Case File
efta-efta00313225DOJ Data Set 9OtherDS9 Document EFTA00313225
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00313225
Pages
2
Persons
0
Integrity
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Extracted Text (OCR)
Text extracted via OCR from the original document. May contain errors from the scanning process.
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LORI GRIFFIN
81211201310:15_
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Lori Griffin
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4848 SW 36th Strot4
Oklahoma Coy, OK 73179
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Insured Aircraft Title Serv
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P O. Boax 19527
Oktahorna Cory. Oklahoma 7314
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SHIP TO (2121971.1701
Leslie Groff
DKI, PLLC
575 Lexington Avenue
4th Floor
NEW YORK CITY, NY 10022
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BILL SENDER
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EFTA00313225
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FORM APPROVED
OMBNo.2120-0342
UNITED STATES Of AMERICA DEPARTMENT OF TRANSPORTATION
nEWAAL RILATION ADatwitSTTA1101441atil NOMPOMYADIONAVTICAL GOITER
AIRCRAFT REGISTRATION APPLICATION
CERT:
ATE
VNITEO9TATES
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FtEG/STRA
N NUMBER fit 33
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Alla
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t'%e t I 4 30
A/CRAFT SERIAL No.
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TYPE OF REG,KIATION (Check One bar' ,
0 1. Individual
0 2. Partnership
el . 3. 6 -ieiekilet 4
it
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Pr?: ' A
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8. Non-Citizen Corporation
0 9. Non-Citizen
NAME OR APPLICANT (Pensones)shoWn on evidence of ownership. IT include:it di
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VA ‘^( FERION\
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TELEPHONE NUMBER: (
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ADDRESS fieffnanent mane et:dress for tat appocant on kst) Of P.
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'timber and street (4,%
)
Boxes uses.
jCre ddr•SS must also be shown.)
Rural Reuter:
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CITY
ISTATE
ZIP COOS
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sot;.
1.':, \I i
1003 0 -
CI
CHECK HERE IF YOU ARE ONLY REPORTING A CHANGE OF ADDRESS
I
ATTENTION! Read the following statement before signing this application.
This portion MUST be completed.
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.owner sh O all applicants must sign. Use rovers° side if necessary.
TYPE OR PRINT NA7 EI&cry7IATURE
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TITLE
DATE
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
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Phone
(2121971Phone
628-9007Phone
965 0633Forum Discussions
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