Airport Reversion Program Sign Up Form

"*" indicates required fields

Reversion Deferral Program Application

Date of Application 00/00/2025 (Deadline for reduced Reversion Deferral Fee is May 30, 2025)*

LESSEE (Name as it appears on current ground lease)*

NAME OF APPLICANT*

COMPANY NAME OF APPLICANT (if applicable)

Hangar #/Address (Example 1: 63054-00) (Example 2: 63054-01) (Example 3: 63054-02)*

Current Mailing Address (City, State, Zip Code)*

Phone Number*

Email Address*

Effective Date of Current Lease

End Date of Lease

Initial Term (in years)

Renewal / Option Terms under Original Lease

1 Renewal / Option

2 Renewal / Option

3 Renewal / Option

Renewal / Option Terms under Original Lease

Ground Lease Area (in sq. ft.)

Acknowledgment:
By entering my (our) name and submitting this application, I (we) warrant that, to the best of my (our) knowledge, all the representations and information set forth in this application are true and complete and I (we) have read and understand the Reversion Deferral Fee Program Terms and Conditions as well as the Bend Municipal Airport Rules and Regulations, Minimum Standards, and Leasing Development Policy provided by the City of Bend and agree to comply with all the policies and procedures outlined therein. I (we) agree to pay the non-refundable Reversion Deferral Program application fee of $500, and I (we) are aware that any violation of these terms may result in my application being deemed incomplete.

Signature*

Acknowledgment:

Application Fee:
After submitting your Reversion Deferral Application, you will be taken to a screen thanking you for your submission. On this page there will be a URL (link). Copy and paste this into your web browser to access the City of Bend’s online payment portal where you can pay the non-refundable $500 fee.

Fill out the form and from “Store Items” select “Reversion Deferral Fee.”