Heartland Aviation Tax Consulting

Have you worked with an aviation consultant before? YesNo

If yes, please indicate group

Customer Information

First Name

Last Name

Referred By

Email Address

Home Phone

Mobile Phone

Preferred Method Of Contact

Home Address

Home City

Home State

Home Zip

Drivers License Number

State Issued

SSN

Date Of Birth

Are You A US Citizen?YesNo

Choose the name of your airplane holding company

Business Address

Business City

Business State

Business Zip

County

Business Phone

Business Fax

Aircraft Demographics

Make and Model

Anticipated Purchase Date

Purchase Price

New or Used

Take Off Weight

N Number

Base Airport ID

Base Air Port Name

Base Airport County

Seller First Name

Seller Last Name

Seller Address

Seller City

Seller State

Seller Zip

Operations

Aircraft Operator

Operator State of Formation

What is your ownership % in your current operating business?

Operator Address

Operator City

Operator State

Operator Zip

Please distribute these intended hours within the following categories

Charter Operator Use %

Training Maintenance Use %

Third Party Use %

Business Employed Use %

Personal Use Use %

Do you have business interests or personal residences in any other states outside of your home state?

How many hours do you intend to fly on an annual basis?

SERVICES TAILORED TO YOUR AIRCRAFT

Customer Information

Aircraft Demographics

Operations

Please distribute these intended hours within the following categories