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 |
| Customer Name | |
| Contact Name | |
| Contact's e-mail | |
| Contact's Business Phone Number | |
| Contact's Cell Phone Number | |
| Contact's Fax Number | |
| Billing Address | |
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| Delivery Address | |
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| Name on A/C Registration | |
| 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 | |
| MTOGW (lbs.) | |
| RVSM | YesNo |
| MNPS Certified | YesNo |
| VHF Radio 8.33 Khz Spacing | YesNo |
| HF Radio | YesNo |
| ROUTING INFORMATION |
| Leg 1 |
| Departure Airport (ICAO) / Date | |
Flight Plan Route (from flight plan, block 15)
ETD, ETE, ETA, EET/ (FIR's from block 18)
All times UTC
(not responsible for invalid routings) | |
| Arrival Airport (ICAO) | |
| Number of Passengers | |
| Number of Crew | |
| Purpose of Trip | |
|
Leg 2 |
| Departure Airport (ICAO) / Date | |
Flight Plan Route (from flight plan, block 15)
ETD, ETE, ETA, EET/ (FIR's from block 18)
All times UTC
(not responsible for invalid routings) | |
| Arrival Airport (ICAO) | |
| Number of Passengers | |
| Number of Crew | |
| Purpose of Trip | |
|
| Leg 3 |
| Departure Airport (ICAO) / Date | |
Flight Plan Route (from flight plan, block 15)
ETD, ETE, ETA, EET/ (FIR's from block 18)
All times UTC
(not responsible for invalid routings) | |
| Arrival Airport (ICAO) | |
| Number of Passengers | |
| Number of Crew | |
| Purpose of Trip | |
|
| Leg 4 |
| Departure Airport (ICAO) / Date | |
Flight Plan Route (from flight plan, block 15)
ETD, ETE, ETA, EET/ (FIR's from block 18)
All times UTC
(not responsible for invalid routings) | |
| Arrival Airport (ICAO) | |
| Number of Passengers | |
| Number of Crew | |
| Purpose of Trip | |
|
| Leg 5 |
| Departure Airport (ICAO) / Date | |
Flight Plan Route (from flight plan, block 15)
ETD, ETE, ETA, EET/ (FIR's from block 18)
All times UTC
(not responsible for invalid routings) | |
| Arrival Airport (ICAO) | |
| Number of Passengers | |
| Number of Crew | |
| Purpose of Trip | |
| |
| For Additional Legs Click Here |
| Comments: |
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