5100-141 Inventory of Snow Removal Equipment

U.S. Department
of Transportation
Federal Aviation
Administration

FAA Form 5100-141, Inventory of Snow Removal Equipment
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 2120-0569. 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: Information Collection
Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.

U.S. Department of Transportation
Federal Aviation Administration

OMB CONTROL NUMBER: 2120-0569
EXPIRATION DATE: 6/30/2023

Inventory of Snow Removal Equipment (SRE)
Name of Airport:

Date of submittal:

Prepared by:

SRE Acquired with Airport Improvement Program (AIP) Grant Funds
Equipment
Number

AIP Grant
Number

Acquisition
Date

Type of Equipment Acquired
(Include Year, Make, Model, Serial
Number)

Total Cost
of
Equipment

Earliest
Replacement
Date

Report Information:
1. Attach photograph(s) of the equipment (taken upon delivery to the airport) to this form.
2. This information fulfills equipment property records requirements of 2 CFR § 200.313.
3. The FAA airports district office (ADO) will retain a copy of this form in the associated AIP grant file as well as the
location’s central file for the purpose of future reference.
4. Sponsor must notify the FAA ADO if they proposed to dispose of any snow equipment procured with FAA federal
assistance. (2 CFR § 200.313(e)
5. Attach additional sheets of this form if extra space is necessary.
FAA Form 5100-141 (8/20) SUPERSEDES PREVIOUS EDITION

Submit by email