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FItPlan.com eAPIS Departure Manifest Date Submitted: 03/22/2011 Aircraft Registration: N722JE - (S76) Departure Airport Information: Airport ID: TJBQ City Name: AGUADILLA State: PR Local Departure Date: 03/22/2011 Local Departure Time: 16:30 Estimated Border Crossing Location/Time: SAN ANTONIO PR AT 2055 UTC Arrival Airport Information: Airport Ident: MBPV City: PROVIDENCIALES Country Code: TCA Local Arrival Date: 03/22/2011 Local Arrival Time: 19:04 Foreign Airports) Landing at within 24 hrs of U.S.A. departure: None Aircraft Operator Information Aircraft Operator’s Company Name: FREEDOM AIR INTERNATIONAL Street: 3800 SOUTHERN BLVD Apartment or Suite #: 204 City: WEST PALM BEACH State: FL Zip Code: 00802 Country Code: USA Phone: 9178686145 Fax: N/A Email: LVJET@AOL.COM Aircraft Owner Information Aircraft Owner’s Company Name: FREEDOM AIR INTERNATIONAL Street: 3800 SOUTHERN BLVD Apartment or Suite #: City: WEST PALM BEACH State: FL Zip Code: 33406 Country Code: USA Phone: 91786861435 Fax: Email: LVJET@AOL.COM Total Number Of Crewmembers: 2 Name: NICOLAS GERARD ROBERT VAN HEURCK Crew Catagory: CREW Sex: MALE Date Of Birth:I City Of Birth: WILRYK State Of Birth: BE Country Of Birth: BEL Country Of Residence: USA Country Of Citizenship: BEL Crewmember’s Permanant Address: N722JE AGUADILLA to PROVIDENCIALES Time Submitted: 14:43:00 Confirmation #: EAPIS-2359992 Callsign: SIKORSKYAircraft Color: BLACK Decal Number: 1513868 Document 1: PASSPORT Document 1 Number: Document 2: PILOT LICENSE Document 2 Number Name: LAWRENCE PAUL VISOSKI Crew Catagory: PILOT Sex: MALE Date Of Birth City Of Birth: BERWYN State Of Birth: IL Country Of Birth: USA Country Of Residence: USA Country Of Citizenship: USA Crewmember’s Permanant Address: Document 1 Exp.: 06/14/2015 Document 1 Country.: BEL Document 2 Exp.: N/A Document 2 Country.: USA Document 1: PASSPORT Document 1 Number: Document 2: PILOT LICENSE Document 2 Number Total Number of Passengers: 0 Emergency Contact Information Contact Name: Phone: Document 1 Exp.: 04/02/2011 Document 1 Country.: USA • Document 2 Exp.: N/A Document 2 Country.: USA Email: https://ww10.fltplan.com/APIS2SubmittedPrintout.exe?a=4 1/20/20, 9:31 PM Page 1 of 1¶