EFTA00315760.pdf

OMB Control Number 2l22.0729 PRINT PAGE 1 PRIVACY ACT STATEMENT Expires 05131120m Paperwork Reduction Act Statement: The information collected on this form is necessary to maintaii aicraft registration. We estimate that it will take approximately 30 mimes to complete the form. Please note that an agency may not conduct or sponsor. and a person is not required to respond to. a colection of rformation unless it displays a valid OMB control number. Form Approved, OMB No. 2120.0729 'Comments concerning the accuracy of his burden and suggestions for reducing the burden should be drected to the FAA at: 800 Independence Avenue SW. Washington. DC 20591. ATTN: Information Collection Clearance Officer. AES-200.* FAILURE TO RENEW REGISTRATION WILL DEPARTMENT OF TRANSPORTATION- FEDERAL AVIATION ADMINISTRATION RESULT IN CANCELLATION OF REGISTRATION AIRCRAFT REGISTRATION RENEWAL APPLICATION AND REGISTRATIONNUMBER ASSIGNMENT (See 14 C.F.R. §§ 47.15(0. 47.40 and 47.41) AIRCRAFT REGISTRATION NUMBER SERIAL NUMBER N MANUFACTURER MODEL DATE OF ISSUANCE DATE OF EXPIRATION TYPE OF REGISTRATION ENTER REGISTERED OWNERS) & ADDRESS FROM FAA FILE HELPFUL INFORMATION (Owner 1) Review Aircraft Registration File Information for this aircraft at: http://renistry.faa.qoviaircraftinauiry. (Owner 2) Note: Enter any additional owner names on page Iwo. Assistance may be obtained at our web page: htbrfireaistry.faa.00virenewreoistration, (Address) by e-mail al: [email protected]. or (Address) by telephone at: (866) 762 - 9434 (toll free). or (405) 954 - 3116 City State Zip When mailing fees, please use a check or money order made Country payable to the Federal Aviation Administration. Physical Address: Required when mailing address is a P.O. Box or mail drop. Signature and Title Requirements for Common Registration Types: - Individual owner must sign. title would be "owner'. (Address) Partnership general partner signs showing 'general partner" as title. (Address) - Corporation corporate officer or manager signs, showing lull title. City State Zip - Limited Liabikty Co authorized member. manager. or officer identified in the LLC organization document signs. showing lull title. Country - Co-owner each co-owner must sign: showing "co.ownet as title. - Government authorized person must sign and show their full title. TO RENEW REGISTRATION: BUTS aircraft registration Information. Note: All signatures must be in ink, or other permanent media. SELECT the appropriate statement ENTER any change in address in the spaces below. SIGN. DATE. & SEND form with the $5 renewal fee to the: To correct entries: Draw a single line through error. Make correct entry in FAA Aircraft Registry. PO Box 25504, Oklahoma City OK 73125-0504, or remaining space, or complete the form on-line. An application form will be by courier to: 6425 S Denning Room 118, Oklahoma City OK 73169.6937 rejected if any entry is covered by correction tape or similarly obscured. ❑ I (WE) CERTIFY, THE NAME(S) AND ADDRESSES FROM THE FM FILES FOR THE OWNER(S) OF THIS AIRCRAFT ARE CORRECT. OWNERSHIP TO CANCEL THE REGISTRATION FOR THIS AIRCRAFT: MEETS CITIZENSHIP REQUIREMENTS OF 14 CFR §47.3. AIRCRAFT IS CHECK all applicable blocks below. COMPLETE. SIGN, DATE & MAIL this NOT REGISTERED UNDER THE LAWS OF ANY FOREIGN COUNTRY. form with any fees to the: FM Aircraft Registry. PO Box 25504, Oklahoma City, OK. 73125.0504, or by courier to: ❑ UPDATE THE MAILING ( PHYSICAL ADDRESS AS SHOWN BELOW. 6425 S Denning Rm. 118. Oklahoma City OK 73169-6937 I (WE) CERTIFY THE: NAME(S) SHOWN ABOVE FOR THE OWNER(S) OF THIS AIRCRAFT IS CORRECT, OWNERSHIP MEETS THE CITIZENSHIP In CANCELLATION OF REGISTRATION IS REQUESTED. REQUIREMENTS OF 14 CFR §47.3, AIRCRAFT IS NOT REGISTERED THE AIRCRAFT WAS SOLD TO: UNDER THE LAWS OF ANY FOREIGN COUNTRY. (Show purchaser's name and address.) NEW MAILING ADDRESS ❑ THE AIRCRAFT IS DESTROYED OR SCRAPPED. NEW PHYSICAL ADDRESS: complete if physical address has changed, or ❑ THE AIRCRAFT WAS EXPORTED TO: the new mailing address Is a PO Box or Mail Drop. ❑ OTHER. Specify ❑ PLEASE RESERVE N-NUMBER IN THE OWNER'S NAME AND ADDRESS. The $10 reservation lee is enclosed. SIGNATURE OF OWNER I (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. AC Form 8050-IB (04112) EFTA00315760 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 dick the 'Reset' button to clear the data fields (from page 2 only) to add more names. Repeat action as needed. PRINT PAGE 2 RESET NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE NAME OF OWNER DATE SIGNATURE PRINTED NAME OF SIGNER TITLE AC Form 8050-I B (04/12) REF N-NUM: EFTA00315761