DECLARATION
of
INTERNATIONAL OPERATIONS
The undersigned owner of aircraft N____________, Manufacturer __________________
Model ___________________________ Serial Number __________________________
declares that this aircraft is scheduled to make an international flight* on ____________ ,
(date)
as flight Number ____________ departing _____________________________________
(City/State)
with a destination of _____________________________________________________ .
(City/Country)
*[If required route between two points in the United States involves international navigation, explain under
Comments below, e.g. “partly over Canada” or “partly in international airspace”.]
Expedited registration in support of this international flight is requested this
____________ day of _______________________ 20_____ with knowledge that:
Whoever, in any matter within the jurisdiction of the executive branch of the
Government of the United States, knowingly and willfully makes or uses any
false writing or document knowing the same to contain any materially false,
fictitious or fraudulent statement of representation shall be fined under Title 18
United States Code or imprisoned not more than 5 years, or both. 18 U.S.C.
§1001(a).
Name of Owner
Signature
Typed Name and Title of Signer
Phone: _______________________ Fax: ____________________________________
Comments:
AFS-750-DIO-1 (02/12)