Fuel Reimbursement Form
Choice Aviation aircraft are rented at a "wet", (fuel included) rate. When a renter takes an aircraft, and chooses to purchase fuel at an FBO other than a Choice Aviation facility, the renter will be responsible for the fuel purchase. A renter, however, is eligible for reimbursement of a portion, or all, of the cost of the fuel, as dictated by the formula below. The following three steps must be adhered to when seeking reimbursement.

1) Complete this form.
2) Attach receipt to this form.
3) Submit to Choice Aviation within 48 hours of returning the aircraft.

DATE: *
MM
/
DD
/
YYYY
TAIL: *
NAME: *
PHONE: *
Make check payable to: *
Formula to determine reimbursement:
A. Gallons of fuel purchased= *
B. Price per gallon= *
C. Total cost of fuel purchase ( line A x line B)= *
D. Current Choice Aviation posted price/gallon minus \$0.40= *
E. Line A x line D= *
F. Reimbursable amount is the lesser of lines C & E= *
Sample Problem:
Pilot flies from Cody to Cheyenne. At Cheyenne pilot purchases 20 gallons at \$6.20 per gallon bringing total fuel purchase to \$124.00. Posted price of fuel at departure Choice Aviation FBO is \$6.00 per gallon.

A. Gallons of fuel purchased...........................................................= 20
B. Price per gallon...............................................................................= \$6.20
C. Total cost of fuel purchased (line A x line B)..........................= \$124.00
D. Current Choice Aviation posted price/gallon minus \$0.40...= \$5.40
E. Line A x Line D.................................................................................= \$112.00
F. Reimbursable amount is the lesser of lines C & E..................= \$112.00

Attach fuel receipt below *
Required