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Name of Possessor
（２）占有人地址____________________________________________________
Address of Possessor
法定代表人姓名_____________________
Name of Legal Representative
１０．抵押所担保的债权
Obligatory Right Secured by Mortgage
数额和利息率________________________________________________________
Amount and Interest Rate
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
受偿期限__________________
Reimbursement Period
１１．抵押人是否要求抵押权人进一步之贷款？ □是 □否
Is Additional Loan from the Mortgagee Requested Yes No
如有，请填写抵押进一步担保的债权
If Yes, Obligatory Right Secured by the Additional Mortgage
数额和利息率________________________________________________________
Amount and Interest Rate
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
受偿期限__________________
Reimbursement Period
１２．抵押权取得日期_______________________
Date of Acquisition of Mortgage
１３．备注
Remarks
____________________________________________________________________
____________________________________________________________________
１４．证明文件清单
List of Evidencing Documents
（１）______________________________________________________________
（２）______________________________________________________________
（３）______________________________________________________________
（４）______________________________________________________________
（５）______________________________________________________________
声明：兹证明，上述所填各项及所提供的文件完全真实、合法、有效，填写人对其合法性和真实性承担一切责任。
Statement: It is hereby guaranteed that all information above and
the documents furnished are completely lawful, correct, true and valid.
The applicant undertakes all liabilities for any irregularity, incorrect-
ness, falseness or invalidity thereof.
申请人（签章)________________ 法定代表人（签字）________________
Seal or Signature of Applicant Signature of Legal Representative
联系电话_____________________ 联系传真__________________________
Telephone Facsimile
代办人（签字)________________ 申请日期及时间____________________
Signature of Agent Date and Time
民用航空器优先权登记申请书
APPLICATION FOR REGISTRATION OF
CIVIL AIRCRAFT LIEN
１．国籍标志和登记标志 _____________________________________________
Nationality Mark and Registration Mark of PRC
２．航空器型号________________________
Aircraft Model
制造地点__________________________
Place of Manufacture
３．航空器制造者名称________________________________________________
Name of Aircraft Manufacturer
４．航空器出厂序号____________________
Serial Number
出厂日期__________________________
Date of Manufacture
５．所有人姓名或名称________________________________________________
Name of Owner
所有人地址__________________________________________________________
Address of Owner
____________________________________________________________________
法定代表人姓名________________
Name of Legal Representative
６．航空器已出租的，请填写以下项目:
Fill in the Following Blanks Only if There is a Lease on the Air-
craft:
（１）承租人姓名或名称______________________________________________
Name of Lessee
（２）承租人地址____________________________________________________
Address of Lessee
____________________________________________________________________
法定代表人姓名_____________________
Name of Legal Representative
７．航空器经营人不同于所有人或承租人的，请填写以下项目:
Fill in the Following Blanks Only if Aircraft Operator is neither
Owner nor Lessee:
（１）经营人姓名或名称______________________________________________
Name of Operator
（２）经营人地址____________________________________________________
Address of Operator
___________________________________________________________________
法定代表人姓名_____________________
Name of Legal Representative
８．债权发生原因（请在方框内划X）
The Cause Giving Rise to the Obligatory Right （Please Tick Box）
□援救该航空器的报酬
Compensation Due for Salvage of the Aircraft
□保管维护该民用航空器的必需费用
Extraordinary Expenses Indispensable for the Preservation of the
Aircraft
□其他原因
Other Cause
９．债权发生日期__________________________
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