KUBAT AVIATION SERVICES, LLC
Ferry Flight Request Form V1.1
Section 1: Contact Information
Aircraft Owner Name (or Customer Name if Different)
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Ground Contact (Person at Location of Aircraft) Name and Phone Number
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Section 2: Aircraft Information
Aircraft Year Make and Model ex 1965 Mooney M20E
Aircraft Tail Number
Is Aircraft Airworthy (Yes/No)
Please Select
Yes
No
If not, has ferry permit been acquired?
Please Select
Yes
No
Date of last annual
-
Month
-
Day
Year
Date
Aircraft TTAF/TSMOH:
Location of Aircraft Logbooks
Known Squawks/Issues
Section 3: Ferry Information
Aircraft Pickup Location (Airport Code)
Aircraft Dropoff Location (Airport Code)
Date Aircraft Will Be Available for Ferry
/
Month
/
Day
Year
Date
Requested Delivery Date
/
Month
/
Day
Year
Date
Section 4: Insurance Information
Insurance Company Name
Insurance Company Phone Number
Format: (000) 000-0000.
Section 5: Misc Information
Special Requests
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