5100-137 Buy American Preferences-Final Assembly Questionnaire

U.S. Department
of Transportation

Federal Aviation
Administration

FAA Form 5100-137, Buy American Preferences – Final Assembly Questionnaire

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.

Buy American Preferences – Final Assembly Questionnaire

To assist the Federal Aviation Administration (FAA) in making the determination of whether final assembly of the product occurs in the United States, please complete and submit this questionnaire when requesting a Buy American Waiver under 49 USC § 50101(b)(3)(A).

1. Please provide a description of the assembly process occurring at the specified final location in the United States?

     

1. Please describe the final assembly process and its various operations?

     

2. How long does the final assembly process take to complete?

     

2. Please provide a description of the resources used to conduct the assembly of the product at the specified location in the United States?

     

1. How many employees are involved in the final assembly process and what is the general skill level of those employees?

     

2. What type of equipment is used during the final assembly process?

     

3. What is a rough estimate of the associated cost to conduct final assembly of the product at the specified location in the United States?

     

The undersigned certifies that this information is true and accurate to the best of their knowledge.¹

Signature: ___________________________

Name:      

1 A false certification represents a violation of 18 U.S.C § 1001 and 49 U.S.C § 47126. Signatory has the burden of proof to establish compliance.