HomeMy WebLinkAboutAIR Card Enrollment FormNon -Don AIR Card Account Enrollment Form
(Please complete the form, Sign it where indicated, and FAX to DESC at (703) 767-8746)
Account Name
DoDAAC/FedAAC/UIC
Supplemental DoDAAC
Branch of Service/Fed Civ Agency
Fund/Signal code
Accountable Official:
Accounts Payable contact:
Title/Rank
Title/Rar}�
Name
Name
Address 400 NW 2 Ave
Billing Address: 400 NW 2 Ave
City,State/Prow, Postal Code Miami FL
33128
City,State/Prov, Postal Code Miami , FL
33128
Country USA
Country USA
Commercial Phone 305 579-5413
Commercial Phone 305 579-5413
DSN Phone
DSN Phone
Fax 305 579-6634
Fax 305 579-6634
E-mail address
-
L
Signature:
Signature:
(By Signing, the Accountable Official agrees to the Terms and Conditions contained in the Cardholder Agreement)
Card Information:.
Tail Number
A/C Type
Estimated
Monthly firs
flown
Estimated Monthly
Gals Used
Comments
1
N 1E0MP
EC 120
50
1550
2
3
4
5
6
7
i
8
9
DESC Approval:
Date
Signature, Approving Official