Fill and Sign the Cvs Prior Form

Paperwork Reduction Act Statement: The information collected is used to register an aircraft or hold an aircraft in trust. The information is required to determine eligibility of an applicant to receive a Dealer’s Certificate and issue same to correct name and address. We estimate that it will take .5 hour to complete. Use of this form is optional. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number associated with this collection is 2120-0024. Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800 Independence Ave SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, AES-200. Form Approved OMB No. 2120-0024 U.S. Department of Transportation Federal Aviation Administration DEALER’S AIRCRAFT REGISTRATION CERTIFICATE APPLICATION INSTRUCTIONS: Mail this application with check or money order, payable to FEDERAL AVIATION ADMINISTRATION to Civil Aviation Registry, P.O. Box 25504, Oklahoma City, OK 73125 Telephone: 405-954-3116 1. NAME & MAILING ADDRESS OF APPLICANT 2. ADDRESS OF PRINCIPAL PLACE OF BUSINESS (No., Street, City, and ZIP code.) NOTE: PHYSICAL LOCATION/ADDRESS REQUIRED, P.O. BOX IS UNACCEPTABLE TELEPHONE: (Include Area Code) 3. BUSINESS THE APPLICANT IS SUBSTANTIALLY ENGAGED IN (Check one) 4. OWNERSHIP (Check one) Manufacture of aircraft Individual (1) The distribution or sale of new aircraft under authority of a franchise, license, letter of authority, agreement, or other arrangement from the manufacturer or his authorized agent. Partnership The distribution or sale of used aircraft through ordinary trade channels Corporation (3) CoOwnership (4) (2) 5. APPLICATION IS HEREBY MADE FOR DEALER’S AIRCRAFT REGISTRATION CERTIFICATE NUMBER OF CERTIFICATES APPLIED FOR AMOUNT OF CHECK OR MONEY ORDER ATTACHED $ ATTENTION! Read the following before signing this application A false or dishonest answer to any question in this application may be grounds for punishment by fine, or imprisonment, or both. (18 U.S.C. 1001) CERTIFICATION: I hereby certify that each person whose name appears hereon as an applicant is a citizen of the United States as defined in Title 49 United States Code 40102(a)(15), with an established place of business located at the address set forth in item 2 of this application; and that the applicant is substantially engaged in the manufacture of aircraft, the distribution or sale of new aircraft, or the distribution or sale of used aircraft as set forth in item 3 of this application. DATE TITLE (MUST AGREE WITH OWNERSHIP CHECKED IN ITEM 4) SIGNATURE AND NAME TYPED OR PRINTED GENERAL INFORMATION The Federal Aviation Act provided for issuance of dealer’s aircraft registration certificates to be used as an alternative for the certificate of aircraft registration. This form identifies the applicant as a person engaged in the business of manufacturing, distributing, or selling aircraft. The signature certifies U.S. citizenship as required by the Act. Incomplete submission will prevent or delay issuance of dealer’s aircraft registration certificates. 1. A citizen of the United States means (a) an individual who is a citizen of the United States; or (b) a partnership each of whose partners is an individual who is a citizen of the United States; or (c) a corporation or association organized under the laws of the United States or a State, the District of Columbia, or a Territory or possession of the United States, of which the president and at least two-thirds of the board of directors and other managing officers are citizens of the United States, and in which at least 75 percent of the voting interest is owned or controlled by persons that are citizens of the United States. Title 49 United States Code 40102(a)(15). 2. Before operating an aircraft he owns while using his dealer’s aircraft registration certificate, the holder of the certificate (other than a manufacturer) must send to the Civil Aviation Registry evidence satisfactory to the Administrator that he is the owner of the aircraft. (Limitations may be found in Section 47.69 of the Federal Aviation Regulations.) 3. A Dealer’s Aircraft Registration Certificate expires one year after the date on which it was issued. All additional certificates expire on the date of expiration of the original certificate. 4. The fee for a Dealer’s Aircraft Registration Certificate is $10 and $2 for each additional Dealer’s Aircraft Registration Certificate issued to the same dealer. DO NOT WRITE BELOW THIS LINE (FOR FAA USE ONLY) Issue............................................................ certificate(s) Date of Issue ................................................................... Expiration Date................................................................ AC Form 8050-5 (03/11) Employee identification stamp