First Name	Last Name
Birth Date	Home Phone	No. of Dependents
Home Address
Street		No. of Years There
City	State     Zip
E-mail Address:
Previous Address (if less than three years)
Street		No. of Years There
City	State     Zip
Applicant Employed By	Position	No. of Years There
Street		Business Phone
City	State     Zip
Previous Employer (if less than three years)		Business Phone
Other Income Sources (explain fully) Alimony, child support or separate maintenance income need not be revealed. If you do not wish to have it considered as a basis for repaying the obligation.
Living Facilities (indicate which) Rent Own w/Parents	Home Purchase Price	Original Mortgage Amount
CREDIT REFERENCES Describe fully all debt and include open loans, mortgages, checking, saving accounts at banks, credit unions, finance companies, etc.
Name 1.	Address
Phone	Type Account	Amount
Name 2.	Address
Phone	Type Account	Amount
Name 3.	Address
Phone	Type Account	Amount
Name 4.	Address
Phone	Type Account	Amount
Have you ever had any judgements, attachments, bankruptcy, or legal proceedings against you? Yes   No
Are you co-maker on another person's loan? Yes   No
Nearest Relative not living with you
Name	Relationship
Address
Name in which aircraft is to be registered
Registrant's Address
Make of Aircraft	Model	Year
Registration Number	Serial Number
Sale Price	Loan Amount Needed	Loan Term (Years)
Base Airport Name		Date (mm/dd/yy)
Check here if you are a U.S. citizen
I authorize you to obtain such information as you may require concerning the statements made in this application and agree that the application shall remain the property of Aviat Aircraft, Inc. whether or not the request is granted. I understand that if the lender approves my request, a copy of the appropriate agreement form(s) stating the terms  of our agreement(s) with the lender will be furnished by me. If I fail to advise the lender of any objections to the agreement(s) and utilize the credit extended, the terms of the agreement will be binding on me. I certify that the foregoing statements are true in every respect to the best of my knowledge and belief, and are made for the purpose of obtaining credit and under the penalty of perjury.
The Federal Equal Credit Opportunity Act requires that all creditors, including banks and others, make credit equally available to all creditworthy customers without regard to sex or marital status. The federal agency which administers compliance with this law concerning this lender is the Federal Deposit Insurance Corporation, 60 State Street, Boston, MA  02101