NDAC (SFN 2360) - APPLICATION FOR PRIVATE AERIAL APPLICATOR LICENSE (MANNED)

APPLICATION FOR PRIVATE AERIAL APPLICATOR LICENSE (MANNED)

SFN 2360
No person may engage in the activity or business of aerial application in the State of North Dakota without first obtaining an aerial applicator's license from the North Dakota Aeronautics Commission.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Owner/Applicant
Address

Street Address

CityState

Zip Code
County
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com

Questions about your FAA Part 137 should be directed to the Flight Standards District Office (FSDO) at (701) 492-5800.
Part 137 Agriculture Aircraft Operator Certificate Number
Operator must provide copy of certification with this form.

Cancelof
Name of ND Chief Pilot

Aircraft To Be Included On License

Rows	Make/Model	FAA N Number	Owner's Name	Address	State Registration Number
Aircraft 1
Aircraft 2

Airmen To Be Included on License

Rows	Name	Address	Restricted Cert Number	FAA Number and Rating
Airmen 1
Airmen 2

Lands Leased and Owned to Include on License

Rows	Description	Section	Township	Range	Leased or Owned
Land Lease 1
Land Lease 2