SB012 Reimbursement Form Submitted By Maintenance FacilityAircraft Owner / Operator Name Address City State Zip Phone Email Part Information Spark Plug Part Number(s) UREB36SUREB37EUREM37BYUREM38EUREM38SUREM40EURHB32EURHB32HSURHB32SURHB36SURHB37EURHM38EURHM38SURHM40E Number of Spark Plugs Returned Purchase Information Date Spark Plug(s) Purchased Return Shipment Information Return Tracking Number Lot Number(s) Returned Aircraft Information Aircraft Registration (N-Number) Engine Make & Model Reimbursement Preference CheckCredit with McFarlane Aviation Certification I certify that the information provided above is true and accurate.
