LICENSING: HELIPORT REGISTRATION FORM
PERSONAL INFORMATION
Full name: Heilee Kilback
Contact number(s): 222333 - 1247
Residential Address: 260 Barbareno Road, Chumash, Los Santos
HELIPORT INFORMATION
Address(es): Diamond Casino & Resort, Vinewood Park Drive, Vinewood Hills, Los Santos
Number of requested pads: 1
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Photograph(s) of the location(s):
https://imgur.com/a/BJiArbC
ACKNOWLEDGEMENT & AUTHORIZATION
By submitting this request, I, Heilee Kilback, hereby certify that the above statements are true and correct to the best of my knowledge. I fully authorize the investigation of any content shared on this document. I am aware that lying, omitting, or maliciously adulterating this request will result in immediate rejection and an indefinite ban from applying for a flight instructor certification.
