PARTURE DATE: MODEL: TRIM: APT: 202 COUNTRY: US ZIP: 19803 INSPECTOR ID: (b )(7)( e) AIRCRAFT REGISTRATION CERTIFICATE VERIFIED: N PILOT NAME: IWM1M ,~•. DOB: 02051960 NAT : • • • .. LICENSE NUMBER: ~ LICENSE COUNTRY: - STREET ADDRESS: jjjjl(,_ - ·. •. . APT;"" CITY: JUPITER ------ ST: