THE GENERAL AVIATION

RISK APPLICATIONWEBINAR
Presented by:
BLAIS AVIATION INSURANCE SERVICES
JANUARY 28, 2010
WWW.BLAIS AVIATION.COM
1

ffd8ffe000104a4649
46000102010097009
70000ffe20c5849434
35f50524f46494c450
0010100000c484c69
6e6f021000006d6e7
4725247422058595a
2007ce00020009000
60031000061637370
4d534654000000004
94543207352474200
00000000000000000
000000000f6d60001
00000000d32d48502
02000000000000000
00000000000000000
00000000000000000
00000000000000000
00000000000000000
00000000000011637
07274000001500000
00336465736300000
1840000006c777470
74000001f00000001
4626b707400000204
000000147258595a0
00002180000001467
58595a0000022c000
000146258595a0000
024000000014646d6
e6400000254000000
70646d6464000002c
40000008876756564
0000034c000000867
6696577000003d400
0000246c756d69000
003f8000000146d65
61730000040c00000
02474656368000004
300000000c7254524
30000043c0000080c
675452430000043c0
000080c6254524300
00043c0000080c746
5787400000000436f
70797269676874202
86329203139393820
4865776c6574742d5
061636b6172642043
6f6d70616e7900006
46573630000000000
00001273524742204
9454336313936362d

AVIATION INSURANCE
APPLICATIONS

There are a number of aviation exposures and each has its

own application(s). This webinar will focus on the general
aviation exposure application and pilot questionnaire. You
can view the various applications by visiting the Blais
Aviation Insurance Services website.
www.blaisaviation.com

ffd8ffe000104a46494600010201
001900190000ffe20c584943435f
50524f46494c4500010100000c48
4c696e6f021000006d6e7472524
TYPES OF AVIATION EXPOSURES
7422058595a2007ce0002000900
0600310000616373704d5346540
000000049454320735247420000 ffd8ffe000104a46494600010201001e001e0000ffe20
000000000000000000000000f6dc584943435f50524f46494c4500010100000c484c696e
6f021000006d6e74725247422058595a2007ce000200
6000100000000d32d485020200009000600310000616373704d5346540000000049454
000000000000000000000000000320735247420000000000000000000000000000f6d60
00100000000d32d4850202000000000000000000000
0000000000000000000000000000000000000000000000000000000000000000000000
0000000000000000000000000000000116370727400
0000000000000000000000000000001500000003364657363000001840000006c777470
00000000000116370727400000174000001f000000014626b7074000002040000001472
58595a00000218000000146758595a0000022c000000
500000003364657363000001840146258595a0000024000000014646d6e640000025400
000070646d6464000002c40000008876756564000003
000006c77747074000001f00000 4c0000008676696577000003d4000000246c756d6900
0014626b70740000020400000010003f8000000146d6561730000040c00000024746563
68000004300000000c725452430000043c0000080c67
PLEASURE &
47258595a0000021800000014675452430000043c0000080c625452430000043c000008
0c7465787400000000436f7079726967687420286329
BUSINESS
INDUSTRIAL AID
58595a0000022c0000001462585
2031393938204865776c6574742d5061636b61726420
SINGLE ENGINE
95a0000024000000014646d6e64436f6d70616e79000064657363000000000000001273
5247422049454336313936362d322e3100000000000
0000025400000070646d64640000000000000012735247422049454336313936362d32
2e31000000000000000000000000000000000000000
3
002c40000008876756564000003000000000000000
4c0000008676696577000003d40
00000246c756d69000003f80000
00146d6561730000040c0000002
474656368000004300000000c72

ffd8ffe000104a464946000102
01001b001b0000ffe20c584943
435f50524f46494c4500010100
TYPES OF AVIATION
EXPOSURES
000c484c696e6f021000006d6e
74725247422058595a2007ce0
ffd8ffe000104a46494600010201001f001f0000ffe2
0020009000600310000616373
0c584943435f50524f46494c4500010100000c484c6
704d534654000000004945432
96e6f021000006d6e74725247422058595a2007ce0
0020009000600310000616373704d534654000000
0735247420000000000000000
00494543207352474200000000000000000000000
00000f6d6000100000000d32d48502020000000000
000000000000f6d60001000000
00000000000000000000000000000000000000000
00d32d4850202000000000000
00000000000000000000000000000000000000000
00011637072740000015000000033646573630000
0000000000000000000000000
01840000006c77747074000001f000000014626b70
7400000204000000147258595a000002180000001
0000000000000000000000000
46758595a0000022c000000146258595a000002400
0000000000000000000000000
0000014646d6e640000025400000070646d646400
0002c400000088767565640000034c000000867669
0000000011637072740000015
6577000003d4000000246c756d69000003f8000000
146d6561730000040c00000024746563680000043
0000000336465736300000184
00000000c725452430000043c0000080c675452430
0000006c77747074000001f000
000043c0000080c625452430000043c0000080c746
PLEASURE &
5787400000000436f7079726967687420286329203
000014626b707400000204000
BUSINESS
PLEASURE &
1393938204865776c6574742d5061636b61726420
436f6d70616e790000646573630000000000000012
000147258595a000002180000
MULTI ENGINE
BUSINESSROTORWING
735247422049454336313936362d322e310000000
00146758595a0000022c00000
00000000000000012735247422049454336313936
362d322e310000000000000000000000000000000
0146258595a00000240000000
00000000000000000000000
14646d6e64000002540000007 4
0646d6464000002c400000088
767565640000034c000000867
6696577000003d4000000246c
756d69000003f8000000146d65

ffd8ffe000104a464946
0001020100220022000
0ffe20c584943435f505
24f46494c4500010100
TYPES OF AVIATION EXPOSURES
000c484c696e6f021000
006d6e7472524742205
8595a2007ce00020009
ffd8ffe000104a46494600010201001c001c000
0ffe20c584943435f50524f46494c45000101000
0006003100006163737
00c484c696e6f021000006d6e74725247422058
595a2007ce0002000900060031000061637370
04d5346540000000049
4d534654000000004945432073524742000000
0000000000000000000000f6d6000100000000
4543207352474200000
d32d4850202000000000000000000000000000
00000000000000000000000000000000000000
0000000000000000000
00000000000000000000000000000011637072
74000001500000003364657363000001840000
0000f6d600010000000
006c77747074000001f000000014626b707400
000204000000147258595a0000021800000014
0d32d48502020000000
6758595a0000022c000000146258595a000002
4000000014646d6e640000025400000070646d
0000000000000000000
6464000002c400000088767565640000034c00
AEROBATIC
00008676696577000003d4000000246c756d69
0000000000000000000
STUDENT PILOTS
000003f8000000146d6561730000040c000000
2474656368000004300000000c725452430000
0000000000000000000
043c0000080c675452430000043c0000080c62
5452430000043c0000080c7465787400000000
0000000000000000000
436f7079726967687420286329203139393820
4865776c6574742d5061636b61726420436f6d
0000000000001163707
70616e79000064657363000000000000001273
5247422049454336313936362d322e31000000
2740000015000000033
00000000000000001273524742204945433631
3936362d322e31000000000000000000000000
6465736300000184000
000000000000000000000000000000
0006c77747074000001

ffd8ffe000104a464946000102
01002100210000ffe20c584943
435f50524f46494c4500010100
000c484c696e6f021000006d6e
TYPES OF AVIATION EXPOSURES
74725247422058595a2007ce0
0020009000600310000616373
704d534654000000004945432
ffd8ffe000104a46494600010201001d001d0000ffe
20c584943435f50524f46494c4500010100000c484c
0735247420000000000000000 696e6f021000006d6e74725247422058595a2007ce0
000000000000f6d60001000000 0020009000600310000616373704d5346540000000
049454320735247420000000000000000000000000
00d32d4850202000000000000 000f6d6000100000000d32d4850202000000000000
0000000000000000000000000 000000000000000000000000000000000000000000
000000000000000000000000000000000000000001
0000000000000000000000000 163707274000001500000003364657363000001840
000006c77747074000001f000000014626b7074000
0000000000000000000000000 00204000000147258595a000002180000001467585
0000000011637072740000015 95a0000022c000000146258595a000002400000001
4646d6e640000025400000070646d6464000002c40
0000000336465736300000184 0000088767565640000034c0000008676696577000
003d4000000246c756d69000003f8000000146d656
0000006c77747074000001f000 1730000040c0000002474656368000004300000000
000014626b707400000204000 c725452430000043c0000080c675452430000043c0
000080c625452430000043c0000080c74657874000
WARBIRDS
00000436f707972696768742028632920313939382
000147258595a000002180000
AIRSHOWS
04865776c6574742d5061636b61726420436f6d706
00146758595a0000022c00000 16e790000646573630000000000000012735247422
0146258595a00000240000000 049454336313936362d322e3100000000000000000
0000012735247422049454336313936362d322e310
14646d6e64000002540000007 000000000000000000000000000000000000000000 6
00000000000
0646d6464000002c400000088
767565640000034c000000867
6696577000003d4000000246c
756d69000003f8000000146d65

ffd8ffe000104a4649460001020
1001d001d0000ffe20c58494343
5f50524f46494c4500010100000
c484c696e6f021000006d6e7472
TYPES OF AVIATION EXPOSURES
5247422058595a2007ce000200
09000600310000616373704d53
ffd8ffe000104a46494600010201001b001b0000ffe2
465400000000494543207352470c584943435f50524f46494c4500010100000c484c69
420000000000000000000000006e6f021000006d6e74725247422058595a2007ce000
20009000600310000616373704d534654000000004
0000f6d6000100000000d32d485
945432073524742000000000000000000000000000
020200000000000000000000000f6d6000100000000d32d4850202000000000000000
000000000000000000000000000000000000000000
00000000000000000000000000000000000000000000000000000000000000001163
707274000001500000003364657363000001840000
00000000000000000000000000006c77747074000001f000000014626b70740000020
000000000000000000000116374000000147258595a00000218000000146758595a00
00022c000000146258595a0000024000000014646d6
07274000001500000003364657e640000025400000070646d6464000002c400000088
767565640000034c0000008676696577000003d4000
363000001840000006c7774707000246c756d69000003f8000000146d656173000004
0c0000002474656368000004300000000c725452430
4000001f000000014626b707400
000043c0000080c675452430000043c0000080c6254
000204000000147258595a000052430000043c0000080c7465787400000000436f707
97269676874202863292031393938204865776c6574
0218000000146758595a000002742d5061636b61726420436f6d70616e79000064657
LARGE AIRPORTS
363000000000000001273524742204945433631393
SMALL
AIRPORTS
2c000000146258595a000002406362d322e310000000000000000000000127352474
00000014646d6e64000002540022049454336313936362d322e31000000000000000
000000000000000000000000000000000000000
000070646d6464000002c40000
0088767565640000034c000000
8676696577000003d400000024
6c756d69000003f8000000146d6
561730000040c0000002474656

ffd8ffe000104a46494600010
201002500250000ffe20c5849
43435f50524f46494c4500010
TYPES OF AVIATION EXPOSURES
100000c484c696e6f02100000
6d6e74725247422058595a20 ffd8ffe000104a46494600010201001600160000ffe
20c584943435f50524f46494c4500010100000c484c
07ce00020009000600310000 696e6f021000006d6e74725247422058595a2007ce
616373704d53465400000000 00020009000600310000616373704d53465400000
00049454320735247420000000000000000000000
494543207352474200000000 000000f6d6000100000000d32d485020200000000
00000000000000000000000000000000000000000
00000000000000000000f6d6000000000000000000000000000000000000000000
00100000000d32d485020200 00000116370727400000150000000336465736300
0001840000006c77747074000001f000000014626b
000000000000000000000000 707400000204000000147258595a0000021800000
0146758595a0000022c000000146258595a000002
000000000000000000000000 4000000014646d6e640000025400000070646d646
000000000000000000000000 4000002c400000088767565640000034c00000086
76696577000003d4000000246c756d69000003f800
000000000000000000000116 0000146d6561730000040c0000002474656368000
004300000000c725452430000043c0000080c67545
370727400000150000000336 2430000043c0000080c625452430000043c0000080
MANUFACTURES
4657363000001840000006c7 c7465787400000000436f707972696768742028632
92031393938204865776c6574742d5061636b6172
PRODUCTS
7747074000001f000000014626420436f6d70616e79000064657363000000000000
0012735247422049454336313936362d322e31000
FIXED BASED
COMPLETED
6b7074000002040000001472 00000000000000000001273524742204945433631
OPERATORS FBOS
OPERATIONS
58595a000002180000001467 3936362d322e31000000000000000000000000000
000000000000000000000000000
58595a0000022c0000001462
58595a000002400000001464
6d6e64000002540000007064
6d6464000002c40000008876
7565640000034c0000008676
696577000003d4000000246c

AVIATION UNDERWRITING & ANALYSIS

Every aviation insurance underwriter has slightly

different guidelines he/she follows to arrive at a
rate, but virtually without exception they all take
the following into consideration somewhere in
their deliberations. Each factor, to the
Underwriter, represents a change in the chance
of an accident or affects his/her chances of
profit from your policy.
9

ffd8ffe000104a4
W
64946000102010
ha
06300630000ffe2
t
KEY FACTORS AVIATION UNDERWRITERS CONSIDER
0c584943435f50
kin
524f46494c4500
d
010100000c484c
of
696e6f02100000
air
6d6e7472524742
cr
2058595a2007ce
aft
00020009000600
&
31000061637370
ag
4d534654000000
e
00494543207352
Av
47420000000000
io
00000000000000
nic
0000f6d6000100
s
000000d32d4850

20200000000000
Co
00000000000000
ntr

10

ffd8ffe000104a464946
ffd8ffe000104a46494600010
ffd8ffe000104a464946000
0001020100700070000
201006c006c0000ffe20c5849
10201006700670000ffe20c
0ffe20c584943435f505
43435f50524f46494c4500010
584943435f50524f46494c4
24f46494c4500010100
000c484c696e6f021000
100000c484c696e6f02100000
500010100000c484c696e6f
006d6e7472524742205
6d6e74725247422058595a20
THE COMPONENTS OF021000006d6e7472524742
AVIATION
8595a2007ce00020009
07ce00020009000600310000
2058595a2007ce00020009
0006003100006163737
UNDERWRITING
616373704d53465400000000
000600310000616373704d
04d5346540000000049
4543207352474200000
494543207352474200000000
5346540000000049454320
0000000000000000000
00000000000000000000f6d6
7352474200000000000000
0000f6d600010000000
000100000000d32d48502020
00000000000000f6d60001
0d32d48502020000000
ffd8ffe000104a4649460001020101860
000000000000000000000000
00000000d32d4850202000
0000000000000000000
0000000000000000000
0960000ffe20c584943435f50524f46494
000000000000000000000000
0000000000000000000000
0000000000000000000
000000000000000000000000 c4500010100000c484c696e6f02100000
0000000000000000000000
0000000000000000000
000000000000000000000011 6d6e74725247422058595a2007ce0002
0000000000000000000000
0000000000001163707
0009000600310000616373704d534654
2740000015000000033
637072740000015000000033
0000000000000000000000
6465736300000184000
64657363000001840000006c 00000000494543207352474200000000
0000116370727400000150
0006c77747074000001
00000000000000000000f6d600010000
77747074000001f000000014
0000003364657363000001
f000000014626b70740
0000d32d485020200000000000000000
626b70740000020400000014
840000006c777470740000
0000204000000147258
00000000000000000000000000000000
595a000002180000001
Pleasure & Business
7258595a0000021800000014
01f000000014626b707400
46758595a0000022c00
Student
00000000000000000000000000000000
6758595a0000022c00000014
000204000000147258595a
Industrial Aid
0000146258595a00000
00000000000000116370727400000150
Private
6258595a0000024000000014
0000021800000014675859
Instructional Rental
24000000014646d6e64
646d6e640000025400000070 0000003364657363000001840000006c
5a0000022c000000146258
0000025400000070646
Commercial
Charter
d6464000002c4000000
646d6464000002c400000088 77747074000001f000000014626b7074
595a000002400000001464
ATP
Pipeline Patrol
88767565640000034c0
767565640000034c00000086 00000204000000147258595a00000218
6d6e640000025400000070
Instrument
0000086766965770000
AIRCRAFT
Power Line Patrol
000000146758595a0000022c00000014
76696577000003d400000024
646d6464000002c4000000
03d4000000246c756d6
Instructor
Crop Dusting
6258595a0000024000000014646d6e64
6c756d69000003f8000000146
88767565640000034c0000
9000003f8000000146d
Type Rating
6561730000040c00000
0000025400000070646d6464000002c4
d6561730000040c000000247
008676696577000003d400
Banner Towing
0247465636800000430
Total Hours
4656368000004300000000c7 00000088767565640000034c00000086
0000246c756d69000003f8
0000000c72545243000
76696577000003d4000000246c756d69
Make & Model Hours
25452430000043c0000080c6
000000146d656173000004
0043c0000080c675452
430000043c0000080c6
75452430000043c0000080c6 000003f8000000146d6561730000040c0
0c00000024746563680000
Single Engine LandMulti Engine Land
25452430000043c0000
25452430000043c0000080c7 000002474656368000004300000000c7
04300000000c7254524300
Single Engine
SeaMulti Engine Sea
080c746578740000000
25452430000043c0000080c675452430
465787400000000436f70797
00043c0000080c67545243
0436f70797269676874
Turbo
PropTurbo Jet
269676874202863292031393 000043c0000080c625452430000043c0
0000043c0000080c625452
2028632920313939382
Complex
AvionicsUnusual
Characistics
04865776c6574742d50
938204865776c6574742d506 000080c7465787400000000436f707972
430000043c0000080c7465
61636b61726420436f6
69676874202863292031393938204865
1636b61726420436f6d70616
787400000000436f707972
d70616e790000646573
e79000064657363000000000 776c6574742d5061636b61726420436f6
6967687420286329203139
6300000000000000127
000001273524742204945433 d70616e7900006465736300000000000
3938204865776c6574742d
3524742204945433631
3936362d322e3100000
00012735247422049454336313936362
6313936362d322e310000000
5061636b61726420436f6d
0000000000000000012
000000000000000127352474 d322e310000000000000000000000127
70616e7900006465736300
7352474220494543363
22049454336313936362d322 35247422049454336313936362d322e3
0000000000001273524742
13936362d322e310000
10000000000000000000000000000000
0000000000000000000
e31000000000000000000000
2049454336313936362d32
0000000000000000000
000000000000000000000000 00000000000000000000000
2e31000000000000000000

11

FOR GENERAL AVIATION RISKS

UNDERWRITERS WILL REQUIRE
THE FOLLOWING APPLICATIONS
PILOT QUESTIONNAIRE
&
AIRCRAFT APPLICATION

12

ffd8ffe00010
4a464946000
10201009c00
9c0000ffe20c
584943435f5
0524f46494c4
50001010000
0c484c696e6f
021000006d6
e7472524742
2058595a200
7ce00020009
00060031000
0616373704d
53465400000
00049454320
73524742000
00000000000
00000000000
000f6d600010
0000000d32d
48502020000
00000000000
00000000000
00000000000
00000000000
00000000000
00000000000
00000000000
00000000000
00011637072
74000001500
00000336465
73630000018
40000006c77
74707400000
1f000000014
626b7074000
00204000000
147258595a0
00002180000
00146758595

ffd8ffe000
104a46494
600010201
PILOT QUESTIONNAIRE
006400640
000ffe20c5
84943435f
50524f464
Name of Aircraft Owner:
94c450001
Name of Pilot:
0100000c4
Date of Birth:
84c696e6f
Address:
Pilots Occupation:
021000006
Employer:
d6e747252
Date Employed:
474220585
95a2007ce
000200090
006003100

13

ffd8ffe00010
4a464946000
10201009c00
9c0000ffe20c
584943435f5
0524f46494c4
50001010000
( ) Student
0c484c696e6f
021000006d6
( ) Private
e7472524742
2058595a200
( ) Instrument
7ce00020009
00060031000
0616373704d
( ) Commercial
Check
All Certificates
53465400000
00049454320
( ) Instructor
73524742000
00000000000
( ) Airline Transport
00000000000
000f6d600010
( ) SingleEngine Land
0000000d32d
48502020000
( ) Single EngineSea
00000000000
00000000000
00000000000
( ) MultiEngine Land
00000000000
00000000000
( ) MultiEngine Sea
00000000000
00000000000
( ) Rotorwing
00000000000
00011637072
( ) Centerline Thrust
74000001500
00000336465
( ) Mechanic Airframe
73630000018
40000006c77
74707400000
( ) Mechanic Powerplant
1f000000014
626b7074000
( ) Other (Specify)
00204000000
147258595a0
( ) Type Rating
00002180000
(Specify Aircraft)
00146758595

ffd8ffe000
104a46494
600010201
007a007a0
PILOT QUESTIONNAIRE
000ffe20c5
and84943435f
Ratings Currently Held
50524f464
94c450001
0100000c4
84c696e6f
021000006
d6e747252
474220585
95a2007ce
000200090
006003100

14

ffd8ffe0001
04a4649460
0010201009
c009c0000ff
e20c584943
435f50524f4
6494c45000
10100000c4
84c696e6f02
1000006d6e
7472524742
2058595a20
07ce000200
0900060031
0000616373
704d534654
0000000049
4543207352
4742000000
0000000000
0000000000
00f6d60001
00000000d3
2d48502020
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000116370
7274000001
5000000033
6465736300
0001840000
006c777470
74000001f0
0000001462
6b70740000

ffd8ffe000104a46494
600010201007a007a0
000ffe20c584943435f
50524f46494c450001
0100000c484c696e6f
021000006d6e747252
47422058595a2007ce
000200090006003100
00616373704d534654
000000004945432073
524742000000000000
0000000000000000f6
d6000100000000d32d
ertificate No:
485020200000000000
ed:
000000000000000000
Name of instructor or FBO) -(Instruction
airport location)
000000000000000000
000000000000000000
t Medical:
000000000000000000
dical:
000000000000116370
ivers ( ) Yes ( ) No If Yes please
explain:
727400000150000000
st Biennial Review :
336465736300000184
0000006c7774707400
rcraft Used:
0001f000000014626b
st Simulator Instruction:
707400000204000000
ers Ground and Attended and Dates:
147258595a00000218
bership #:
EAA
Membership #:
000000146758595a00
00022c000000146258
PILOT
QUESTIONNAIRE
595a00000240000000
14646d6e6400000254
00000070646d646400
0002c4000000887675
65640000034c000000
8676696577000003d4

15

ffd8ff
ffd8ffe000
e0001
104a46494
04a46
600010201
49460
007a007a0
00102
PILOT QUESTIONNAIRE
000ffe20c5
01009
High School:
84943435f
c009c
1. ( ) 2. ( ) 3. ( ) 4. ( )
EDUCATION
50524f464
0000ff
College:
1. ( ) 2. ( ) 3 ( ) 4.( )
e20c5
94c450001
Graduate School
1. ( ) 2. ( ) 3 ( ) 4.( )
84943
0100000c4
435f50
Name Of School
84c696e6f
Years Attended
524f46
Did You Graduate?
021000006
494c4
d6e747252
50001
474220585
01000
95a2007ce
00c48
4c696
000200090
e6f021
006003100
00000

16

ffd8ffe000104a46494
ffd8ff
600010201007a007a0
000ffe20c584943435f
e0001
50524f46494c450001
0100000c484c696e6f
04a46
021000006d6e747252
49460
47422058595a2007ce
000200090006003100
PILOT
QUESTIONNAIRE
00102
00616373704d534654
000000004945432073
01009
524742000000000000
0000000000000000f6
c009c
FLYING
EXPERIENCE
d6000100000000d32d
0000ff
485020200000000000
Please
in logged hours. Do
000000000000000000
e20c5 show flying experience
000000000000000000
not
group
different
aircraft
of
the
same
type
in
the
000000000000000000
84943
000000000000000000
category
for
the
make
and
model
on
which
000000000000116370
435f50
727400000150000000
approval
is
being
sought.
If hours can not be
524f46
336465736300000184
substantiated
by log 0000006c7774707400
books, please explain how
494c4
0001f000000014626b
hours
have
been
verified/reconstructed.
707400000204000000
50001
147258595a00000218
000000146758595a00
01000
00022c000000146258
00c48
595a00000240000000
14646d6e6400000254
4c696
00000070646d646400
0002c4000000887675
e6f021
65640000034c000000
8676696577000003d4
00000

17

ffd8ffe00010
ffd8ffe000104a46494
4a464946000
600010201007a007a0
10201009c00
000ffe20c584943435f
9c0000ffe20c
50524f46494c450001
584943435f5
Single Engine Aircraft
0524f46494c4
0100000c484c696e6f
50001010000
021000006d6e747252
0c484c696e6f
Make and Model of Aircraft
47422058595a2007ce
021000006d6
Pilot in Command
e7472524742
000200090006003100
FLYING EXPERIENCE
Co-Pilot PILOT QUESTIONNAIRE
2058595a200
00616373704d534654
Total Time
7ce00020009
Total Last 12 Months
000000004945432073
00060031000
Total Last 90 Days
524742000000000000
0616373704d
53465400000
0000000000000000f6
00049454320
d6000100000000d32d
73524742000
485020200000000000
00000000000
000000000000000000
00000000000
000f6d600010
000000000000000000
0000000d32d
000000000000000000
48502020000
000000000000000000
00000000000
000000000000116370
00000000000
00000000000
727400000150000000
00000000000
336465736300000184
00000000000
0000006c7774707400
00000000000
00000000000
0001f000000014626b
00000000000
707400000204000000
00011637072
147258595a00000218
74000001500
000000146758595a00
00000336465
73630000018
00022c000000146258
40000006c77
595a00000240000000
74707400000
14646d6e6400000254
1f000000014
00000070646d646400
626b7074000
00204000000
0002c4000000887675
147258595a0
65640000034c000000
00002180000
8676696577000003d4
00146758595

18

ffd8ffe00010
ffd8ffe000104a46494
4a464946000
600010201007a007a0
10201009c00
000ffe20c584943435f
9c0000ffe20c
50524f46494c450001
584943435f5
Multi
Engine
Aircraft
&
Jet
Aircraft
0524f46494c4
0100000c484c696e6f
50001010000
021000006d6e747252
0c484c696e6f
Make and Model of Aircraft
47422058595a2007ce
021000006d6
PILOT QUESTIONNAIRE
FLYING EXPERIENCE
Pilot
in
Command
e7472524742
000200090006003100
Co-Pilot
2058595a200
00616373704d534654
7ce00020009
Total Time
000000004945432073
00060031000
524742000000000000
Total Last 12 Months
0616373704d
53465400000
0000000000000000f6
Total Last 90 Days
00049454320
d6000100000000d32d
73524742000
485020200000000000
00000000000
000000000000000000
00000000000
000f6d600010
000000000000000000
0000000d32d
000000000000000000
48502020000
000000000000000000
00000000000
000000000000116370
00000000000
00000000000
727400000150000000
00000000000
336465736300000184
00000000000
0000006c7774707400
00000000000
00000000000
0001f000000014626b
00000000000
707400000204000000
00011637072
147258595a00000218
74000001500
000000146758595a00
00000336465
73630000018
00022c000000146258
40000006c77
595a00000240000000
74707400000
14646d6e6400000254
1f000000014
00000070646d646400
626b7074000
00204000000
0002c4000000887675
147258595a0
65640000034c000000
00002180000
8676696577000003d4
00146758595

19

ffd8ffe00010
Total Multi-Engine:
4a464946000
10201009c00
9c0000ffe20c
584943435f5
0524f46494c4
50001010000
0c484c696e6f
021000006d6
PILOT
e7472524742
2058595a200
7ce00020009
00060031000
0616373704d
53465400000
00049454320
73524742000
00000000000
00000000000
000f6d600010
0000000d32d
48502020000
00000000000
00000000000
00000000000
00000000000
00000000000
00000000000
00000000000
00000000000
00011637072
74000001500
00000336465
73630000018
40000006c77
74707400000
1f000000014
626b7074000
00204000000
147258595a0
00002180000
00146758595

ffd8ffe000104a46494
600010201007a007a0
000ffe20c584943435f
50524f46494c450001
Seaplanes and Helicopters
0100000c484c696e6f
021000006d6e747252
Make and Model of Aircraft
47422058595a2007ce
FLYING EXPERIENCE
Pilot in Command QUESTIONNAIRE
000200090006003100
Co-Pilot
00616373704d534654
000000004945432073
Total Time
Total Last 12 Months 524742000000000000
0000000000000000f6
Total Last 90 Days
d6000100000000d32d
485020200000000000
000000000000000000
000000000000000000
000000000000000000
000000000000000000
000000000000116370
727400000150000000
336465736300000184
0000006c7774707400
0001f000000014626b
707400000204000000
147258595a00000218
000000146758595a00
00022c000000146258
595a00000240000000
14646d6e6400000254
00000070646d646400
0002c4000000887675
65640000034c000000
8676696577000003d4

20

ffd8ffe00010
ffd8ffe000104a46494
4a464946000
600010201007a007a0
10201009c00
000ffe20c584943435f
9c0000ffe20c
Single Engine Aircraft
50524f46494c450001
584943435f5
0524f46494c4
0100000c484c696e6f
Make and Model of Aircraft
50001010000
Pilot in Command
021000006d6e747252
0c484c696e6f
Co-Pilot
47422058595a2007ce
021000006d6
PILOT QUESTIONNAIRE
FLYING EXPERIENCE
Total Time
e7472524742
000200090006003100
Total Last 12 Months
Total Last 90 Days
2058595a200
00616373704d534654
7ce00020009
000000004945432073
Total Single Engine:
00060031000
Multi Engine Aircraft & Jet Aircraft 524742000000000000
0616373704d
53465400000
0000000000000000f6
Make and Model of Aircraft
00049454320
d6000100000000d32d
Pilot in Command
73524742000
Co-Pilot
485020200000000000
00000000000
Total Time
000000000000000000
00000000000
Total Last 12 Months
000f6d600010
000000000000000000
Total Last 90 Days
0000000d32d
000000000000000000
48502020000
000000000000000000
00000000000
000000000000116370
00000000000
00000000000
727400000150000000
00000000000
336465736300000184
00000000000
0000006c7774707400
00000000000
Total Multi-Engine:
00000000000
0001f000000014626b
Seaplanes and Helicopters
00000000000
707400000204000000
00011637072
147258595a00000218
Make and Model of Aircraft
74000001500
Pilot in Command
000000146758595a00
00000336465
Co-Pilot
73630000018
00022c000000146258
Total Time
40000006c77
Total Last 12 Months
595a00000240000000
74707400000
Total Last 90 Days
14646d6e6400000254
1f000000014
00000070646d646400
626b7074000
Total Sea/Helo.:
00204000000
0002c4000000887675
147258595a0
65640000034c000000
00002180000
8676696577000003d4
00146758595

Total Sea/Helo. :

Grand Total

21

ffd8ffe000104a46494
ffd8ff
600010201007a007a0
000ffe20c584943435f
e0001
50524f46494c450001
0100000c484c696e6f
04a46
021000006d6e747252
49460
47422058595a2007ce
PILOT
QUESTIONNAIRE
ever been involved in an
aircraft
accident?
000200090006003100
00616373704d534654
) No 00102
AIRCRAFT
ACCIDENTS
000000004945432073
01009
ase explain:
524742000000000000
0000000000000000f6
c009c
d6000100000000d32d
0000ff
485020200000000000
000000000000000000
e20c5
d Model
000000000000000000
000000000000000000
84943
000000000000000000
000000000000116370
435f50
727400000150000000
524f46
336465736300000184
0000006c7774707400
494c4
0001f000000014626b
707400000204000000
50001
147258595a00000218
000000146758595a00
01000
00022c000000146258
00c48
595a00000240000000
14646d6e6400000254
4c696
00000070646d646400
0002c4000000887675
e6f021
65640000034c000000
8676696577000003d4
00000

22

ffd8ffe000104a46494
ffd8ffe00
600010201007a007a0
0104a464
000ffe20c584943435f
94600010
50524f46494c450001
201009c0
0100000c484c696e6f
09c0000ff
021000006d6e747252
e20c5849
47422058595a2007ce
PILOT
QUESTIONNAIRE
43435f505
000200090006003100
24f46494c
00616373704d534654
Please
Explain Circumstances:
000000004945432073
45000101
524742000000000000
00000c48
1.If you have a physical impairment,
waiver, limitation, or conditions on
0000000000000000f6
4c696e6f0
your Medical or Pilot Certificate.
d6000100000000d32d
21000006
485020200000000000
d6e74725
000000000000000000
2.If an FAA, Transport Canada,
Military Pilot or other similar Certificate held
24742205
by you has been suspended000000000000000000
or revoked.
8595a200
000000000000000000
7ce00020
000000000000000000
3.If
you
have
ever
been
cited
for a violation of any aviation regulation in
000000000000116370
00900060
any country.
727400000150000000
03100006
336465736300000184
16373704
0000006c7774707400
4.If you have ever been convicted
of or pleaded guilty to a felony or
d5346540
driving while intoxicated. 0001f000000014626b
00000004
707400000204000000
94543207
147258595a00000218
Explanations:
35247420
000000146758595a00
00000000
00022c000000146258
595a00000240000000
00000000
14646d6e6400000254
00000000
00000070646d646400
000f6d600
0002c4000000887675
01000000
65640000034c000000
00d32d48
8676696577000003d4

23

ffd8ffe00010
ffd8ffe000104a46494
4a464946000
600010201007a007a0
10201009c00
000ffe20c584943435f
9c0000ffe20c
50524f46494c450001
584943435f5
0524f46494c4
0100000c484c696e6f
50001010000
021000006d6e747252
0c484c696e6f
47422058595a2007ce
021000006d6
PILOT
QUESTIONNAIRE
e7472524742
000200090006003100
2058595a200
00616373704d534654
7ce00020009
000000004945432073
00060031000
524742000000000000
0616373704d
53465400000
0000000000000000f6
00049454320
d6000100000000d32d
73524742000
485020200000000000
00000000000
000000000000000000
00000000000
000f6d600010
000000000000000000
0000000d32d
000000000000000000
48502020000
000000000000000000
00000000000
000000000000116370
00000000000
nd the terms
and conditions of the policy
in use by the insurer shall
00000000000
727400000150000000
00000000000
336465736300000184
00000000000
0000006c7774707400
00000000000
OR MAKE
THE APPLICANT LIABLE FOR
ANY PREMIUM UNLESS
00000000000
0001f000000014626b
00000000000
707400000204000000
00011637072
147258595a00000218
74000001500
000000146758595a00
00000336465
73630000018
00022c000000146258
40000006c77
595a00000240000000
74707400000
14646d6e6400000254
1f000000014
00000070646d646400
626b7074000
00204000000
0002c4000000887675
147258595a0
65640000034c000000
00002180000
8676696577000003d4
00146758595

be the basis of any contract betw

AND UNTIL THE COMPANY AG

24

ffd8ffe000104a4649
46000102010072007
20000ffe20c5849434
35f50524f46494c450
0010100000c484c69
6e6f021000006d6e7
4725247422058595a
2007ce00020009000
60031000061637370
4d534654000000004
BLAIS AVIATION INSURANCE SERVICES
94543207352474200
00000000000000000
Phone: 972-818-4090
000000000f6d60001
Fax
972-818-4088
00000000d32d48502
www.blaisaviation.com
02000000000000000
00000000000000000
or Broker
00000000000000000
00000000000000000
s
00000000000000000
00000000000011637
07274000001500000
00336465736300000
1840000006c777470
74000001f00000001
Insured
& Address:
4626b707400000204
Address:
000000147258595a0
00002180000001467
t Insurance
Company:
58595a0000022c000
ve Date:
000146258595a0000
ss Occupation:
024000000014646d6
nce is e6400000254000000
requested from: 12:01 AM
70646d6464000002c
Residence
( )
40000008876756564
Business ( )
0000034c000000867
Fax ( 6696577000003d400
)
Address:
0000246c756d69000
003f8000000146d65
61730000040c00000
02474656368000004
300000000c7254524
30000043c0000080c
675452430000043c0

ffd8ff
e0001 AIRCRAFT INSURANCE APPLICATION
04a46
49460
00102
01008
c008c0
000ffe
20c58
49434
35f505
24f464
94c45
00010
10000
0c484c
to 12:01 AM
696e6f
02100
0006d
6e747
25247
42205

25

ffd8ffe
000104
a46494 AIRCRAFT
600010
201008
c008c00
00ffe20
c58494
AIRCRAFT
3435f50
524f464
Year,
Make & Model
94c450
FAA
001010
Number
0000c4
Total
84c696
Seats
e6f0210
Engine Hours
00006dHorsepower
Engine
6e7472
524742
205859
5a2007
ce0002
000900
060031
000061
637370
4d5346

INSURANCE APPLICATION
ffd8ffe000104a4649460001
0201007200720000ffe20c58
4943435f50524f46494c4500
010100000c484c696e6f0210
00006d6e747252474220585
95a2007ce00020009000600
310000616373704d5346540
00000004945432073524742
00000000000000000000000
00000f6d6000100000000d32
d4850202000000000000000
00000000000000000000000
00000000000000000000000
00000000000000000000000
00000000000116370727400
00015000000033646573630
00001840000006c77747074
000001f000000014626b7074
00000204000000147258595
a0000021800000014675859
5a0000022c0000001462585
95a0000024000000014646d
6e640000025400000070646
d6464000002c40000008876
7565640000034c000000867
6696577000003d400000024
6c756d69000003f800000014
6d6561730000040c0000002
47465636800000430000000
0c725452430000043c000008
0c675452430000043c000008
0c625452430000043c000008
0c7465787400000000436f70
79726967687420286329203
1393938204865776c657474
2d5061636b61726420436f6d
70616e79000064657363000
00000000000127352474220
49454336313936362d322e3
10000000000000000000000
12735247422049454336313
936362d322e310000000000
00000000000000000000000
000000000000000000000

26

ffd8ffe
000104
a46494 AIRCRAFT INSURANCE APPLICATION
600010
ffd8ffe000104a4649460001
0201007200720000ffe20c58
201008
4943435f50524f46494c4500
010100000c484c696e6f0210
c008c00
00006d6e747252474220585
95a2007ce00020009000600
00ffe20
310000616373704d5346540
AIRCRAFT
00000004945432073524742
c58494
00000000000000000000000
00000f6d6000100000000d32
3435f50
d4850202000000000000000
00000000000000000000000
Aircraft
usually
based
and
(
) Hangered ( ) Tied Down at (City &
524f464
00000000000000000000000
00000000000000000000000
State):________________________________________________
94c450
00000000000116370727400
00015000000033646573630
001010
00001840000006c77747074
000001f000000014626b7074
Airport:
0000c4__________________________________
00000204000000147258595
( 84c696
) Private Airport ( ) Publica0000021800000014675859
Airport
5a0000022c0000001462585
e6f0210
Paved
Runways Yes ( ) No95a0000024000000014646d
( )
6e640000025400000070646
d6464000002c40000008876
00006d
7565640000034c000000867
6696577000003d400000024
6e7472
Are
any flights contemplated6c756d69000003f800000014
outside continental U.S.? ( ) Yes ( ) No
6d6561730000040c0000002
47465636800000430000000
If 524742
Yes, where: _____________________________________
0c725452430000043c000008
205859
0c675452430000043c000008
0c625452430000043c000008
5a2007
0c7465787400000000436f70
79726967687420286329203
ce0002
1393938204865776c657474
2d5061636b61726420436f6d
000900
70616e79000064657363000
00000000000127352474220
060031
49454336313936362d322e3
10000000000000000000000
000061
12735247422049454336313
936362d322e310000000000
637370
00000000000000000000000
000000000000000000000
4d5346

27

ffd8ffe000
104a46494
600010201
TY COVERAGE
008c008c0
erson
Each Occurrence
Premiums
000ffe20c5
84943435f5
Injury, excluding
passengers
COVERAGES
AND LIMITS
0524f46494
c45000101
00000c484
c696e6f021
assenger Bodily
Injury
000006d6e
747252474
22058595a
roperty Damage
2007ce000
X
200090006
003100006
16373704d
mbined Single
Limit Bodily Injury and
534654000
ty Damage,
000004945
cluding Passengers ( ) Excluding Passengers
432073524
742000000
Limiting Each
erson or ( 000000000
) Passenger to $
Each Occurrence
000000000
0000f6d600
010000000
0d32d4850
al Payments:
___including Crew
202000000
000000000
000000000
000000000
CAL DAMAGE
COVERAGE
000000000
Insured Value
Deductible
000000000
000000000
e Not In Motion
000000000
000000000
000000000
hile In Motion
000000001
163707274

LIMITS
AIRCRAFT INSURANCE APPLICATION

28

ffd8ffe00
0104a464
94600010
AIRCRAFT INSURANCE
201008c0
08c0000ff
e20c5849
43435f505
USAGE AND OPERATION
24f46494c
( ) Pleasure and Business
45000101
( ) Industrial Aid
00000c48
( ) Limited Commercial
4c696e6f0
( ) Commercial Excluding Instruction & Rental
21000006
( ) Commercial
d6e74725
( ) Flying Club
24742205
( ) Low Altitude Photography
8595a200
( ) Air Ambulance
7ce00020
( ) Air Hearse
00900060
( ) Patrol Flights
03100006
( ) Banner Towing
16373704
( ) Crop Dusting
d5346540
( ) Instruction of: (Name of Student):
00000004
( ) Special Uses Please Describe:
94543207
35247420
00000000
00000000
00000000
000f6d600
01000000
00d32d48
50202000
00000000
00000000
00000000

APPLICATION

29

ffd8ffe
000104
a46494 AIRCRAFT INSURANCE APPLICATION
600010
201008
c008c00
OWNERSHIP
INFORMATION
00ffe20
c58494
3435f50
is:
Owner 524f464
r subject94c450
to mortgage or conditional sales contract.
e ( ) Other
explain
001010
s:
0000c4
dual (
) Corporation ( ) Limited Liability Corporation
84c696
wnership/Partnership
e6f0210
s encumbered,
00006dname and address of lienholderor lessor:
6e7472
encumbrance
(excluding interest and finance chargers):$
524742
oldersInterest
be required by lienholder? (
) Yes (
) No
205859
5a2007
ce0002
000900
060031
000061
637370
4d5346

30

ffd8ffe000104a46

PILOT INFORMATION
494600010201008
c008c0000ffe20c5
84943435f50524f4
6494c4500010100
000c484c696e6f0
21000006d6e7472
5247422058595a2
007ce0002000900
060031000061637
3704d5346540000
000049454320735
247420000000000
000000000000000
000f6d600010000
0000d32d4850202
000000000000000
000000000000000
000000000000000
000000000000000
000000000000000
000000000000000
000001163707274
000001500000003
364657363000001
840000006c77747
074000001f00000
0014626b7074000
002040000001472
58595a000002180
00000146758595a
0000022c0000001
46258595a000002
4000000014646d6
e64000002540000
0070646d6464000
002c40000008876
7565640000034c0
000008676696577
000003d40000002
46c756d69000003
f8000000146d656
1730000040c0000
002474656368000
004300000000c72
5452430000043c0
000080c67545243
0000043c0000080
c62545243000004
3c0000080c74657
87400000000436f
707972696768742
028632920313939
38204865776c657
4742d5061636b61
726420436f6d706
16e790000646573
630000000000000
012735247422049

Pilot No. 1Pilot No. 2Pilot No. 3

AIRCRAFT INSURANCE APPLICATION

PILOT

NAME OF PILOT
Date
Of
Birth
Certification (s) & Ratings
Please List
Medical Certificate
Date Class
Hours Logged as Pilot in Command
All Aircraft
Make and Model
Total
SEL
MEL
Total
Last 90 days
12 Months

31

ffd8ffe000
PILOT INFORMATION

104a464946
0001020100
8c008c0000
ffe20c58494
3435f50524f
46494c4500
010100000c
484c696e6f
021000006d
6e74725247
422058595a
2007ce0002
0009000600
3100006163
73704d5346
5400000000
4945432073
5247420000
0000000000
0000000000
0000f6d600
0100000000
d32d485020
2000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000001163
7072740000
0150000000
3364657363
0000018400
00006c7774
7074000001
f000000014
626b707400

Pilot No. 1Pilot No. 2Pilot No. 3

AIRCRAFT INSURANCE APPLICATION

PILOT

icate Number
st Biennial Flight Review
other proficiency training
address of pilots employer if other than applicant:
A or EAA Membership Number/s if a member:

32

ffd8ffe000
104a46494
600010201
008c008c0
000ffe20c5
84943435f5
0524f46494
SUPPLEMENTAL QUESTIONS
c45000101
00000c484
c696e6f021
000006d6e
747252474
22058595a
2007ce000
200090006
003100006
16373704d
ertificate in full effect?
534654000
000004945
d by the
manufacturer?
432073524
ublic airports?
742000000
than for
recurrent training of pilots listed in the Pilot Information Section of this application?
000000000
rmation
Section of this application have use of the aircraft?
000000000
made? 0000f6d600
010000000
Section 0d32d4850
of this application ever been involved in any aircraft accident?
Section 202000000
of this application ever been cited for violation of any aviation regulation in any country?
000000000
000000000
000000000
000000000
000000000
000000000
000000000
000000000
000000000
000000001
163707274

AIRCRAFT INSURANCE APPLICATION

33

ffd8ffe00
0104a464
94600010
201008c0
AIRCRAFT INSURANCE APPLICATION
08c0000ff
e20c5849
43435f505
24f46494c
SUPPLEMENTAL QUESTIONS
45000101
00000c48
4c696e6f0
21000006
d6e74725
24742205
8595a200
7ce00020
00900060
03100006
other pilot
certificate suspended or revoked?
rments,16373704
(b) waivers, limitations, conditions on their medical certificates or on their airman certificates? If Yes p
ad guilty
to a felony, possession of drugs, or of driving while intoxicated?
d5346540
00000004
94543207
35247420
00000000
00000000
00000000
000f6d600
34
01000000
00d32d48
50202000
00000000
00000000
00000000

ffd8ffe000
104a46494
600010201
008c008c0
000ffe20c5
84943435f5
0524f46494
c45000101
MINIMUM PILOT REQUIREMENTS
00000c484
I/We understand and acknowledge that there is no coverage in flight unless the aircraft is
c696e6f021
being operated by the pilot(s) designated on this document who has/have at least the
000006d6e
certificates, ratings, and pilot experience indicated, and who, is/are qualified for the flight
747252474
involved.
22058595a
2007ce000
200090006
INITIAL .
003100006
USE REQUIREMENTS
16373704d
I/We understand and acknowledge that there is no coverage in flight if the aircraft is used for
534654000
any purpose other than the use designated on this document.
000004945
432073524
INITIAL .
742000000
000000000
AIRWORTHINESS REQUIREMENTS
000000000
I/We understand and acknowledge that there is no coverage in flight unless a standard
0000f6d600
airworthiness certificate in full effect
010000000
0d32d4850
INITIAL
202000000
000000000
000000000
000000000
000000000
000000000
000000000
000000000
000000000
000000000
000000001
163707274

AIRCRAFT INSURANCE APPLICATION

35

ffd8ffe000
104a464946
0001020100
8c008c0000
ffe20c58494
3435f50524f
46494c4500
010100000c
484c696e6f
021000006d
6e74725247
422058595a
2007ce0002
0009000600
3100006163
73704d5346
5400000000
4945432073
5247420000
0000000000
0000000000
n and the0000f6d600
terms and conditions of the policy in use by the insurer shall be the basis of any contract between Me/U
0100000000
alse information or conceals, for the purpose of misleading, information concerning any fact material hereto comm
d32d485020
2000000000
0000000000
NOR MAKE
THE APPLICANT LIABLE FOR ANY PREMIUM UNLESS AND UNTIL THE COMPANY AGREES TO
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000000000
0000001163
36
7072740000
0150000000
3364657363
0000018400
00006c7774
7074000001
f000000014
626b707400

AIRCRAFT INSURANCE APPLICATION

ffd8ffe000104a4
ffd8ffe000104a464946000102
64946000102010
ffd8ffe000104a4649460001020
ffd8ffe000104a4649460001020
ffd8ffe000104a4649460001020
ffd8ffe000104a4649460001020
0100ab00960000ffe20c584943
ffd8ffe000104a4649460001020
100ab00960000ffe20c58494343
100ab00960000ffe20c58494343
100ab00960000ffe20c58494343
100ab00960000ffe20c58494343
435f50524f46494c4500010100
0ab00960000ffe2
100ab00960000ffe20c58494343
5f50524f46494c4500010100000
5f50524f46494c4500010100000
5f50524f46494c4500010100000
000c484c696e6f021000006d6e
Make5f50524f46494c4500010100000
sure you take note
0c584943435f505
5f50524f46494c4500010100000
c484c696e6f021000006d6e7472
c484c696e6f021000006d6e7472
c484c696e6f021000006d6e7472
c484c696e6f021000006d6e7472
74725247422058595a2007ce00
of the pilot warranty
c484c696e6f021000006d6e7472
5247422058595a2007ce000200
5247422058595a2007ce000200
5247422058595a2007ce000200
5247422058595a2007ce000200
0200090006003100006163737
24f46494c450001
wording
ffd8ffe000104a46494600010201002400240000ffe20c584943435f50524f46494c45000101
5247422058595a2007ce000200
09000600310000616373704d53
09000600310000616373704d53
09000600310000616373704d53
09000600310000616373704d53
04d5346540000000049454320
0100000c484c696
00000c484c696e6f021000006d6e74725247422058595a2007ce0002000900060031000061
09000600310000616373704d53
46540000000049454320735247
46540000000049454320735247
46540000000049454320735247
46540000000049454320735247
7352474200000000000000000
Aircraft
6373704d5346540000000049454320735247420000000000000000000000000000f6d6000
e6f021000006d6e
46540000000049454320735247
42000000000000000000000000
42000000000000000000000000
42000000000000000000000000
42000000000000000000000000
00000000000f6d600010000000
100000000d32d485020200000000000000000000000000000000000000000000000000000
42000000000000000000000000
0000f6d6000100000000d32d48
0000f6d6000100000000d32d48
0000f6d6000100000000d32d48
0000f6d6000100000000d32d48
0d32d48502020000000000000
74725247422058
000000000000000000000000000000000000000000116370727400000150000000336465
0000f6d6000100000000d32d485
50202000000000000000000000
50202000000000000000000000
50202000000000000000000000
50202000000000000000000000
0000000000000000000000000
Pilot
7363000001840000006c77747074000001f000000014626b7074000002040000001472585
595a2007ce0002
02020000000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
0000000000000000000000000
95a00000218000000146758595a0000022c000000146258595a0000024000000014646d6e
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
0000000000000000000000000
00090006003100
640000025400000070646d6464000002c400000088767565640000034c000000867669657
00000000000000000000000000
00000000000000000000001163
00000000000000000000001163
00000000000000000000001163
00000000000000000000001163
0000000116370727400000150
00616373704d53
7000003d4000000246c756d69000003f8000000146d6561730000040c0000002474656368
00000000000000000000011637
70727400000150000000336465
70727400000150000000336465
70727400000150000000336465
70727400000150000000336465
0000003364657363000001840
000004300000000c725452430000043c0000080c675452430000043c0000080c625452430
07274000001500000003364657
7363000001840000006c777470
7363000001840000006c777470
7363000001840000006c777470
7363000001840000006c777470
000006c77747074000001f0000
46540000000049
000043c0000080c7465787400000000436f70797269676874202863292031393938204865
363000001840000006c7774707
74000001f000000014626b7074
74000001f000000014626b7074
74000001f000000014626b7074
74000001f000000014626b7074
00014626b7074000002040000
PILOT
WARRANTY
45432073524742
776c6574742d5061636b61726420436f6d70616e790000646573630000000000000012735
4000001f000000014626b707400
00000204000000147258595a00
00000204000000147258595a00
00000204000000147258595a00
00000204000000147258595a00
00147258595a0000021800000
247422049454336313936362d322e31000000000000000000000012735247422049454336
00000000000000
000204000000147258595a0000
000218000000146758595a0000
000218000000146758595a0000
000218000000146758595a0000
000218000000146758595a0000
0146758595a0000022c000000
313936362d322e31000000000000000000000000000000000000000000000000000000
Other
0218000000146758595a000002
022c000000146258595a000002
022c000000146258595a000002
022c000000146258595a000002
022c000000146258595a000002
146258595a000002400000001
00000000000000f
2c000000146258595a00000240
4000000014646d6e6400000254
4000000014646d6e6400000254
4000000014646d6e6400000254
4000000014646d6e6400000254
4646d6e640000025400000070
6d600010000000
Location
00000014646d6e640000025400
00000070646d6464000002c400
00000070646d6464000002c400
00000070646d6464000002c400
00000070646d6464000002c400
646d6464000002c4000000887
000070646d6464000002c40000
000088767565640000034c0000
000088767565640000034c0000
000088767565640000034c0000
000088767565640000034c0000
67565640000034c0000008676
0d32d485020200
0088767565640000034c000000
008676696577000003d4000000
008676696577000003d4000000
008676696577000003d4000000
008676696577000003d4000000
696577000003d4000000246c7
00000000000000
8676696577000003d400000024
246c756d69000003f8000000146
246c756d69000003f800000014
246c756d69000003f8000000146
246c756d69000003f800000014
56d69000003f8000000146d656
Use
00000000000000
6c756d69000003f8000000146d6
d6561730000040c00000024746
6d6561730000040c0000002474
d6561730000040c00000024746
6d6561730000040c0000002474
1730000040c00000024746563
561730000040c0000002474656
56368000004300000000c72545
656368000004300000000c7254
56368000004300000000c72545
656368000004300000000c7254
68000004300000000c7254524
00000000000000
368000004300000000c7254524
2430000043c0000080c6754524
52430000043c0000080c675452
2430000043c0000080c6754524
52430000043c0000080c675452
30000043c0000080c675452430
00000000000000
30000043c0000080c6754524300
30000043c0000080c625452430
430000043c0000080c62545243
30000043c0000080c625452430
430000043c0000080c62545243
000043c0000080c62545243000
00043c0000080c6254524300000
000043c0000080c74657874000
0000043c0000080c7465787400
000043c0000080c74657874000
0000043c0000080c7465787400
0043c0000080c7465787400000
00000000000000
43c0000080c7465787400000000
00000436f70797269676874202
000000436f7079726967687420
00000436f70797269676874202
000000436f7079726967687420
000436f7079726967687420286
00000000000000
436f70797269676874202863292
863292031393938204865776c6
2863292031393938204865776c
863292031393938204865776c6
2863292031393938204865776c
3292031393938204865776c65
031393938204865776c6574742
574742d5061636b61726420436
6574742d5061636b6172642043
574742d5061636b61726420436
6574742d5061636b6172642043
74742d5061636b61726420436f
00000000011637
37
d5061636b61726420436f6d7061
f6d70616e79000064657363000
6f6d70616e7900006465736300
f6d70616e79000064657363000
6f6d70616e7900006465736300
6d70616e79000064657363000
07274000001500
6e790000646573630000000000
00000000000127352474220494
00000000000012735247422049
00000000000127352474220494
00000000000012735247422049
0000000000012735247422049
00000336465736
00001273524742204945433631
54336313936362d322e3100000
454336313936362d322e310000
54336313936362d322e3100000
454336313936362d322e310000
454336313936362d322e31000
3936362d322e31000000000000
00000000000000000127352474
00000000000000000012735247
00000000000000000127352474
00000000000000000012735247
0000000000000000000127352
30000018400000
00000000001273524742204945
22049454336313936362d322e3
422049454336313936362d322e
22049454336313936362d322e3
422049454336313936362d322e
47422049454336313936362d3
06c77747074000
4336313936362d322e31000000
10000000000000000000000000
31000000000000000000000000
10000000000000000000000000
31000000000000000000000000
22e3100000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
00000000000000000000000000
0000000000000000000000000
001f00000001462
0000000000000000000000
000

0000 000

0000

000000000

ffd8ffe000104a46494600
HIGH
WING
AIRCRAFT
010201004b004b0000ffe2
0c584943435f50524f4649
4c4500010100000c484c69
6e6f021000006d6e747252
47422058595a2007ce000
200090006003100006163
73704d534654000000004
945432073524742000000
000000000000000000000
0f6d6000100000000d32d4
850202000000000000000
000000000000000000000
000000000000000000000

38

ffd8ffe000104a4649460001
LOW
WING
AIRCRAFT
0201003400340000ffe20c58
4943435f50524f46494c4500
010100000c484c696e6f0210
00006d6e747252474220585
95a2007ce000200090006003
10000616373704d53465400
00000049454320735247420
00000000000000000000000
0000f6d6000100000000d32d
48502020000000000000000
00000000000000000000000
00000000000000000000000
00000000000000000000000

39

ffd8ffe000104a464946000102010044
BI PLANE
00440000ffe20c584943435f50524f464
94c4500010100000c484c696e6f02100
0006d6e74725247422058595a2007ce
00020009000600310000616373704d5
3465400000000494543207352474200
00000000000000000000000000f6d60
00100000000d32d4850202000000000
0000000000000000000000000000000
0000000000000000000000000000000
0000000000000000000000001163707
2740000015000000033646573630000
01840000006c77747074000001f0000
00014626b7074000002040000001472
58595a00000218000000146758595a0
000022c000000146258595a00000240
00000014646d6e64000002540000007
0646d6464000002c400000088767565

40

ffd8ffe000104a46
494600010201008
600860000ffe20c5
AVIATION
PHONETIC ALPHABET
84943435f50524f4
6494c4500010100
000c484c696e6f02
1000006d6e74725
247422058595a20
07ce00020009000
600310000616373
704d53465400000
000494543207352
474200000000000
000000000000000
My aircraft tail number is 1935
Lima Tango and I am located on Taxiway
00f6d6000100000
Quebec on the north
side of airport Alpha Delta -Sierra
000d32d48502020
000000000000000
TRANSLATION
My aircraft tail number is 000000000000000
1935LT and I am located on Taxiway Q on the
000000000000000
north
side of airport ADS
000000000000000
000000000000000
000000000000000
000011637072740
000015000000033
646573630000018
40000006c777470
74000001f000000
014626b70740000
020400000014725

41

CHARACTER
TELEPHONY
PHONIC (PRONUNCIATION)

A
Alfa
(AL-FAH)
B
Bravo
(BRAH-VOH)
C
Charlie
(CHAR-LEE) or (SHAR-LEE)
D
Delta
(DELL-TAH)
E
Echo
(ECK-OH)

The Aviation Phonetic Alphabet

42

CHARACTER
TELEPHONY
PHONIC (PRONUNCIATION)

F
FOXTROT
(FOX-TROT)
G
Golf
(GOLF)
H
Hotel
(HOH-TEL)
I
India
(IN-DEE-AH)
J
Juliet
(JEW-LEE-ETT)
K
Kilo
(KEY-LOH)

The Aviation Phonetic Alphabet

43

CHARACTER
TELEPHONY
PHONIC (PRONUNCIATION)

L
Lima
(LEE-MAH)
M
Mike
(MIKE)
N
November
(NO-VEM-BER)
O
Oscar
(OSS-CAH)
P
Papa
(PAH-PAH)

The Aviation Phonetic Alphabet

44

CHARACTER
TELEPHONY
PHONIC (PRONUNCIATION)

Q
Quebec
(KEH-BECK)
R
Romeo
(ROW-ME-OH)
S
Sierra
(SEE-AIR-RAH)
T
Tango
(TANG-GO)
U
Uniform
(YOU-NEE-FORM) or (OO-NEE-FORM)

The Aviation Phonetic Alphabet

45

CHARACTER
TELEPHONY
PHONIC (PRONUNCIATION)

V
Victor
(VIK-TAH)
W
Whiskey
(WISS-KEY)
X
X ray
(ECKS-RAY)
Y
Yankee
(YANK-KEY)
Z
Zulu
(ZOO-LOO)

The Aviation Phonetic Alphabet

46

ffd8ffe000104a46
494600010201008
600860000ffe20c5
AVIATION
ABBREVIATIONS
84943435f50524f4
6494c4500010100
000c484c696e6f02
1000006d6e74725
247422058595a20
07ce00020009000
600310000616373
704d53465400000
I am willing to insure a CFI
who will be using a Fixed CONV SEL to give
000494543207352
Dual to Ps, COMs, or
ATPs; no SOLO until 10 hours in M&M
474200000000000
000000000000000
TRANSLATION
00f6d6000100000
000d32d48502020
I am willing to insure a Certified
Flight Instructor who will be using a plane with
000000000000000
non retractable conventional gear
with a tail wheel to give training by a qualified
000000000000000
instructor to Private Licensed,000000000000000
Commercial Licensed or Airline Transport Pilots.
There will be no solo flying until
10 hours instruction in the make and model has
000000000000000
been completed.
000000000000000
000000000000000
000011637072740
000015000000033
646573630000018
40000006c777470
74000001f000000
014626b70740000
020400000014725

47

AVIATION ABBREVIATIONS
The following abbreviations are found in aviation insurance applications,
policies, aircraft advertisements, manuals and pilot operating handbooks.
Insurance abbreviations
Page 1 of 11
AMESAircraft multi engine, sea
ASES Aircraft single engine, sea
ATP Airline Transport Pilot
BFR Biannual flight review
C Commercial license
CFICertified flight instructor
CFIICertified flight instructor, instrument
Conv-Conventional landing gear with tail wheel
Dualtraining given by a qualified instructor

48

AVIATION ABBREVIATIONS
The following abbreviations are found in aviation insurance applications,
policies, aircraft advertisements, manuals and pilot operating handbooks.
Insurance abbreviations
Page 2 of 11
Fixednon-retractable landing gear
Fixed triFixed tri-cycle landing gear
FRFlight review
G & Fground and flight
GNIM ground not in motion
GNIFGround not in flight
G & TGround and taxi
Helihelicopter or rotor wing
Hr -Hours

49

AVIATION ABBREVIATIONS
The following abbreviations are found in aviation insurance applications,
policies, aircraft advertisements, manuals and pilot operating handbooks.
Insurance abbreviations
Page 3 of 11
IInstrument rated
IFR Instrument rated
ICCInstrument competency check
IPC Instrument proficiency check
M multi engine
Med medical payments
Med paymedical payments
ME Multi engine
MELMulti engine land
MEI Multi engine instructor
MMMake and model
M & MMake and model

50

AVIATION ABBREVIATIONS
The following abbreviations are found in aviation insurance applications,
policies, aircraft advertisements, manuals and pilot operating handbooks.
Insurance abbreviations
Page 4 of 11
OPWOpen pilot warranty
PPrivate license
Pax-Passengers
PIC -Pilot in command
RG Retractable gear
Rotor Helicopter or rotorcraft
RWRotor wing
SESingle engine
SELSingle engine land
SESSingle engine sea
SICSecond in command
Solono passengers or flight instructor in aircraft

51

AVIATION ABBREVIATIONS
The following abbreviations are found in aviation insurance applications,
policies, aircraft advertisements, manuals and pilot operating handbooks.
Insurance abbreviations
Page 5 of 11
TOTake off
TO & LTake off and landings
TRITri-gear
TWTailwheel
TTTotal timeTTLTotal
time logged

52

AIRCRAFT ABBREVIATION
Page 6 OF 11
0SFRM-zero time since a factory remanufacture
0SMOH -Zero time since major engine overhaul
FWF-Firewall forward
MDH -major damage history
NDH -No damage history

53

AIRCRAFT ABBREVIATION
Page 7 OF 11
SCMOH -Since chrome cylinder major overhaul
SFRM-Since factory remanufacture
SMOH -Since major engine overhaul
SOH-since engine overhaul (not necessarily a major)
SPOH-Since prop overhaul
STOH-Sincetop overhaul (pistons, cylinders and valve train)

54

AIRCRAFT ABBREVIATION
Page 8 of 11
TBO -Time between overhauls (factory recommendations)
TT-Total time
TTA -Total time on the airframe
TTAE-Total time on the airframe and engine
TTE-Total time on the engine
TTSN -Total time since new

55

AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONS

Page 9 of 11
Amp-Amperage of the alternator (electrical system rating)
Alt -Alternator
AOC-Angle of climb
C/S -Constant speed (governed speed, adjustable pitch) propeller
Cu. In.-Cubic inches displacement of engines
Fixed tri gear-non retractable tricycle landing gear with a nose wheel
F/P -Fixed pitch (non adjustable) propeller
FPM-Feet per minute (usually regarding climb)

56

AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONS

Page 10 of 11
Gen-Generator
GPH-Gallons per hour MPH -Miles per hour
HP-Horsepower of engine
KTS-Knots (1 knot = 1.151 statue miles per hour, or 1852 kilometers per hour)
L/R-Long-range fuel
NM -Nautical mile = approximately 6,080 ft.
Oct.-Octane rating of fuel.

57

AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONS

Page 11 of 11
PSI -Pounds per square inch (tire and strut pressure)
Ret. tri gear-Retractable tricycle landing gear with a nose wheel
ROC-Rate of climb
SM -Statue mile= 5,280 ft.
Sq. Ft.-Square feet regarding wing area.
STD-Standard fuel
VVolts
Vis-Viscosity of oil

58

ffd8ffe000104a4
ffd8ffe000104a46494
ffd8ffe000104a46494
64946000102010
60001020100ab00960
6000102010043004300
0ab00960000ffe2
000ffe20c584943435f5
00ffe20c584943435f50
0c584943435f505
0524f46494c45000101
524f46494c450001010
ffd8ffe000104a4649460001020100ab00960000ffe20c584943435f50524f46494c4500
24f46494c450001
00000c484c696e6f021
0000c484c696e6f0210
010100000c484c696e6f021000006d6e74725247422058595a2007ce00020009000600
0100000c484c69
000006d6e747252474
00006d6e74725247422
310000616373704d53465400000000494543207352474200000000000000000000000
00000f6d6000100000000d32d48502020000000000000000000000000000000000000
6e6f021000006d6
22058595a2007ce0002
058595a2007ce000200
000000000000000000000000000000000000000000000000000000000011637072740
e7472524742205
000900060031000061
0900060031000061637
00001500000003364657363000001840000006c77747074000001f000000014626b70
8595a2007ce000
6373704d5346540000
3704d53465400000000
7400000204000000147258595a00000218000000146758595a0000022c00000014625
8595a0000024000000014646d6e640000025400000070646d6464000002c400000088
20009000600310
000049454320735247
4945432073524742000
767565640000034c0000008676696577000003d4000000246c756d69000003f800000
000616373704d5
420000000000000000
0000000000000000000
0146d6561730000040c0000002474656368000004300000000c725452430000043c00
34654000000004
000000000000f6d6000
000000f6d6000100000
00080c675452430000043c0000080c625452430000043c0000080c746578740000000
94543207352474
100000000d32d48502
000d32d485020200000
0436f70797269676874202863292031393938204865776c6574742d5061636b617264
20436f6d70616e7900006465736300000000000000127352474220494543363139363
20000000000000
020000000000000000
0000000000000000000
62d322e31000000000000000000000012735247422049454336313936362d322e3100
00000000000000
000000000000000000
0000000000000000000
0000000000000000000000000000000000000000000000000000
0f6d6000100000
000000000000000000
0000000000000000000
000d32d4850202
000000000000000000
0000000000000000000
00000000000000
000000000000000000
0000000000000011637
00000000000000
000000011637072740
0727400000150000000
00000000000000
000015000000033646
3364657363000001840
00000000000000
573630000018400000
000006c777470740000
00000000000000
06c77747074000001f0
01f000000014626b707
00000000000000
00000014626b707400
4000002040000001472
00000000000116
000204000000147258
58595a0000021800000
37072740000015
595a00000218000000
0146758595a0000022c
00000003364657
146758595a0000022c0
000000146258595a000
36300000184000
00000146258595a000
0024000000014646d6e
0006c777470740
0024000000014646d6
6400000254000000706
00001f00000001
e64000002540000007
46d6464000002c40000
4626b707400000
0646d6464000002c400
0088767565640000034
20400000014725
000088767565640000
c000000867669657700
8595a000002180
034c000000867669657
0003d4000000246c756
00000146758595
7000003d4000000246c
d69000003f800000014
a0000022c00000
756d69000003f800000
6d6561730000040c000
0146258595a000
0146d6561730000040c
0002474656368000004
00240000000146
000000247465636800
300000000c725452430
46d6e640000025
0004300000000c72545
000043c0000080c6754
400000070646d6
2430000043c0000080c
52430000043c0000080
464000002c4000
675452430000043c000
c625452430000043c00
00088767565640
0080c62545243000004
00080c7465787400000
000034c0000008
3c0000080c746578740
000436f707972696768
67669657700000
0000000436f70797269
7420286329203139393

AVIATION APPLICATION
QUESTION ANSWER
SESSION

59