Aircraft Avionics Configuration Survey for RVSM Compliance
Please fill out this survey as completely as possible.   This will help
us evaluate the RVSM compliance of your aircraft more accurately.

AIRCRAFT INFORMATION
Owner:
Reg. No.:
Reg. Country:
Cycles:
Model:
Serial No.:
Home Base:
Total Time:
OPERATOR INFORMATION
Contact Name:
Phone:
FAX:
E-mail:
Address:
Certified By:
e.g. FAA, CAA, JAA, BDCA, etc.
AIRCRAFT AVIONICS CONFIGURATION

Pilot’s/Captain’s System

Manufacturer

Model

Part Number

Air Data Computer/Sensor
Mach/Airspeed Indicator
Altimeter
Transponder
Flight Director Computer
Radio Altimeter Transceiver

CoPilot’s/First Officer’s System

Manufacturer

Model

Part Number

Air Data Computer/Sensor
Mach/Airspeed Indicator
Altimeter
Transponder
Flight Director Computer
Radio Altimeter Transceiver
General

Manufacturer

Model

Part Number

Autopilot Computer
Autopilot Amplifier
Altitude Alerter
What is your pitot-static system configuration?
Enter the static port/probe information - Manufacturer:
Part Number:
Which altimetery systems provide input to the autopilot in alt hold?
Is the V-Nav configured with a deviation mode? YesNo
Is the altitude alerter configured with a deviation mode? YesNo
If yes, what deviation from selected altitude generates a warning? ft.
Do both the pilot & copilot systems provide input to the altitude alerter? YesNo
If the captain’s ADC fails, will the autopilot still function normally? YesNo
If the captain’s ADC fails will the altitude alert still function normally? YesNo
Which altimeter is a Radio Altimeter Indicator (Rad-Bar)?
How accurate is the autopilot? (assume calm air) Alt. Hold #1:
Alt. Hold #2:
When establishing a new IAS in Altitude Hold, how much deviation is there from the original altitude?

Press to forward your information to Alternative Avionics for evaluation.
You will be contacted as soon as possible.  Press to clear all information.