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4.  Do you now hold:

(1). A valid instructor rating?   Yes- Re-rated 

(2) An airplane mechanic's certificate of competency?   No

(3) An airplane engine mechanic's certificate of competency? No

If your answer is "yes" to any of the above, state when granted

5. Do you use intoxicants in any measure? If so, state to extent.   Yes, very moderately

6. State and describe any physical defects you have. Read the physical requirements in the announcement.   None

7. Show in what classes of aircraft your qualifying experience in student instruction has been acquired; also, show where and in what manner this instructional experience was obtained.

I first began gaining student instruction for hire in my own airplane in 1937 at Flushing airport. In 1938 while employed by Bennett Air Lines Hightstown N.J. I gave instructions in Class 1 - Land and Water type of Aircraft. In 1939 while employed by Unger Aircraft, New Brunswick, N.J. I gave student Instr. in Class 1 & 2 [[?]] Airplanes.

Sign your name, evidencing your understanding that the information herein given is covered by the jurat appended to the application form. 
Date: Feb. 9/40
Signature: 

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