BEYOND Program Withdrawal Reports

U.S. Department of Transportation
Federal Aviation Administration

OMB Control No. 21XX-XXXX
Collection Expires XX/XX/XXXX

BEYOND Program Withdrawal Report
Public 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 21XX-XXXX. Public reporting for this collection of information is estimated to be
approximately 4 hours per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. All responses to this collection of information are required to obtain or retain a benefit (49
U.S.C. § 106(l) and (m)). 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.

BEYOND Program Withdrawal Reporting Requirements
If a Lead Participant or a team member ends its participation in the BEYOND program because it has
determined that its operations are infeasible or because of technical, financial or other challenges, the
Lead Participant must submit a Program Withdrawal Report to the Federal Aviation Administration (FAA)
within 30 calendar days after notifying the FAA of the withdrawal.

Instructions for Writing the Program Withdrawal Report
The Program Withdrawal Report must detail the challenges faced in meeting the operational milestones
and reaching key performance indicators. The Lead Participant should use the following outline when
preparing the report.
1. Executive Summary
2. Reason(s) for Exiting BEYOND: Detail the challenges faced in meeting the operational
milestones and reaching key performance indicators. Examples of information to capture:
a. Technical issues
b. Financial issues
c. Regulatory issues
d. Time sensitivities
e. Other issues
3. Interest in Returning to BEYOND: Does the Lead Participant or team member expect to
overcome its challenges, and if so, would it be open to a potential return to the BEYOND
program?

Instructions for Submitting the BEYOND Program Withdrawal Report

1. Complete the cover page attached to these instructions.
2. Attach the report to the cover page.
3. Upload the report package to the designated, secure folder on the Aeronautical Data Exchange
(ADX).

Instrument/Withdrawal Report (5/21)

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U.S. Department of Transportation
Federal Aviation Administration

OMB Control No. 21XX-XXXX
Collection Expires XX/XX/XXXX

BEYOND Program Withdrawal Report
Lead Participant:
Date of Entry into Program:
Date of Program Withdrawal:
Report Date:
Submitted By:
___________________________________________________________________________________

Public 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 21XX-XXXX. Public reporting for this collection of information is estimated to be
approximately 4 hours per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. All responses to this collection of information are required to obtain or retain a benefit (49
U.S.C. § 106(l) and (m)). 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.

Instrument/Withdrawal Report (5/21)

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