a N t (pa AE &macs AM oR,1/45 3 :7(DC NROWT FERAL Nct - 1 c'fn 41 - FOR FAA USE ONLY TYPE OF REOGIRATION 'Pock One bad O1. Indivklual 02. Pailnenthip MeCaperalion 04. C042vaner 0b. <Weinman' O EL Non.Ceizon Cdtpecation O 9. Nce-CitizenCeigaseenCo-Ormar NAM( OR APPLICANT (Permed) shown on elid