5100-101 Application for Federal Assistance (Planning Projects)

U.S. Department
of Transportation
Federal Aviation
Administration

FAA Form 5100-101, Application for Federal Assistance
(Planning Projects)
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 2120-0569. Public reporting for this collection of information is estimated to be approximately 28
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; no assurance of confidentiality is provided. 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.

INSTRUCTIONS FOR FORM 5100-101,
Application for Federal Assistance (Planning Projects)
Part I of the Application for Federal Assistance consists of a completed Standard Form (SF) 424. The remaining parts of
Form 5100-101 (Parts II, III, and IV) represent continuation pages that the Sponsor must attach to the SF-424 form. The
signature of the Sponsor’s authorized representative on the associated SF-424 form represents acceptance of the
representations and certifications made within the corresponding FAA 5100-101 form.

Part II – Project Approval Information
Section A. Statutory Requirements
This information is necessary for the Federal Aviation Administration to evaluate this request for Federal assistance.
Responses do not require an explanation unless explicitly requested by the question. As necessary, provide any
supplemental information by attaching sheets to this application.
Item 1 – Indicate whether the Sponsor maintains an active registration in the Federal System for Award Management
(SAM). Pursuant to 2 CFR §25.200(b), a Sponsor must maintain an active registration in the Central Contractor
Registration repository (housed within www.SAM.gov) with current information at the time of the application and during the
active period of the Federal award.
Item 2 – Indicate whether the Sponsor can commence the project within the same fiscal year the grant is made or within 6
months of when the grant is made, whichever is later. Attach explanation for negative responses. This information is
considered when allocating available discretionary funds. (49 U.S.C. § 47115(d)(2))
Item 3 – Indicate whether the Sponsor can complete the project without unreasonable delays. If applicable, provide listing
of foreseeable events (e.g. sponsor share issues, controversial issues, coordination delays, etc.) that have potential to
delay completion of the project. (49 USC § 47106(a))
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Item 4 – Indicate whether the project covered by this request is also covered by another Federal assistance program .If
the project, or portions thereof, is covered by another Federal assistance program, identify the Federal assistance
program by name and the Catalog of Federal Domestic Assistance (CFDA) number.
Item 5 – Indicate whether the Sponsor intends to seek reimbursement of indirect costs as defined by 2 CFR §200.414 and
2 CFR Appendix VII to Part 200. This information request does not include the indirect costs claimed by a for-profit entity
(e.g. consultant).
The De Minimis rate may only be used if the Sponsor has not previously received a negotiated Indirect Cost Rate (ICR)
and does not exceed the limitations prescribed in Appendix VII to Part 200.
A Sponsor with an existing approved negotiated ICR must identify the ICR value, the name of the cognizant agency that
approved the ICR and the date of approval.
Limitations of use: Per policy, Sponsor’s may only apply an approved ICR to allowable direct salary expenses that are
reasonable and necessary to carry out the project.
Section B. Certification Regarding Lobbying
This section addresses the Sponsor’s declaration regarding lobbying activities. The declaration made in the section are
under signature of the authorized representative as identified in box 21 of form SF-424, to which this form is attached
Title 31 U.S.C. § 1352 establishes that no appropriated funds may be expended by a recipient of a Federal grant to pay
any person for influencing or attempting to influence an officer or employee of any agency, Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with this covered Federal
assistance action. Pursuant to 40 CFR part 20, this certification attests that the Sponsor has not made, and will not make,
any payment prohibited payment by 31 U.S.C. § 1352.

Part III – Budget Information
This form section is designed so that application can be made for funds from one or more assistance programs. Include
budget estimates for the whole project when completing Sections A, B, C, and D. All applications must contain a
breakdown by the object class categories shown in Lines a-e of Section B.
Section A. Budget Summary
Lines 1-2, Columns (a) and (b) – For applications pertaining to a single grant program, enter on Line 1 under Column (a)
the catalog program title and the Catalog of Federal Domestic Assistance (CFDA) number in Column (b). For applications
pertaining to two funding programs, enter the program title on each line in Column (a) and the respective CFDA number (if
applicable) on each line in Column (b).
Lines 1-2, Columns (c) through (e) – For each line entry in Columns (a) and (b), enter in Columns (c), (d), and (e) the
appropriate amounts of funds needed to support the project. For changes to an existing application, enter new budget
values in Columns (c), (d), and (e).
Line 3 – Show the totals for all columns used.
Section B. Budget Categories
The column headings (1) and (2) correspond to the program titles shown for Lines 1-2, Column (a), Section A. For each
program, fill in the total requirements for funds (both Federal and non-Federal) by object class categories. The subcolumns address the “amount” and “adjusted amount”. The sub-column for “adjusted amount” need only be completed
when revising a previously submitted application. The Total column represents the sum across all columns.
Lines 4 a-d – Show the estimated amount for each cost budget (object class) category for each column with program
heading.
Line 4e – Enter the subtotal of lines 4a through 4d.
Line 4f – Enter the estimated amount of program income, if any, the Sponsor expects to generate from this project.
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Line 4g – Subtract line 4f from line 4e. For all applications, the total amount in Total column, line 4g, must equal the total
amount shown in Section A, Column (e), Line 3.
Section C. Source of Non-Federal Resources
Line 5-6 – Enter amounts of non-Federal resources that will be used on the grant. If in-kind contributions are included,
provide a brief explanation on a separate sheet.
Column (a) - Enter the program titles identical to Column (a), Section A.
Column (b) - Enter the amount of cash and in-kind contributions to be made by the applicant.
Column (c) - Enter the State contribution if the applicant is not a State or State agency. Applicants that are a State or
State agencies should leave this column blank.
Column (d) - Enter the amount of cash and inn-kind contributions to be made from all other sources.
Column (e) - Enter the totals of Columns (b), (c), and (d).
Line 7 – Enter the total for each of Columns (b)-(e). The amount in Column (e) should be equal to the amount on Line 3,
Column (d), Section A.
Section D. Forecasted Cash Needs
Line 8 –
a.
Column “Total for Project” - Enter the amount of cash needed from the grantor agency for the project.
st
th
b.
Columns 1 Year through 4 Year – Enter the anticipated cash need from grantor agency per fiscal year. The
sum of years 1-4 must equal the value shown under Column “Total for Project.”
Lines 814 - Enter the amount of cash from all other sources needed by quarter during the first year.
Line 9 –
Column “Total for Project” - Enter the amount of cash needed from non-Federal sources for the project.
a.
st
th
b.
Columns 1 Year through 4 Year – Enter the anticipated cash need from non-Federal sources per fiscal
year. The sum of years 1-4 must equal the value shown under Column “Total for Project.”
Line 10 – Enter the amount of cash from all other sources needed by fiscal year.
Section E. Budget Estimates of Federal Funds Needed for Balance of the Project
Section E. Other Budget Information
Line 11 – Provide any other explanations required herein or any other comments deemed necessary.

Part IV – Program Narrative
Prepare the program narrative statement in accordance with the following instructions for all new grant programs.
Requests for supplemental assistance should be responsive to Item 5b only. Requests for continuation or refunding or
other changes of an approved project should be responsive to Item 5c only.
1. Objectives and Need for This Assistance
Provide a short and concise description of the proposed planning effort. Include a brief narrative on the objective of the
planning effort and why it is needed.
2. Results or Benefits Expected
Identify anticipated results and benefits to be derived from this planning project.
3. Approach
a. Outline a plan of action pertaining to the scope and detail of how the Sponsor proposes to accomplish the work.
b. Identify any factors that might accelerate or impede progress of the planning effort.
c. Provide list of activities in chronological order to show the anticipated schedule of accomplishments and their
target milestone dates.
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d. Identify project monitoring and oversight mechanisms the Sponsor proposes to implement.
e. List key individuals and entities such as consultant, Sponsor personnel and contractor who will work on the
project. Provide a short description of the nature of their effort or contribution.
4. Geographic Location
Identify the location of the project and surrounding area to be served by the proposed project.
5. If Applicable, Provide the Following Information:
Describe the relationship between this project and other work planned, anticipated, or underway under the Federal
Assistance listed under Part II, Section A. If scope objectives change, explain the circumstances surrounding the need to
revise the application scope of work.

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

U.S. Department of Transportation
Federal Aviation Administration

Application for Federal Assistance (Planning Projects)
Part II – Project Approval Information
Section A – Statutory Requirements
The term “Sponsor” refers to the applicant name as provided in box 8 of the associated SF-424 form.
Item 1
Does Sponsor maintain an active registration in the System for Award Management
(www.SAM.gov)?

Yes

No

Yes

No

N/A

Yes

No

N/A

Yes

No

N/A

Yes

No

N/A

Item 2
Can Sponsor commence the work identified in the application in the fiscal year the grant is
made or within six months after the grant is made, whichever is later?
Item 3
Are there any foreseeable events that would delay completion of the project? If yes,
provide attachment to this form that lists the events.
Item 4
Is the project covered by another Federal assistance program? If yes, please identify other
funding sources by the Catalog of Federal Domestic Assistance (CFDA) number.
CFDA:
Item 5
Will the requested Federal assistance include Sponsor indirect costs as described in 2 CFR
Appendix VII to Part 200, States and Local Government and Indian Tribe Indirect Cost
Proposals?

If the request for Federal assistance includes a claim for allowable indirect costs, select the applicable indirect cost rate
the Sponsor proposes to apply:
De Minimis rate of 10% as permitted by 2 CFR § 200.414
Negotiated Rate equal to
on

% as approved by
(Date) (2 CFR part 200, appendix VII)

(the Cognizant Agency)

Note: Refer to the instructions for limitations of application associated with claiming Sponsor indirect costs.

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Section B – Certification Regarding Lobbying
The declarations made on this page are under the signature of the authorized representative as identified in box 21 of
form SF-424, to which this form is attached. The term “Sponsor” refers to the applicant name provided in box 8 of the
associated SF-424 form.
The Authorized Representative certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the Sponsor, to any person
for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
contract, grant, loan, or cooperative agreement
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract,
grant, loan, or cooperative agreement, the Authorized Representative shall complete and submit Standard
Form-LLL, ‘‘Disclosure Form to Report Lobbying,’’ in accordance with its instructions
(3) The Authorized Representative shall require that the language of this certification be included in the award
documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts under grants, loans,
and cooperative agreements) and that all subrecipients shall certify and disclose accordingly
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification
shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

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Part III – Budget Information
Section A – Budget Summary
New or Revised Budget

Federal
Catalog No
(b)

Grant Program
(a)
1. Airport Improvement Program

Federal
(c)

20-106

Non-Federal
(d)

Total
(e)

$

$

$

$

$

$

2.
3. TOTALS

Section B – Budget Categories (All Grant Programs)
Airport Improvement Program
(1)
4. Object Class Categories

Amount

a. Administrative expense

Other Program
(2)

Adjustment
+ or (-) Amount
(Use only for
revisions)

Amount

Total

Adjustment
+ or (-) Amount
(Use only for
revisions)

$

$

$

$

$

$

$

$

$

$

b. Airport Planning
c. Environmental Planning
d. Noise Compatibility Planning
e. Subtotal
f. Program Income
g. TOTALS (line e minus line f)

Section C – Non-Federal Resources
Grant Program
(a)

Applicant
(b)

5.

State
(c)

Other Sources
(d)

Total
(e)

$

$

$

$

$

$

$

$

6.
7. TOTALS

Section D – Forecasted Cash Needs
Source of funds
8. Federal

st

Total for Project

1 Year

2

nd

rd

Year

3 Year

4th Year

$

$

$

$

$

$

$

$

$

$

9. Non-Federal
10. TOTAL

Section E – Other Budget Information
11. Other Remarks: (attach sheets if necessary)

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Part IV - Program Narrative
(Suggested Format)

PROJECT:
AIRPORT:
1. Objective:

2. Benefits Anticipated:

3. Approach: (See approved Scope of Work in Final Application)

4. Geographic Location:

5. If Applicable, Provide Additional Information:

6. Sponsor’s Representative: (include address & telephone number)

Submit by Email

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