Means of Compliance for Remote Identification of UA- Form

Form Approved OMB No. 2120-0781

Expires: Month dd, yyyy

U.S. Department

Of Transportation Federal Aviation Administration

Information for Applicant

Unmanned Aircraft Remote Identification
MEANS OF COMPLIANCE

Paperwork Reduction Act Burden 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 2120-0781. Public reporting for this collection of information is estimated to be approximately 12 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 to obtain or retain a benefit by 14 CFR Part 89. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.

Privacy Act Statement

This statement is provided pursuant to the Privacy Act of 1974, 5 U.S.C. sec. 552a. The authority for collecting this information on FAA Form 8130-33, Unmanned Aircraft Remote Identification Means of Compliance is contained in 49 U.S.C. sections 106(f), 40101, 40103, 44701(a)(5), 44805, 44809, and section 22202 of Pub. L. 114-190 as implemented by 14 CFR Part 89. The purpose of this information is for the applicant to certify that all of the appropriate data and documentation has been provided to the FAA to determine if the means of compliance meets the minimum performance requirements and includes appropriate testing and validation procedures in accordance with part 89. In accordance with the Privacy Act system this information is routinely used to (1) provide persons submitting a means of compliance information about potential mechanical defects or unsafe conditions of their standard remote identification unmanned aircraft or remote identification broadcast modules in the form of a non- compliance letter, (2) locate specific individuals or aircraft for accident investigation, violation, or safety related requirements, and (3) for DOT Prefatory Statement of General Routine Uses. Submission of this data is mandatory and will become part of the Privacy Act system of records. Incomplete submission may result in delay or denial of your request.

Means of Compliance Cover Page

EXAMPLE

Means of Compliance Cover Page

Date: DD-MM-YYYY

Submitter’s Name:

Address:

Point of Contact:

Point of Contact Email:

Type of Means of Compliance (check all that apply):

Standard Remote Identification Unmanned Aircraft _____

Remote Identification Broadcast Module_____

List of documentation included in submission:

[Please include sufficient documentation to demonstrate that the means of compliance meets the applicable performance requirements of part 89 and documentation of testing and validation.]

I, _________________________, hereby state that the attached documentation is true and correct to the best of my knowledge this __[date]__ day of __[month]_____, __[year]______.

_________________________ ___________

Signature Date

FAA Form 8130-33 (10/20) page 1 of 1