taw pleu.S.C.I42”. F lore to reportcan result Ina civil penalty nO1toexceed $1.000 foe each such violation (Section 901 Worn AviatiOn Act ol1968). I. Aircreft 1. Mate Amapa Mode G-IV - Gaeta*. Saul • No. INS Natenatity ma Registration Mark NMICA 2. Owner Name (As Sheen on regIstraloncerldioalt)