque stripe misalignment

. If evidence of mo ve ment or torque stripe m isalignment
, proceed to Step D

. (2) Attempt to rotate each nut (SS5086

- 04) using finger pressure. If hardware can be rotated by hand, proceed to Step D

. (3) Check that hardware is assembled correctly as follows:

(a) Verify that only one radius washer is present under the head of the bolt and oriented correctly, with the radius side adjacent to the inner diameter . ( Refer to Figure 3 ).

(b) Verify that one thick washer and one thin washer are present under the nut. ( Refer to Figure 3 ).

(c) If hardware is not assembled correctly, proceed to Step D

.
NOTE: If locally fabricated special tool (modified McMaster Carr, P/N 5543A35 or equivalent ) is not available, proceed to Step B. (5).

(4) Using locally fabricated special tool ( modified McMaster Carr, P/N 5 543A35 or equivalent ) (Figure 4) , check torque on each nut (SS5086

- 04) on TDS flange

- to

- shaft attachment. If torque on any nut is less than 105 inch

- pounds, proceed to Step D

. (5) If locally fabricated special tool (modified McMaster Carr, P/N 5543A35 or equiv alent ) is not available, perform torque verification check as follows:

(a) Remove snap ring (S1635

- 61210) , closest to flange

, from bearing support assembly.

(b) Slide bearing support assembly away from flange to allow clearance for common tools. (Figure 5 ).

(c) Using torque wrench, check torque on each nut (SS5086

- 04) on tail rotor drive shaft flange

- to

- shaft attachment. If torque on any nut is less than 105 inch

- pounds, proceed to Step D

.

Page 5 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

(d) Reinstall snap ring (S1635

- 61210) to bearing support assembl y.

C. If during the inspection, no evidence of movement was found, torque stripe was not misaligned, hardware could not be rotated by hand, hardware was assembled correctly, or torque of any nut
was not less than 105 inch

- pounds, perform the following:

(1) Re

- app ly torque stripe as required. (Refer to applicable Maintenance Manual, Chapter/Section 20

- 04

- 00). Inspection is complete, proceed to Section 3, Step E.

D. If during the inspection, evidence of movement was found, torque stripe was misaligned, hardware rotated by hand, hardware was not assembled correctly, or torque of any nut was less than 105 inch

- pounds, perform the following:

NOTE: • Index mark is applied to flange and shaft to make sure flange is reinstalled in the same position and to maintain shaft bala nce.

• If applicable, record information in Torque Verification of TDS Flange Bolt Data Sheet.

(1) Apply index mark to flange and shaft.

NOTE: • With the exception of radius washers, all shaft to flange attaching hardware is one time use. After removal, return bolts , washers, and nuts to Sikorsky (address below) with attached Return for Sikorsky Engineering Evaluation form

.

• Radius washers (SS4411

- 08 S 025NP or ALT SS4411

- 08S025) may be reused if inspected and no visible signs of wear or fretting is found. If radius w ashers are damaged return to Sikorsky (address below) with attached Return for Sikorsky Engineering Evaluation form

. (2) Unbolt and remove flange from shaft.

(3) Visually inspect radius washers (SS4411

- 08 S 025NP or ALT SS4411

- 08S025) for wear or fretting.

NOTE: • Include time since new (TSN) and time since overhaul (TSO) for returned hardware.

• Radius washers (SS4411

- 08 S 025NP or ALT SS4411

- 08S025) are only to be returned if found damaged. Make sure snap ring is reseated in groove and locked. Failure to reseat snap ring in groove can cause unintended failure of drive shaft bearing.

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### SERVICE BULLETIN

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

(4) Return flange to shaft hardware (four sets: nuts, bolts, washers, and radius washers if necessary) to Sikorsky with attached Return for Sikorsky Engineering Evaluation form and Torque Verification of TDS Flange Bolt Data Sheet at the address below:

HELICOPTER SUPPORT INC. (H.S.I.) URGENT: Engineering Evaluation Attn: CSS Commercial Aircraft Product Support 300 Monotowese Avenue Extension North Haven, CT 06473

(5) Replace TDS with a serviceable unit, or i nspect flange and stub as follows:

(a) Inspect driveshaft and flange for crack s and fractures using fluorescent penetrant. No cracks or fractures allowed. (Refer to Figure 6, Reference Letter s A and B ).

(b) Inspect wear of mounting hole on driveshaft and flange. Hole diameter shall be no greater that 0.252 inch maximum. Holes may be up to 0.0015 inch out

- of

- round if diameter is met. (Refer to Figure 6, Reference Letter C ).

(c) Using caliper (commercially available or equivalent), m easure stub shaft outer diameter. Diameter shall be no less than 1.756 5 inches minimum. (Refer to Figure 6, Refe rence Letter D).

(d) Using caliper (commercially available or equivalent), measure flange inner diameter. Diameter shall be no more than 1.7585 inches. (Refer to Figure 6, Reference Letter E).

(e) Using caliper (commercially available or equivalent), measure flang e face width

. (Refer to Figure 6, Reference Letter F) :

1. For driveshafts with P/ N 76361

- 04004 (all dash numbers), w idth shall be no less than 0.210 inches minimum

.

2. For driveshafts with P/N 76361

- 046 04 (all dash numbers), w idth shall be no less than 0.275 inc hes minimum

. (f) If any parts fail any of the criteria listed here, the part is to be scrapped and replaced with a serviceable unit.

(6) If necessary, replace bearing support as follows:

(a) Remove bearing support from shaft.

(b) If necessary, remove snap rings (S1635

- 61210) and press out bearing from support.

(c) Coat Outer Diameter ( OD ) of new bearing and Inner Diameter ( ID ) of bearing liner with corrosion preventiv e compound (MIL

- C

- 81309, Type 2, 3 or equivalent ) , and press bearing into support. Remove excess squ eeze out. Install snap rings (S1635

- 61210)

.

Page 7 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

(d) Install bearing support assembly on shaft so that bearing inner race is over liner of shaft.

(7) Align index marks and install flange on shaft.

NOTE: • When installing flange on shaft for shaft assemblies 76361

- 04004 or 76361

- 04604, use new bolts, washers, and nuts.

• Radius washers (SS4411

- 08 S 025NP or ALT SS4411

- 08S025) may be reused if inspected and no damage is found.

(8) Coat grip length of bol ts, and contact surfaces on radius washers and washers with epoxy polyamide primer ( MIL

- PRF

- 23377 or equivalent)

. Do not prime threads of bolts.

NOTE: Ensure that radius washer (SS4411

- 08 S 025NP or ALT SS4411

- 08S025) is properly seated against the inside diameter of the shaft.

(9) If using loc ally fabricated special torque tool ( modified McMaster Carr, P/N 5543A35 or equivalent) to install flange to shaft, perform the following (Refer to Figure 4 ):

(a) Hand tighten attaching hardware in all locations.

(b) Measure prevailing torque of nuts (SS5086

- 04) at every location and record value. Prevailing torque values should be between 3.5

- 30 inch

- pounds. If prevailing torque value is above or below 3.5

- 30 inch

- pounds, replace nut.

(c) Torque nuts (SS5086

- 04) to 50 inch

- pounds in the sequence shown in Figure 3

. (d) Repeat torque sequence on nuts at 75 inch

- pounds.

(e) Repeat torque sequence on nuts at 110 inch

- pounds p lus measured prevailing torque for each location and until torque has stabilized for each location.

(10) If locally fabricated special torque tool ( modified McMaster Carr, P/N 5543A35 or equivalent) is unavailable, perform the following:

(a) Remove snap ring (S1635

- 61210), closest to flange , from bearing support assembly.

(b) Slide bearing support assembly away from flange to allow clearance for common tools. (Figure 5).

(c) Hand tighten attaching hardware in all locations. THE NUT (SS5086

- 04) IS TO BE TORQUED WHILE THE BOLT IS HELD STATIONARY.

Page 8 ONE

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Section 3. A CCOMPLISHMENT INSTRUCTIONS (Contin ued)

(d) Measure prevailing torque of nuts (SS5086

- 04) at every location and record value. Prevailing torque values should be between 3.5

- 30 inch

- pounds. If prevailing torque value is above or below 3.5

- 30 inch

- pounds, replace nut.

(e) Torque nuts (SS5086

- 04) to 50 inch

- pounds in the sequence shown in Figure 3

. (f) Repeat torque sequence on nuts at 75 inch

- pounds.
(g) Repeat torque sequence on nuts at 110 inch

- pounds plus measured prevailing torque for each lo cation and until torque has stabilized for each location.

(h) Reinstall snap ring (S1635

- 61210) to bearing support assembly.

(11) Apply torque stripe, to nuts, washers, and bolt ends. (Refer to applicable Maintenance Manual, Chapter/Section 20

- 04

- 00 ).

(12) Service TDS assembly

. (Refer to applicable Maintenance Ma nual ).

(13) Reinstall TDS assembly

. (Refer to applicable Maintenance Manual).

E. Perform inspection on all TDS assemblies listed in Effectivity section.

F. R eturn helicopter to service. THE NUT (SS5086

- 04) IS TO BE TORQUED WHILE THE BOLT IS HELD STATIONARY.

Page 9 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

G. Torque Verification of TDS Flange Bolt Data Sheet.

(1) Report the following data back to Sikorsky Aircraft Desi gn Engineering Point of Contact. (Refer to Section 3, Step D. (4)).

(2) Record the following information for each helicopter:

C ustomer/Operator Name:
Helicopter Serial Number:
Helicopter Total Time Since New:

Time Since Last Overhaul:

Flange Location Between Driveshaft Sections I and II :

Driveshaft Serial Number:
Last Hardware Replacement Date (if known):
Number of Flange Bolts that Passed /Failed Torque Check: Passed Failed
Flange Location Between Driveshaft Sections II and III:

Driveshaft Serial Number:
Last Hardware Replacement Date (if known):
Number of Flange Bolts that Passed/Failed Torq ue Check: Passed Failed
Flange Location Between Driveshaft Sections III and IV:

Driveshaft Serial Number:
Last Hardware Replacement Date (if known):
Number of Flange Bolts that Passed/Failed Torque Check: Passed Failed

Date Inspection is Performed:

Page 10 ONE

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### SERVICE BULLETIN

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

TDS FLANGE

- TO

- SHAFT HARDWARE INSTALLATION FIGURE 1

Page 11 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

TORQUE STRIPE VERIFICATION FIGURE 2

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### SERVICE BULLETIN

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

HARDWARE STACK

- UP AND TORQUE PATTERN FIGURE 3

Page 13 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

LOCALLY FABRICATED SPECIAL TOOL (MCMASTER P/N 5543A35) FIGURE 4

Page 14 ONE

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### SERVICE BULLETIN

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

BEARING SUPPORT ASSEMBLY FIGURE 5

Page 15 ONE

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### SERVICE BULLETIN Basic Issue ▪ April 1 /14

Section 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

DRIVESHAFT INSPECTION FIGURE 6

Page 16 ONE

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### SERVICE BULLETIN

S ection 3. A CCOMPLISHMENT INSTRUCTIONS (Continued)

H. Record of Compliance:

(1) Make helicopter logbook entries to show compliance with this ASB as follows:

(a) Make helicopter level logbook entry on form SA7343

- 15.

(b) When ASB modifies a component that can be removed from this helicopter:

1. Make component log card entries on forms SA7343

- 22 & SA7343

- 21 as applicable.

2. If a component modified by this ASB does n ot have a log card and the ASB does not create one, then annotate compliance on the next higher assembly that the component belongs to which does have a log card.

NOTE: If access to www.Sikorsky360.com is unavailable, complete attached ALERT SERVICE BULLETIN COMPLIANCE RECORD CARD and return it to Sikorsky Aircraft Corporation.

(2) Make an appropriate electronic compliance entry in the E

- Notification section at www.Sikorsky360.com . Refer to User Guide located on the www.Sikorsky360.com/E

Notification Search page

.

Page 17 ONE

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### (Fold over and tape closed)

SIKORSKY AIRCRAFT CORPORATION 

# FACSIMILE NUMBER (860) 998

- 7565

EMAIL ADDRESS: GPSIKSASProductSafet@utc.com

ATTENTION: SAS PRODUCT SAFETY MANAGER SIKORSKY AEROSPACE SERVICES

(Fold Up to Arrows) 

# IM PORTANT NOTICE

Upon COMPLIANCE with the attached ASB , Sikorsky requests your cooperation in completing and returning this ENTIRE PAGE by MAIL, FAX, or scan & EMAIL.

P lease fill in the requested information at the bottom of the page, so we may maintain proper records documenting the configuration of your aircraft. This information is useful when determining configuration and effectivity of issues affecting fielded aircr aft. This request is in keeping with our policy to assure that our customers receive the latest information applicable for the maintenance of your aircraft. Thank you.

AL ERT SERVICE B U LLETIN :

________________ Compliance Record Card

TITLE:

________________________________________________________________ ___

___________________________________________________________________

________________________________________________________________ ___ OWNER/OPERATOR:

_____________________________________________________ SUBMITTED BY:

___________________________ DATE:

____________________ FOLLOWING SERIAL NUMBERS ARE NOT AFFECTED BY THIS ASB

ASB HAS BEEN COMPLIED WITH ON HELICOPTER SERIAL NUMBERS :

___________ ___________ ___________ ___________ ___________ ___________

___________ ___________ ___________ ___________ ___________ ___________ ASB No. 76

- 66

- 52



### POWERTRAIN

– Tail Drive Shaft

– One

- Time Inspection and Torque Verification of Tail Drive Shaft (TDS) Flange BoltNo Postage Necessary



### BUSINESS REPLY MAIL FIRST

- CLASS MAIL PERMIT NO. 432 BRIDGEPORT CT

POSTAGE WILL BE PAID BY ADDRESSEE


### SIKORSKY AIRCRAFT CORPORATION P.O. BOX 9729 6900 MAI N STREET STRATFORD, CONNECTICUT 06615

- 9129 U.S.A. MAILSTOP: S328A ATTENTION: SAS PRODUCT SAFETY MANAGER SIKORSKY AEROSPACE SERVICES



## Please complete the form on the reverse side and FAX to 

# FACSIMILE NUMBER (860) 998

- 7565
Or scan and email to: EMAIL ADDRESS: GPSIKSASProductSafet@utc.com or fold and return ENTIRE form to Sikorsky Aircraft Corporation

# Return for Sikorsky Engineering Evaluation

RETURN INSTRUCTIONS :

Return parts indicated below to Sikorsky Aircraft Corporation by the fastest traceable means with the following information:

Send to: Helicopter Support, Inc. (H.S.I.) URGENT: Engineering Evaluation Attn: CS S Commercial Aircraft Product Support 

### 300 Montowese Avenue Extension North Haven, CT 06473

Mark for: S

- 61 S

- 70 S

- 76 S

- 92

Product Safety /Engineering Evaluation

Engineering
HUMS Anomaly or Exceedance

PART INFORMATION :

Part Number

_________ Serial Number:

____________ Nomenclature

____________________________________________________________ Reason for Removal Failed torque inspection per ASB 76

- 66

- 55
Helicopter Serial Number

__________ A/C Hours at Removal:

________ Date Removed :

________ Component Hours at Removal:

________ TSR:

________ TSO:

________ Customer/Operator Name

______________________________ _________________________ Sikorsky FTR #

_______________ Sikorsky RFA #

_______________ Requested by customer or Sikorsky? Sikorsky per ASB 76

- 66

- 52 TRD Hardware Check (if Sikorsky, please list requestor name)

Remarks: Notify Tim Tomasko upon part arrival and send to the materials lab

ADDITIONAL INSTRUCTIONS :
1. Fax or email a copy of this form with shipping information (AWB#, Flight#, Shipper Tracking#) as applicable to +1 860

- 353

- 6557 or sascommercialproduct@utc.com Include a copy of this form in the box with the part.

2. If a Sikorsky FSR is on

- site, obtain the FTR # from him and record in the spaces above, if not already annotated.

3. Any questions regarding the return of this part should be directed to the Requestor listed above.

SA 1600 5/4/11 Verify current r evision of form