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I have read and understand the foregoing and agree to be bound thereby. I will notify the owner or <br />its Representatives of any changes in my address or aircraft ownership. <br />Dated this day of <br />TENANT <br />Mailing Address <br />City, State <br />Phone Number <br />Tenant Signature <br />COX FIELD AIRPORT <br />By: Lisa Wright, Airport Director <br />20 <br />Aircraft Make /Model <br />Registration Number <br />Insurance Agent <br />Phone Number <br />Page 4 of 4 <br />