5100-141 Inventory of Snow Removal Equipment

U.S. Department
of Transportation

Federal Aviation
Administration

FAA Form 5100-141, Inventory of Snow Removal Equipment

Paperwork Reduction Act Statement

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0569. Public reporting for this collection of information is estimated to be approximately 8 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the Federal Aviation Administration at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ASP-110.

Inventory of Snow Removal Equipment (SRE)

Name of Airport:       Date of submittal:      

Prepared by:      

SRE Acquired with Airport Improvement Program (AIP) Grant Funds

Equipment Number	AIP Grant Number	Acquisition Date	Type of Equipment Acquired. (Include Year, Make, Model, Serial Number)	Total Cost of Equipment	Earliest Replacement Date
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     
     	     	     	     	     	     

Report Information:

1. Attach photograph(s) of the equipment (taken upon delivery to the airport) to this form.

2. This information fulfills equipment property records requirements of 2 CFR § 200.313.

3. The FAA airports district office (ADO) will retain a copy of this form in the associated AIP grant file as well as the location’s central file for the purpose of future reference.

4. Sponsor must notify the FAA ADO if they proposed to dispose of any snow equipment procured with FAA federal assistance. (2 CFR § 200.313(e)

5. Attach additional sheets of this form if extra space is necessary.