Certification of Recall Notice Requirement - No Involunt

OMB Control No. 1505-0263

CERTIFICATION OF YOUR RECALL NOTICE REQUIREMENT

The Payroll Support Program Extension (PSP2) under Division N, Title IV, Subtitle A of the Consolidated Appropriations Act, 2021 (PSP Extension Law) required you to provide information and certifications to validate your compliance with the RECALL and REHIRE provisions of the PSP2.

In your application for PSP2 funding, you indicated that your company did not involuntarily terminate or furlough any of its employees between October 1, 2020 and the date that ______________ (name of airline) signed its PSP 2 Agreement.

Before we can process your second PSP2 payment, you must certify, by the CERTIFICATION AND SUBMISSION form included below, that ___________________ did not furlough or involuntarily terminate any employees between October 1, 2020 and ____________________ [date of PSP2 Agreement].

PSP2 Application Number:

PSP1 Application Number:

Under Section 404 of the Extension Law and your PSP2 Agreement, any passenger carrier that (1) received financial assistance under the Payroll Support Program (PSP1) under the Coronavirus, Aid, Relief, and Economic Security Act (CARES Act) and (2) conducted an Involuntary Termination or Furlough between October 1, 2020 and the date on which the passenger carrier or contractor entered into its PSP2 Agreement with Treasury (i.e., the date Treasury executed the agreement), must:

1. Recall, not later than 72 hours after the PSP2 Agreement has been executed, each Employee who was subject to an Involuntary Termination or Furlough between October 1, 2020, and the date that the passenger carrier or contractor entered into its PSP2 Agreement, and enable each Returning Employee to return to employment within 30 days after making the election to do so;
   
   

2. Compensate, not later than 30 days after a Returning Employee returns to employment, such Returning Employee for lost Salary, Wages, and Benefits (offset by any amounts received by the Returning Employee from the Recipient or an Affiliate as a result of such Returning Employee’s Involuntary Termination or Furlough, including any Severance Pay or Other Benefits or furlough pay) between, with respect to passenger carriers, December 1, 2020 and the date that the passenger carrier entered into its PSP2 Agreement, or, with respect to contractors, between December 27, 2020, and the date that the contractor entered into its PSP2 Agreement; and

3. Restore the rights and protections for each Returning Employee as if such Returning Employee had not been subject to an involuntary termination or furlough.

Did you involuntarily furlough or terminated any Employees between October 1, 2020 and the date of your PSP2 Agreement?

□ Yes □ No

[Certification Page to Follow]

CERTIFICATION

On behalf of the Recipient (including all Affiliates participating in the PSP2) and its undersigned authorized representatives, I certify that the responses and information the Recipient provided above are true and correct. I make this certification after reasonable inquiry of people, systems, and other information available to the Recipient. I acknowledge that a materially false, fictitious, or fraudulent statement (or concealment or omission of material fact) in this submission may be the subject of criminal prosecution and also may subject the Recipient to civil penalties and/or administrative remedies for false claims or otherwise.

The undersigned are authorized representatives of the Recipient with authority to make the above certifications and representations on behalf of the Recipient.

_______________________

First Authorized Representative of Recipient(s): 

Name:  

Title: 

Date: 

 

_______________________

Second Authorized Representative of Recipient(s): 

Name:  

Title: 

Date: 

WARNING: Anyone who knowingly submits a false claim or makes a false statement is subject to criminal and/or civil penalties, including confinement for up to 5 years, fines, and civil penalties. (18 U.S.C. §§ 287, 1001; 31 U.S.C. §§ 3729, 3802).

PAPERWORK REDUCTION ACT NOTICE: The information collected will be used for the U.S. Government to process requests for support. An agency many not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid control number assigned by OMB. The estimated burden associated with this collection of information is 30 minutes per response. Comments concerning the accuracy of this burden estimates and suggestions for reducing this burden should be directed to the Office of Privacy, Transparency and Records, Department of the Treasury, 1500 Pennsylvania Ave, N.W., Washington, DC 20220. DO NOT send the form to this address.