AircraftPortal.com Piston Powered Aircraft Regular Advertisement Submission Form. Payment methods and totals are listed at the end of this form. Important Note... Please print this form and fill in the required information. Please print clearly for all responses. Mail/fax using the following information. AircraftPortal.com 3336 Associates Drive Burton, Michigan 48529-1302 810-232-9979 Phone 810-232-7177 Fax 866-232-9979 Toll Free Phone 866-232-7177 Toll Free Fax
Required Information (*)
- Aircraft Company/Owner Information
First Name (*): _______________________________
Last Name (*): _______________________________
Company Name: _______________________________
Address (*): _______________________________
_______________________________
City (*): _______________________________
State/Location (*): _______________________________
Zip (*): _______________________________
Phone Number - Day (*): _______________________________
Phone Number - Evenings: _______________________________
Optional Phone Number: _______________________________
Fax Number: _______________________________
Cellular Number: _______________________________
Pager Number: _______________________________
E-mail Address - One: _______________________________
E-mail Address - Two: _______________________________
(Home Page Link is required for
External Link Address)
Home Page Link: _______________________________
- Aircraft Overview and Summary Data
Aircraft Manufacturer
and Type/Description(*): _______________________________
Aircraft Year: _______________________________
Aircraft Registration Number: _______________________________
Aircraft Serial Number: _______________________________
Aircraft Total Time: _______________________________
Location of Aircraft: _______________________________
Asking Price: _______________________________
Last Annual Inspection: _______________________________
- Aircraft Engine and Propeller Times
Engine Total Time - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
Engine Total Time STOH - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
Engine Total Time SMOH - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
Propeller Time SPOH - Left Outboard: _______________________________
Left Inboard: _______________________________
Right Inboard/Single Engine Aircraft: _______________________________
Right Outboard: _______________________________
- Exterior/Interior Colors/Appointments
Exterior Color: _______________________________
Exterior Trim One: _______________________________
Exterior Trim Two: _______________________________
Interior Overview: _______________________________
Interior Color One: _______________________________
Interior Color Two: _______________________________
- Avionics
Avionics Overview: _______________________________
Audio Panel: _______________________________
Autopilot: _______________________________
Nav/Comm 1: _______________________________
Nav/Comm 2: _______________________________
Weather Protection: _______________________________
GPS: _______________________________
Transponder: _______________________________
Description 1: _______________________________
Description 2: _______________________________
- Any additional information we should have to process this ad?
_______________________________________________________________________
_______________________________________________________________________
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Sixty (60) Day Run Time...
Piston Powered Regular Advertisement: $ 6.95
________
Total Enclosed $
- Payment Method (please mark the appropriate selection)
Check: _____ (see note below)
Money Order: _____
MasterCard: _____ Card Number: ______________________ Exp. Date: _____
Name on Card: _________________________________
Credit Card Authorization Signature: _________________________________
(Please charge my credit card the
total listed above)
Visa: _____ Card Number: ______________________ Exp. Date: _____
Name on Card: _________________________________
Credit Card Authorization Signature: _________________________________
(Please charge my credit card the
total listed above)
Important Notes:
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