Download:
pdf |
pdfForm Approved
OMB No. 2120-0593
Expiration Date: 04/30/2018
PREAPPLICATION STATEMENT OF INTENT
US Department of Transportation
Federal Aviation Administration
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 2120-0593. Public reporting for this collection of information is estimated to be approximately 96 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 mandatory per 14 CFR Part 119. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden should be directed to the FAA at: 800 Independence Ave
SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ASP-110.
Section 1A. To Be Completed By All Applicants
2. Address of principal base where operations will be conducted
(do not use post office box)
1. Name and mailing address of company
3. Proposed Start-up date
4. Requested three-letter company identifier in order of preference
Company Email Address
Doing Business As (DBA)
1.
2.
3.
5. Management Personnel
Name (Last, first, middle)
Telephone (including area code) and
Email Address
Title
Section 1B. To Be Completed By Air Operators
6. Proposed type of operation (check as many as applicable)
Air Carrier Certificate
Part 121
Passengers and Cargo
Single Pilot Operator
Operating Certificate
Part 125
Cargo Only
Single Pilot-in-Command Operator
Part 133
Scheduled Operations
Basic Part 135 Operator
Part 135
Nonscheduled Operations
Section 1C. To Be Completed By Air Agencies
7. Proposed type of agency and rating(s)
Part 147 Maintenance Technical School
Part 145 Repair Station
Domestic
Foreign
Airframe
New
Renew
Satellite
Powerplant
Both
Airframe
Instrument
Powerplant
Propeller
Accessory
Radio
Any other purpose for which the FAA finds the applicant's request if appropriate
Specialized Service
Section 1D. To Be Completed By Air Operators
9. Geographic area of Intended operations
8. Aircraft Data
Numbers and types of aircraft (Include Registration if available)
(by make, model, and series)
FAA Form 8400-6 (05-17) Supersedes Previous Edition
Number of passenger seats or
cargo payload capacity
Page 1
Electronic Version
Section 1E. To Be Completed By All Applicants
10. Additional information that provides a better understanding of the proposed operation or business (attach additional sheets, if necessary)
11. The statements and information contained on this form denote an intent to apply for FAA certification.
Signature
Date
Name and Title
Section 2. To Be Completed By FAA District Office
Received by (district office):
Precertification Number
Date:
Date Coordinated with AFS-620
Remarks
FAA Form 8400-6 (05-17) Supersedes Previous Edition
Page 2
Electronic Version
File Type | application/pdf |
File Title | Preapplication Statement of Intent |
Subject | Preapplication Statement of Intent |
Author | C.Naylor |
File Modified | 2017-05-10 |
File Created | 2015-03-03 |