Replacement of License, Permits or Certificate - National Aviation Registration

Customer Information

Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Company

Part A - Personal Information

Surname

Given name(s)

Date of Birth (yyyy-mm-dd)

Licence No./ Permit No. / File No.*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Work Phone

Email

Part B - Declaration

Reason for re-issuing

Document Lost
Document not received in the mail
Document rendered illegible
Document Stolen

Reissue or replace the following documents*

Aviation Document Booklet - Flight Crew or ATC
Medical Certificate Label
Licence / Permit Label
FLVC
90 Day Document
Other

CAT

Type

CAT

Type

Please describe:

Declaration

I am/we are the sole person/entity that has legal custody and control of the aircraft described herein.
I am authorized by the owner(s) of the aircraft described herein to make this application (documentary proof is required)

I am/we are qualified to be the owner(s) of a Canadian registered aircraft in accordance with section 202.15 of the Canadian Aviation Regulations.

All statements contained in this application are true and complete to the best of my or our knowledge and belief.

Signature of Applicant*

Terms*

I AGREE TO PAY THE ABOVE TOTAL AMOUNT ACCORDING TO THE CARD ISSUER AGREEMENT AND HEREBY AUTHORIZE THE CHARGE FOR THE TOTAL AMOUNT ABOVE FOR THE PROCESSING OF SELECTED DOCUMENTS. I UNDERSTAND THAT MY APPLICATION WILL BE PROCESSED IN THE ORDER IN WHICH IT IS RECEIVED BY NATIONAL AVIATION REGISTRATION, A PRIVATE FEE FOR SERVICE REGISTRATION COMPANY, NOT OWNED OR OPERATED BY ANY GOVERNMENTAL AGENCY. I UNDERSTAND THAT APPLICATION AND PROCESSING FEES ARE NON-REFUNDABLE AS PER NATIONAL AVIATION REGISTRATION.

I agree

Pricing and Options

Aviation Document Booklet - Flight Crew or ATC*

Price:

Medical Certificate Label*

Price:

Licence / Permit Label*

Price:

Medical Certificate (paper format)*

Price:

FLVC*

Price:

Medical Certificate (paper format)*

Price:

90 Day Document*

Price:

Other*

Price:

Please select any additional services you wish to have processed:

Rush Processing

Rush Processing*

Price:

Total

$ 0.00 CAD

Payment Information

Credit Card

Card Details

Cardholder Name

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

By clicking submit you agree to these Terms and Conditions and the above authorization of payment.