2152 Astoria Circle # 104
Herndon, VA 20170
Fax 703 657-0340

e-APIS INFORMATION - AFTER SELECTING DEPARTURE OR ARRIVAL NOTIFICATION AS APPROPRIATE, ALL FIELDS ON THIS FORM ARE MANDATORY FOR U.S. CUSTOMS CLEARANCE - ANY FIELDS LEFT BLANK CONSTITUTES DENIAL OF THE CLEARANCE

FLIGHT SUMMARY INFORMATION - please select arrival or departure as appropriate
NOTICE OF ARRIVAL
Aircraft Tail Number

Departure Country

Departure Airport (ICAO)
Departure City
Departure Date  MM/DD/YYYY
ETD Local Time (0001 - 2400)  HH/MM
Foreign Airports Landed Within 24 Hours of Departure (ICAO) 
Estimated Time and Location Crossing US Border or Coastline (UTC)
US Arrival Airport (ICAO)
US Arrival Date  MM/DD/YYYY
ETA Local Time (0001 - 2400)  HH/MM
US Arrival City
US Arrival State

Parking Location at Arrival Airport e.g. FBO, Private Hangar, etc. 

24 Hour Emergency Contact Last Name
24 Hour Emergency Contact First Name
24 Hour Emergency Contact Middle Name
24 Hour Emergency Contact Telephone Number
24 Hour Emergency Contact E-Mail Address
Number of Crew
Number of Passengers
NOTICE OF DEPARTURE
AIRCRAFT DETAILS
A/C Make and Model
A/C Year of Manufacture
A/C Registration Number
A/C Serial Number
A/C Base Color and Trim Color
A/C Location (City & ICAO ident)
Engine Type and Dash Number
MTOGW (lbs.)
Zero Fuel Weight (lbs.)
Basic Empty Weight BEW/BOW (lbs.)
Service Ceiling
Maximum Fuel in Pounds

RVSM/MNPS EQUIPMENT INFORMATION and
LONG RANGE NAVIGATION AND COMMUNICATIONS SYSTEMS

Qty.

Type of Equipment

Manufacturer

Part No.

Autopilot
Transponder
TCAS
EGPWS/GPWS
GPS
INS
IRU/IRS
LORAN
VHF  8.33 KhzYesNo
HF
SATCOM
SELCAL      CODE: 
MAINTENANCE
Airworthiness Directive's (AD's) Not Complied With
Inspections Out of Date
Inspections Due
Ferry Permit Applied ForYesNo
Ferry Tanks InstalledYesNo
Import/Export Permits Applied ForYesNo
TRIP DETAILS
Departure Airport (City, Airport Name, ICAO ident)
Destination Airport (City, Airport Name, ICAO ident)
Requested Departure Date
Do You Currently Have InsuranceYesNo
Comments:
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