Aircraft Original Registration Application Office of Aeronautics-Licensing South Dakota Department of Transportation 700 E. Broadway Ave. Pierre, SD 57501 (605) 773-4430 THIS FORM MUST BE COMPLETED AND SIGNED BY THE AIRCRAFT OWNER OR LESSEE Owner/Lessee information Owner name Phone Address Cell City State AK AL AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip County Email Email future annual renewal forms Aircraft description FAA reg. no. Serial no. Make Model Gross weight Year Engine manufacturer Engine horsepower Purchase date From: Name Purchase price after trade-in value Address Please include a copy of the proof of purchase price with this application. Certification I hereby certify that the foregoing is a true statement of facts. If the aircraft purchased is to be based, or used 90 days or more, in South Dakota, I understand any taxes and/or registration fees due to the state of South Dakota will be paid by me to the South Dakota Dept. of Transportation within 30 days. Dated this ____ day of ____________________________________________ Signature __________________________________________________________ Registration tax and annual fee calculation (annual fee based on SDCL 50-11-12, 13, 14 and 15) Enter value or purchase price at right. Registration tax: In menu near % symbol, select 3% if aircraft was manufactured solely for agricultural/defoliating applications, or 4% if it was NOT manufactured solely for agricultural/defoliating applications. Annual registration fee: Is the aircraft 10 years old or more? Yes No Select the weight class (maximum gross takeoff weight in pounds) to find the correct fee: 0-1,500 1,501-2,000 2,001-3,000 3,001-4,000 4,001-5,000 5,001-6,000 6,001-10,000 10,001-12,499 12,500-15,000 15,001 or more x 3 4 % = Tax due + Annual fee Total due Payment type Check or money order enclosed Credit card Card type Card number Expiration date Name as it appears on card DOT-164 01/05/2016