Rhode Island Aircraft Registration Application Form - Instructions Page 3

Rhode Island Airport Corporation

Aircraft Registration Fee

Credit Card Payment Form

Aircraft Tail #: _________________

Registration Fee: $ _____________

Name on Card (Please Print): ____________________________________________

Address on statement: _________________________________________________

_________________________________________________

Credit Card Type: ______________________

Card #: __________________________________ Exp. Date: _______________

Three Digit Security Code (last three digits on the back of the card): ________

Signature: __________________________________

Remit this form with the Aircraft Registration Application form to:

Rhode Island Airport Corporation

Attn: Aircraft Registration

2000 Post Road

Warwick, RI 02886

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Parent category: Life