Application for Public-use Airport License Renewal
Change in Status Form
|Instructions |
| |Use this form to report sale of aircraft, change in aircraft location or other changes in aircraft status. |
|Part 1: Your Information |
|Name: | |
|Street Address: | |
|City, State ZIP: | |
|Phone Number: | |
|Email Address: | |
|Part 2: New Owner Information |
|Date of Sale: | |
|New Owner(s) Name: | |
|Street Address: | |
|City, State ZIP: | |
|Phone Number: | |
|Part 3: Aircraft Information |
|FAA Registration Number: | |
|Serial Number: | |
| | |
|City/County to which personal property tax| |
|is paid on aircraft: | |
|Based Airport: | |
| | |
|Changes in Status: |Aircraft is now registered in the state of: _________________ |
| |Effective date: _____________________________________ |
| |Aircraft destroyed as of: _____________________________ |
| |Aircraft does not have an FAA Certificate of Airworthiness as of: |
| |Other changes (Explain and include date): ___________________ |
|Part 4: Supporting Documents |
Provide one or more of the following:
| Personal property tax receipt from locality to which you moved |
| Copy of the aircraft registration from the other state |
| Bill of sale or agreement |
| Letter from insurance company giving the date the aircraft was removed from your policy |
|Copy of last annual inspection |
| | | |
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|Signature | |Date |
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