Air Tour Operators Report Template

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Commercial A

As Mandated by the FAA Modernizat

Please Fill In Shaded A

Note: Guidance is include

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
Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information co
54 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing a
The FAA Modernization and Reform Act of 2012. Send comments regarding this burden estimate or any other aspect of this collection of information, includin
Attn: Information Collection Clearance Officer, AES-20

Operator/Company Name:
dba (doing business as):
Certificate Designator:
Reporting Period:

Click on cell; select from dropdown

Reporting Year:

Notes:

Location Information
National Park Service Unit Name(s):

Alpha-Code(s):

Departure Airports/Helipads:

Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)

Air Tour Data Submission
Date of Tour

Hour of Tour

Aircraft Make/Model

Park-Route Code

End of Air Tour Data Submission Fields. You may insert additional rows as needed.

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 2120-0750. Public reporting for this collection of information is estimated to be approximately
4.5-54 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 The FAA Modernization and Reform Act of 2012. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the FAA at: 800 Independence Ave SW, Washington, DC
20591, Attn: Information Collection Clearance Officer, AES-200.

End of Form

Commercial Air Tour Reporting Data

e FAA Modernization and Reform Act of 2012, Title V, Section 501
Please Fill In Shaded Areas Below Where and As Appropriate
Note: Guidance is included in each cell and the first cell of each section.

red 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
B Control Number for this information collection is 2120-0750. Public reporting for this collection of information is estimated to be approximately 4.5aintaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are mandatory per
of this collection of information, including suggestions for reducing this burden to the FAA at: 800 Independence Ave SW, Washington, DC 20591,
on Collection Clearance Officer, AES-200.

FAA Information:

Go to http://www.faa.gov/about/office_org/field_offices/fsdo/ for more information.

Name of Assigned POI:
Name of Assigned FSDO:
Click on cell; select from dropdown

FSDO Phone No.:

Aircraft Information
Aircraft Tail Number(s):

Route Information
Route Code:

Route Name:

End of Route Information Fields. You may insert additional rows as needed.

on 501

OMB CONTROL NUMBER
2120-0750

offices/fsdo/ for more information.

on

on

Expiration Date 02/28/2027

additional rows as needed.

Commercial A

As Mandated by the FAA Modernizat

Please Fill In Shaded A

Note: Guidance is include

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
Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information c
16 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing a
The FAA Modernization and Reform Act of 2012. Send comments regarding this burden estimate or any other aspect of this collection of information, includin
Attn: Information Collection Clearance Officer, AES-20

Operator/Company Name:

Air Tour Company

dba (doing business as):

Great Tours

Certificate Designator:

XYZABC123

Reporting Period:

January 1 - June 30

Reporting Year:

Notes:
No flights over CARE in this quarter

Location Information
National Park Service Unit Name(s):

Alpha-Code(s):

Departure Airports/Helipads:

Canyonlands National Park

CANY

XYZ

Arches National Park

ARCH

ABC

Glen Canyon National Recreation Area

GLCA

Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)
Park Name (pick from list)

Air Tour Data Submission
Date of Tour

Hour of Tour

Aircraft Make/Model

Park-Route Code

1/1/2018
1/1/2018
1/2/2018
1/2/2018
1/3/2018

8
8
7
9
15

Cessna 208
Cessna 208
Cessna 208
Cessna 208
Cessna 208

CANY - BigMtn
CANY,ARCH - BigMtnG
GLCA - Meadow
ARCH - TallPk
ARCH - TallPk

1/4/2018
1/5/2018
1/5/2018
1/5/2018
1/10/2018
1/15/2018
1/15/2018
1/16/2018

10
11
13
15
9
9
14
8

Cessna 208
Cessna 208
Cessna 208
Cessna 208
Cessna 208
Cessna 208
Cessna 208
Cessna 208

CANY - BigMtn
CANY,ARCH - BigMtnG
GLCA - Meadow
ARCH - TallPk
ARCH - TallPk
GLCA - Meadow
ARCH - TallPk
CANY,ARCH - BigMtnG

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
End reporting
of Air Tour
2120-0750. Public
for Data Submission Fields. You may insert additional rows as needed.
this collection of information is
estimated to be approximately
4-16 hours per response,
including the time for reviewing
instructions, searching existing
data sources, gathering and
maintaining the data needed,
completing and reviewing the
End
of Form
collection
of information. All
responses to this collection of
information are mandatory per
The FAA Modernization and
Reform Act of 2012. Send
comments regarding this
burden estimate or any other

Commercial Air Tour Reporting Data

e FAA Modernization and Reform Act of 2012, Title V, Section 501
Please Fill In Shaded Areas Below Where and As Appropriate
Note: Guidance is included in each cell and the first cell of each section.

red 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
B Control Number for this information collection is 2120-0750. Public reporting for this collection of information is estimated to be approximately 4intaining the data needed, completing and reviewing the collection of information. All responses to this collection of information are mandatory per
of this collection of information, including suggestions for reducing this burden to the FAA at: 800 Independence Ave SW, Washington, DC 20591,
on Collection Clearance Officer, AES-200.

FAA Information:

Go to http://www.faa.gov/about/office_org/field_offices/fsdo/ for more information.

2020

Name of Assigned POI:

J. B. Smith

Name of Assigned FSDO:

XYZ FSDO

FSDO Phone No.:

555-555-5555

Aircraft Information
Aircraft Tail Number(s):
N12345

Route Information
Route Code:

Route Name:

BigMtn
BigMtnG
Meadow
TallPk

Big Mountain, Snowy Lake
Big Mountain, Snowy Lake, Great Basin
Meadow Overlook, Deep Lake
Tall Peak

End of Route Information Fields. You may insert additional rows as needed.

on 501

OMB CONTROL NUMBER
2120-0750

offices/fsdo/ for more information.

on

on

Revised 12/15/2018

additional rows as needed.