BPA F 4450.01e BONNEVILLE POWER ADMINISTRATION (BPA) FLIGHT REQUEST

CUI

BPA F 4450.01e
(10-2021)

OMB Control Number:1910-5196
Expiration Date: 01/31/2026

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)
FLIGHT REQUEST
See second page for Instructions.

VALID SIGNATURES: Per OMB A-130, Digital Signature (web link to instructions) or Electronic Signature (handwritten signature scanned into electronic format) is recognized as a valid signature. Use of “/s/” is NOT a valid signature.

TYPE OF
AIRCRAFT
REQUESTED:
DATE OF
REQUEST

AIRPLANE
HELICOPTER
sUAS

REQUESTOR (E-Signature)

AUTHORIZING OFFICIAL (E-Signature)

MISSION

PRIMARY TRIP POINT OF CONTACT NAME (Last, First) & PHONE

DATE(S)

DEPARTURE POINT

TYPE OF FLIGHT

TRIP ID
(TAA Use Only)

SES NAME (Last,First)

TIMES (LOCAL)

DESTINATION

DEPART

OTHER
OFFICIAL
TRAVEL

PURPOSE/DESCRIPTION

ARRIVAL

F
L
I
G
H
T

BFTE

PASSENGER NAME
(√)

GRADE

CFTE

OTHER

(√)

(√)

ORGANIZATION

TRAVELERS BEST MOBILE PHONE
CONTACT NUMBER FOR
PROPOSED TRIP

EMERGENCY
CONTACT INFO
CURRENT

1

Y

N

2

Y

N

3

Y

N

4

Y

N

5

Y

N

6

Y

N

7

Y

N

8

Y

N

9

Y

N

WEIGHT (LBS) OF
ANY
BAGGAGE/CARGO
OVER 10 LBS

ADDITIONAL INFORMATION AND/OR INSTRUCTIONS:

Approval by Aircraft Services Manager or designated operational control designee verifying type of flight justification►
(TAA USE ONLY)

Page 1 of 3

FLIGHT APPROVAL OFFICIAL (E-Signature)

File Code: FE-1140. Retention: Destroy when 3 years old, but longer retention is authorized if required for business use. Retention Schedule: GRS 5.4.120

BPA F 4450.01e
(10-2021)

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)
FLIGHT REQUEST

WHAT REQUESTERS SHOULD KNOW:
1) The use of any BPA owned aircraft (airplane, helicopter or sUAS) requires the requester to submit a BPA Flight Request form to Bonneville Aircraft Services (BAS). For passenger
transport, the Flight Request Form must be submitted as soon as the traveler, or Requesting Official, identifies a need to travel by air. Helicopter and BAS sUAS flight requests
are scheduled months in advance to facilitate complex scheduling requirements. For emergency requests Flight Request paper work can follow after the fact. Some common
examples of requests can be found on the BAS site. The manager of the requester should be the authorizing official for most flight requests. For Special/Emergency flights, requested
by Transmission Line Maintenance, the Foreman III of the requesting district can sign both as the requester and the authorizing official. BPA organizations, with their own UAS’s, will
be submitting a 4450.01e for situational awareness. For these flights the requester and authorizing official may be the same individual and that individual can be at the user/operator
level. For contracted UAS operations see BPA’s Contractor Safety and Health Requirements for Prime and Subcontractors.

2) BPA aircraft are used exclusively for Official use and this is further divided into “mission use” and “other travel”.
3) Mission Use - BPA aircraft have been acquired for and are primarily used to meet mission requirements. A mission requirement means activities that constitute the
discharge of our agencies official responsibilities. BPA’s published mission statement, its legal obligations and government to government relationships all define those
official responsibilities and are used to define mission flights. Therefore, any flight that directly supports activities in power supply, transmissions system, fish and wildlife
mitigation efforts and BPA’s other legal and government to government obligations are considered mission flights.

4) Other Travel – On occasion official travel falls into the category of “other official travel”. This type of travel is that which does not directly support those activities that define
mission use but are still official BPA activities.

5) All “other official travel” must cost justify (performed by TAA) and cost justification performed for “mission use” may be used to prioritize flights, if needed. If a

“other travel” Flight Request is not cost justified for the use of a government aircraft, then the requester will be notified to choose alternate travel means within 48 hours after
receiving the fully completed Flight Request Form.

6) BAS requires PII including current passenger weight, current Next of Kin, and for Canada travel current passport information. It is the traveler's responsibility to

comply with PII policies and the Privacy Act Statement of 1974. BAS maintains this sensitive information as PII in a secure database, and released only on a strict
official need-to-know basis.
7) Travel that involves Senior Federal Travelers (SES or equivalents) requires additional approval by BPA’s Senior Management Official (SMO); BAS will prepare the required
correspondence, maintain a file for five years, and submit required reports on all travel by BPA Senior Federal Travelers. Senior Federal Travelers from other agencies are required
to be reported to GSA through their agency.

8) Once a passenger transport Flight Request has been loaded into the Aircraft Services Flight Schedule a “Trip Number” will be issued to the Primary Trip Point-of-Contact (POC) by
the Aircraft Services’ Scheduler. All communications between Aircraft Services and the traveler(s) should reference the “Trip Number” to ensure effective communications and
quality control of the scheduling process.

9) Contact Aircraft Services @503.230.4100 or [email protected] if you have any questions regarding this form or travel policy aboard BPA aircraft.

PRIVACY ACT STATEMENT
Authority: 42 U.S.C. § 7101, et seq., 50 U.S.C. § 2401, et seq. FAA-H-80831A, Aircraft Weight & Balance Regulation.
Purpose: BPA aircraft operation, in accordance with Federal Aviation Administration (FAA) regulations, collects required information from passengers, including their
declared weight.
Routine Uses: A record from the system may be disclosed as a routine use to DOE contractors in performance of their contracts, and their officers and employees who
have a need for the record in the performance of their duties. Those provided information under this routine use are subject to the same limitations applicable to DOE
officers and employees under the Privacy Act. Other routine uses can be found listed in DOE-2 and DOE-11. Compliance is required for employees in hourly positions
subject to call for emergency work and/or subject to residency requirements, as well as employees in annual positions that have been specifically identified for emergency
call-back.
Disclosure: Disclosure of the requested information from BPA employees is voluntary; however, failure to provide the information could result in delayed notification in case
of an emergency. The information provided on this form may be disclosed to the FAA, the Office of Management and Budget, the General Accounting Office or other
government agencies to satisfy reporting/compliance requirements.
Page 2 of 3

File Code: FE-1140. Retention: Destroy when 3 years old, but longer retention is authorized if required for business use. Retention Schedule: GRS 5.4.120

BPA F 4450.01e
(10-2021)

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)
FLIGHT REQUEST

Paperwork Reduction Act Burden Disclosure Statement:
This data is being collected for the security, safety and necessity of passenger transport to and from power and transmission sites, and in support of
fish and wildlife mitigation efforts and other legal and government obligations. These passengers include, but are not limited to, BPA employees,
contractors, stakeholders, states, tribes and other members of the public to support BPA’s mission, legal obligations and government-to-government
relationships. The data you supply will be used by Aircraft services personnel to document all daily flights, purpose, and dates of their intended visit/
assignment. Public reporting burden for this collection of information is estimated to average .1 hour per response, including the time for reviewing
instructions, searching exiting data sources, gathering and maintaining that data needed, and completing and reviewing the collection of
information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing
this burden, to Office of the Chief Information Officer, Enterprise Policy Development & Implementation Office, IM-22, Paperwork Reduction
Project (OMB control number: 1910-xxxx), U.S. Department of Energy, 1000 Independence Ave SW, Washington, DC, 20585-1290; and to the
Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (OMB control number:1910-xxxx), Washington, DC 20503.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any 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 Paperwork Reduction Act (PRA) of 1995 requires each Federal agency to seek and obtain approval from the Office of Management and Budget
(OMB) before undertaking a collection of information directed to 10 or more persons of the general public, including persons involved in or
supporting the operations of Government-owned, contractor-operated facilities.
o

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File Code: FE-1140. Retention: Destroy when 3 years old, but longer retention is authorized if required for business use. Retention Schedule: GRS 5.4.120