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

Customer Name
Primary Contact Name
Contact's e-mail
Contact's Business Phone Number
Contact's Cell Phone Number
Contact's Fax Number
Billing Address
Delivery Address
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
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Inspections Out of Date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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