EFTA00313225.pdf

1 DEDI AE DRIGE qinr __ Ar 1- 1-3ERA Hlact‘ Floor: FL4 Insured Aircraft Title Serv P O. Boax 19527 ice Inc. Oktahorna Cory. Oklahoma 7314 4 LORI GRIFFIN (tremely Urgent 81211201310:15_ _ _ 0 111011 19n I Pagel of 1 Ter and ons and Fran. Origin ID OKCA F e dt ..( ts Ex Lori Griffin A Shr,',: C c ippsitao AUG13 3430 I AT.S. AD 2182L:2BigmET Service 4848 SW 36th Strot4 Delnivy A dre s Bar Cot Oklahoma Coy, OK 73179 E S. J13201 nun, 0 1ff SHIP TO (2121971.1701 BILL SENDER Ref 0 N 31JE Leslie Groff Woks 0 DKI, PLLC PO D•91 575 Lexington Avenue 4th Floor NEW YORK CITY, NY 10022 WED - 21 AUG 10:30A PRIORITY OVERNIGHT IRK' 7965 0633 2560 1 0201 10022 NYUS XA JRBA EWR EFTA00313225  -• ^ FORM APPROVED OMBNo.2120-0342 UNITED STATES Of AMERICA DEPARTMENT OF TRANSPORTATION nEWAAL RILATION ADatwitSTTA1101441atil NOMPOMYADIONAVTICAL GOITER AIRCRAFT REGISTRATION APPLICATION CERT: ATE VNITEO9TATES FtEG/STRA N NUMBER fit 33 I , r- % s-ri '-- Alla r MANUFAcilIRER&P.9CEI t'%e t I A/CRAFT SERIAL No. 4 30 • Li 9 O 1 c< TYPE OF REG,KIATION (Check One bar' , it Pr?: ' A 0 1. Individual 0 2. Partnership el . 3. 6 -ieiekilet 4 ' j $fs 0 8. Non-Citizen Corporation 0 9. Non-Citizen NAME OR APPLICANT (Pensones)shoWn on evidence of ownership. IT include:it di IOW VA ‘^( FERION\ I\ \ K 1 A. a TELEPHONE NUMBER: ( I ADDRESS fieffnanent mane et:dress for ta t appocant on kst) Of P. Boxes uses. jCre ddr•SS must also be shown.) i .. 'timber and street (4,% ) Rural Reuter: .. CITY ISTATE ZIP COOS sot; . ' 1.':, \I i ' c 1003 0 - CI CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE OF ADDRESS ATTENTION! Read the following statement before signing this application. This portion MUST be completed. I A false or dutionost answer to any Question $9 tin. apO-etvon may be OfffJOil tot punishment by I He weber imprisonment (US Code Yee IA. Sec 1001) CERTIFICATION TAYE CERTIFY Ilt Thed the above amcraft .3 Owned by tte undersigned apt/cant wtiO is a Giblet, endvding c4XPOtabOnS) of the United States. (For young that. give name 0! truftee. ). 0I CHECK ONE AS APPROPRIATE. a. 0 A resident ahoy with Soo rebisbabon (Form 1.151 or Form 1-551) No. b. 0 A non<ctizon conaccation organized and &Sing busnets under the laws CA (stale) and sad Octet/ is b,sted are pn manly oped al the United States. Records Of night hours are Await.* for inspection al _._ — (2) That IM titre is nal related under !De tines of any foreign country. and (3) That legs evidence al Nynex:hp is attached or has been fib with the Federal Auation Administration NOTE: If ethic uted for co.ownersh O all applicants must sign. Use rovers° side if necessary. TYPE OR PRINT NA7 EI&cry7IATURE 0,_ SIGH-ARAL i / 7 TITLE DATE r'''r.n ,.;,...„ In Lt-. 5-a-‘.) a riy tie i VI sette,,i Moonckyv- I- DZ 1 inl OT - VIGNATuRV TITLE DATE Yr.( a.t, X -kw; TURE TITLE DATE D O. a, 1?Ct° NOTE Pandora receipt of the Centiecate of Ante Rags reran. the &Yuan may De operated for a peter! no ' teas o' 90 days. donne winch brne the PINK copy of this application must Do earned in the aircraft. AC Fern 8050-1 (5/12) (NSW 0052-00-628-9007) EFTA00313226