PRINT
PAGE 1
PRIVACY
ACT STATEMENT
Expires 2/29/2012
Paperwork Reduction Act Statement: A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0729. Public reporting for this collection of information is estimated to be approximately 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are required to obtain or retain a benefit by 14 CFR Part 47. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the FAA at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, AES-200.
|
|||||||||
DEPARTMENT OF TRANSPORTATION - FEDERAL AVIATION ADMINISTRATION AIRCRAFT RE-REGISTRATION APPLICATION |
FAILURE TO RE-REGISTER WILL RESULT IN CANCELLATION OF REGISTRATION AND REGISTRATION NUMBER ASSIGNMENT (See 14 C.F.R. §§ 47.15(i), 47.40 and 47.41)
|
||||||||
AIRCRAFT REGISTRATION NUMBER N |
SERIAL NUMBER |
|
|||||||
MANUFACTURER
|
MODEL |
||||||||
DATE OF ISSUANCE
|
DATE OF EXPIRATION |
TYPE OF REGISTRATION |
|||||||
REGISTERED OWNER(S) & ADDRESS FROM FAA FILE
(Owner 1)
(Owner 2)
Note: Enter any additional owner names on page two.
(Address)
(Address)
City State Zip
Country
Physical Address: Required when mailing address is a P.O. Box or mail drop.
(Address)
(Address)
City State Zip
Country
TO RE-REGISTER AIRCRAFT: REVIEW aircraft registration information, SELECT the appropriate statement, ENTER any change in address in the spaces below, SIGN, DATE, & SEND form with the $5 re-registration fee to the: FAA Aircraft Registry, PO Box 25504, Oklahoma City OK 73125-0504, or by courier to: 6425 S Denning Rm 118, Oklahoma City OK 73169-6937
|
HELPFUL INFORMATION
Review Aircraft Registration File Information for this aircraft at: http://registry.faa.gov/aircraftinquiry.
Assistance may be obtained at our web page: http://registry.faa.gov/renewregistration, by e-mail at: [email protected], or by telephone at:: (866) -762 - 9434 (toll free).or (405) – 954 3116
When mailing fees, please use a check or money order made payable to the Federal Aviation Administration.
Signature and Title Requirements for Common Registration Types: - Individual owner must sign. Title would be “owner”. - Partnership a general partner must sign. - Corporation a corporate officer or managing official must sign. - Limited Liability Co. member, manager, or officer authorized to manage the LLC must sign, see LLC organization documents. - Co-owner each co-owner must sign; title would be “co-owner”. - Government authorized person must sign and show their title.
Note: All signatures must be in ink, or other permanent media.
To correct entries: Draw a single line through error. Make correct entry in remaining space, or complete the form on-line. An application form will be rejected if any entry is covered by correction tape or similarly obscured.
|
||||||||
I (WE) CERTIFY: THE NAME(S) AND ADDRESSES FROM THE FAA FILES FOR THE OWNER(S) OF THIS AIRCRAFT ARE CORRECT, OWNERSHIP MEETS CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3, AIRCRAFT IS NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY.
UPDATE THE MAILING / PHYSICAL ADDRESS AS SHOWN BELOW. I (WE) CERTIFY: THE NAME(S) SHOWN ABOVE FOR THE OWNER(S) OF THIS AIRCRAFT IS CORRECT, OWNERSHIP MEETS THE CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3, AIRCRAFT IS NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY.
NEW MAILING ADDRESS:
NEW PHYSICAL ADDRESS: Required if physical address has changed, or the new mailing address is a PO Box or Mail Drop.
|
TO CANCEL THE REGISTRATION FOR THIS AIRCRAFT: CHECK All applicable block(s) below, COMPLETE, SIGN, DATE & MAIL this form with any fees to the: FAA Aircraft Registry, PO Box 25504, Oklahoma City, OK, 73125-0504, or by courier to: 6425 S Denning Rm. 118, Oklahoma City OK 73169-6937
CANCELLATION OF REGISTRATION IS REQUESTED:
THE AIRCRAFT WAS SOLD TO: Show buyer’s name & address.
THE AIRCRAFT IS DESTROYED OR SCRAPPED.
THE AIRCRAFT WAS EXPORTED TO:
OTHER, Specify:
CANCEL THIS REGISTRATION AND RESERVE N-NUMBER IN THE OWNER’S NAME AND ADDRESS. The $10 reservation fee is enclosed. |
||||||||
SIGNATURE OF OWNER 1 (required field) |
PRINTED NAME OF SIGNER (required field) |
TITLE (required field) |
DATE
|
||||||
SIGNATURE OF OWNER 2 |
PRINTED NAME OF SIGNER |
TITLE |
DATE
|
Use page 2 for additional signatures.
Note: Twelve (12) owner names may be entered on this page. If you require more, enter the first 12 names and then print this page by pressing the ‘Print Page 2’ button below. Next click the ‘Reset’ button to clear the data fields (from page 2 only) to add more names. Repeat action as needed.
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
|
NAME OF OWNER
|
SIGNATURE |
TITLE:
|
PRINTED NAME OF SIGNER
|
DATE:
|
AC Form 8050-1A (XX/XX)
File Type | application/msword |
File Title | Paperwork Reduction Act Statement: The information collected on this form is necessary to obtain aircraft re-registration |
Author | Gloria Watson |
Last Modified By | Taylor CTR Dahl |
File Modified | 2012-07-31 |
File Created | 2011-12-01 |