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d. A 18130 or dishonest answer to any question in this application may be grounds tor punishment by fine and/ or imprisonment (U.S. Code. Title 18. Sec 1001). III I CERTIFICATION VINE CERTIFY: (I) That the above aircraft is owned by the undersigned applicant, who Is a citizen (including corporations)

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d. A false or dishonest answer to any question in this application may be grounds tor punishment by fine and/ or imprisonment (U.S. Code. Title 18. Sec 1001). III I CERTIFICATION UWE CERTIFY: (I) That the above aircraft is owned by the undersigned applicant, who Is a citizen (including corporations)

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fore signing This portion MUST be completed. or dishonest answer to any question in th-s application may be grounds for punishment Code, lltht 18. Sec 1001). CERTIFICATION this application. by fine corporations) ZIP CODE OF ADDRESS and / or imposonment ) or: CERTIFY: the above Wendt is owned by

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