Experimental Built Evaluation Form

Please complete as much of the following information as possible to request a Market Analysis for Experimental Built Aircraft. Although there are only a few required fields, be sure to provide as much infomation as possible. The more accurate and complete the data are the more accurate the Market Analysis will be. For Help with the grading see our Grading Instructions. We Strongly recommend that you print this form and use it to record informationif you visit the aircraft.

Contact Information

Name: Phone:
Company: Fax:
Address:
City: State:
ZIP: Email:

Be sure to include either your Email or Phone number so that we can contact you in case we need to clarify the data.

Aircraft Information

FAA Number: Date of Last Annual:
Year Built: Manufacturer:
Model: Serial Number:
Engine Type:    

Airframe Information

Airframe Total Time Since New: hrs. Airframe Condition:
Paint Condition: Interior Condition:
Window Condition: Present Damage:
Repair Cost: Damage History:
If there have been incidents of aircraft damage please describe the incidents below. (The text box will scroll) Enter: Date, Extent of damage (Extensive, Major, Moderate, Minor). What happened and the repairs?

Engine and Prop Information

Number of Engines: Manufacturer:
Model: Horsepower (HP):
Time Between Overhaul: hrs.
Time since last overhaul: hrs.    
Engine #1:  
Serial Number: Overhaul or New Date:
Type Of Overhaul:    
Engine #2:  
Serial Number: Overhaul or New Date:
Type Of Overhaul:    

Propellers

Props: Make:
Model: Recommended TBO:
Number of Blades:    
Prop #1:  
Serial Number: Overhaul or New Date:
Total time since New or O/H: hrs.    
Prop #2:  
Serial Number: Overhaul or New Date:
Total time since New or O/H: hrs.    

Airframe and Engine Modifications

If there have been airframe or engine modifications please describe as completely as possible the modifications, cost and dates.

Modification #1: DATE: COST:
Description:
Modification #2: DATE: COST:
Description:
Modification #3: DATE: COST:
Description:
Modification #4: DATE: COST:
Description:
Modification #5: DATE: COST:
Description:

Avionics Equipment

Overall Condition of Avionics: Aircraft is
Type of Avionic Make Model Channels
 
 
 

Additional Equipment

True Air Speed: Cockpit Voice Recorder:
Yaw Damper: Flight Recorder:
De-Ice Boots: Stall Warning:
Prop De-Ice: Air Conditioning:
Rotating Beacon: Long Range Fuel:
Strobe Lights: Aux Fuel Quantity:
Other Equipment:

If there is anything else that would affect the value of this aircraft please describe it below together with its original cost.

Estimated Cost:
Are all Airworthiness Directives complied with?
If all AD's not complied with, what is the estimated cost to comply?
 
    
 
Bold= Denotes a required field