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Get Sd Aerial Applicator Form 2016-2025

L: __ __ __ __ __ __ __ Company Information: Co. Address: Co. City/Town: Co. State: __ __ Co. Zip Code: __ __ __ __ __ Co. Phone: Co. E-mail: 1. Federal Airman's Certificate NUMBER / RATING: ____________________ / ____________________ 2. Ag Aircraft Operator's FAA Certificate NUMBER / ISSUED: ____________________ / ____________________ 3. NUMBER of AIRCRAFT this Application will Cover…………… ____ (Register Aircraft with SD DOT: 605-773-4430) MAKE: a. _______________ b. ___________.

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