OMB Control No. 2120-0042 

Exp. 11/30/2014 

Paperwork Reduction Act Statement: The information collected on this form is necessary to ensure applicant eligibility. The 

information is used to determine that the applicant meets the necessary qualifications as owner of an amateur built aircraft. We 

estimate that it will take approximately 30 minutes to complete the form. The information collection is required to obtain a benefit. The 

information collected becomes part of the aircraft registration system. Please note that an agency may not conduct or sponsor, and a 

person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. OMB 2120-

0042. Comments covering the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at 800 

Independence Avenue SW, Washington, DC 20591. ATTN: Information Collection Clearance Officer, AES-200. 

AFFIDAVIT OF OWNERSHIP FOR AMATEUR-BUILT AND OTHER 

NON-TYPE CERTIFICATED AIRCRAFT 

(does not include light-sport) 

U.S. Identiftcation N534FD 

------------------------------------------------------ Name of Amateur 1 Non TC'd builder DJI Innovations ------------------------------------------- Model Phantom 2 Vision + Serial Number PH645180724 

Class (airplane, rotorcraft, glider, weight shift 

control, powered-parachute, etc.) Rotorcraft- UAS 

Type of Engine Installed (reciprocating, turboprop, 2 or 4 cycle, electric, etc.) Electric 

Manufacturer, Model and Serial Number of each Engine Installed _D_J_I_M_o_d_e_l_2_2_1_2 _________ _ 

Serial # N/A Number of Engines Installed 4 

----------

Built for Land or Sea Operation Land & Sea Number of Seats 0 

---------

MUST CHECK ONE 

0 More than 50% of the above-described aircraft was built from miscellaneous parts and I am the owner. (This option is for aircraft 

eligible for amateur-built certification.} 

D More than 50% of the above-described aircraft was built from a kit (prefabricated parts} and I am the owner. The bill of sale from 

the kit manufacturer is attached. (This option is for aircraft eligible for amateur-built certification.} 

lZ] I certify that the above-described aircraft is a newly built non-type certificated aircraft and is not currently registered in another 

country. (This option is for aircraft eligible for experimental certification other than amateur-built.} 

0 I certify that the above-described aircraft is a previously built (used) non-type certificated aircraft and is not currently registered in 

another country. (This option is for aircraft eligible for experimental certification other than amateur-built certification.) 0 Evidence of ownership from the aircraft builder through any intervening owners is attached (chain of ownership). D Unable to obtain complete chain of ownership. Statement as to ownership history and whereabouts of aircraft is attached. 

Name of Owner: 

Signature of Owner: 

Address: 

City: Seabrook 

Telephone: 281-326-1800 

Notmy Public: 

State of: ·-~ 

Subscribed and sworn to before me this 

My Commissio~xpires: 

(Signature ofNotmy 

=t~ Public) 

AC Form 8050-88 (03/12) 

State: 

Title of Signer 

(If Appropriate): President 

-----------------

xas Zip: 77586 -t------

County of: Y~ 

.:so<f..t!. day of MM-4 ru~ /Lf~ Qon · 
Addendum to AC Form 8050-88 (03/12J 

for DJI INNOVATIONS PHANTOM 2 VISION+, SERIAL NUMBER 

PH645180724, FAA registration number N534FD 

March 30, 2015 

At the behest of the FAA representative, the following additional information is 

added for consideration for the registration of the aircraft: 

FAA Letter dated March 25, 2015 from Jennell Woods. 

Comment b. The Affidavit of ownership has been updated to reflect the correct 

N number. 

/, L/c~rj-~~-~ D;niel Harry -· ) 

President, D&C Inspection Services Inc. 

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