Certification Of Aircraft Registration Name Change {7548}

State Form 7548 (R5 / 10-16) AE-6 Form Certification of Aircraft Registration Name Change Indiana Department of Revenue This form is to be used to change the name on the Indiana Certificate of Aircraft Registration. Some name changes result in a taxable transaction. We will contact you with further instructions upon reviewing this document. Section A: New Name to be Shown on Certificate of Aircraft Registration 1. Name 4. Street Address 2. Telephone Number 3. Email Address 5. City, State and ZIP Code 6. Social Security Number (Individuals) or Federal Employer Identification Number (Businesses) Section B: Current Name on Certificate of Aircraft Registration to be Removed 7. Name 10. Street Address 8. Telephone Number 9. Email Address 11. City, State and ZIP Code Section C: Aircraft to be Updated 12. List all FAA N Numbers that are impacted by the name change: I hereby certify, under penalty of perjury, that the information contained herein is true, correct, and complete to the best of my knowledge. _______________________________________ Printed Name Mailing/Contact Information: Indiana Department of Revenue Special Tax Division P.O. Box 644 Indianapolis, IN 46206-0644 (317) 615-2544 aircrafttax@dor.in.gov ___________________________________ Signature ________________________ Date American LegalNet, Inc. www.FormsWorkFlow.com