Annual Certificate of Aircraft Status


Owner of Aircraft:
I hereby certify that this aircraft will not be flown/or is exempt from registration during the year 20 because:

If applying for an aircraft exemption. Please check one of the reasons:









N:
Make:
Model:
Serial #:
 
Address:
City, State, Zip:
E-mail:
Date: ,

If sold, please fill out the following information:

 
New Owner's Name:
 
Address:
 
City, State, Zip:
E-mail:


I hereby certify that this is a true and accurate statement.

Initials  

Electronic submissions do not require a signature.  When submitted electronically, you are confirming that all information is true, complete and accurate.

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