Navigating the legal and procedural landscape of aviation requires strict adherence to regulations and form submissions, one of which includes the AFS CE17 004 F1 form, addressed to the Louisville Flight Standards District Office. This form is an essential document, specifically crafted for those seeking a Special Flight Permit, often necessitated under circumstances such as the aircraft being out of its annual inspection period or other situations that preclude regular operations. Detailed aircraft information, including registration details, make, model, serial number, and owner's information, form the crux of the document, ensuring that all requests are thoroughly backed with accurate data. Additionally, the form delves into the purpose of the Special Flight Permit, inquiring whether the aircraft has been involved in an accident, the extent of any damage, and any restrictions the applicant deems necessary for safe operation. It also outlines the intended itinerary, crew requirements, and provides space for the owner or an agent of the owner to detail their contact information, concluding with a signature to authenticate the request. Specially designed for compliance and safety, the form acts as a bridge for aircraft owners and operators to attain necessary permissions, underscoring the commitment of aviation authorities to maintain safety while accommodating the needs of the aviation community.
Question | Answer |
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Form Name | Form Afs Ce17 004 F1 |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | AFS-CE17-004-F1, applicant, Louisville, KY |
TO:
FAX:
RETURN ATTENTION:
Louisville Flight Standards District Office
Ormsby III, Suite 310
10200 Forest Green Blvd
Louisville, KY 40223
(502)
REQUEST FOR SPECIAL FLIGHT PERMIT
Fill all blanks / answer all questions
AIRCRAFT INFORMATION
AS SHOWN ON REGISTRATION CERTIFICATE
N___________________MAKE_____________________________MODEL_____________________
S/N____________________________OWNER’S NAME_____________________________________
OWNER’S ADDRESS_________________________________________________________________
___________________________________________________________________________________
FLIGHT PERMIT INFORMATION
Purpose for Special Flight Permit: |
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Out of Annual. |
Date of last Annual______________________. |
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Other. |
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List Other______________________________________________
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_________________________________ |
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_________________________________ |
Has aircraft been in accident? |
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Restrictions the applicant feels necessary for safe operation: |
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Yes |
No |
___________________________________ |
Aircraft damage: [ ] |
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[ ] |
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___________________________________ |
None |
Minor |
Major |
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REQUESTED ITINERARY
______________________ |
_____________________ |
____________________ |
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DEPART FROM |
ENROUTE STOP OR DIRECT |
DESTINATION |
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___________________________ |
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REQUIRED CREW: |
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DEPARTURE DATE |
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PILOT |
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OTHER______________ |
REQUESTER: |
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OWNER |
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TELEPHONE__________________________________ |
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AGENT FOR OWNER |
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FAX_________________________________________ |
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___________________________________________ |
______________________________________ ____________ |
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Print Name |
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Signature |
DATE |
FAA USE ONLY
CHECK FERRY FLIGHT LOG ________________ |
FORM NUMBER |
COMPLETE FAA FORM |
REV. 5 (07/08/2007) |