5500-2 PFC Amendment Request Form

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Overview

PRA
Instructions
5500-2 Amendment Form

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Sheet 1: PRA

		DEPARTMENT OF TRANSPORTATION	OMB CONTROL NUMBER 2120-0557
		FEDERAL AVIATION ADMINISTRATION	EXPIRATION DATE: 11/30/2024
	FAA Form 5500-2 Amendment Request

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Sheet 2: Instructions

Instructions for Form 5500-2
FORM 5500-2, PFC AMENDMENT FORM PASSENGER FACILITY CHARGE (PFC) AMENDMENT REQUEST PROJECT INFORMATION The information that a public agency must file when requesting authority to amend a PFC is specified in 14 CFR 158.37. In accordance with 49 U.S.C. 40117(c), a public agency that chooses to apply for authority to impose a PFC and for the authority to use PFC revenue on a project must do so by using FAA Form 5500-1, PFC Applicaton (latest edition) and all applicable attachments.
PASSENGER FACILITY CHARGE (PFC) NOTICE OF INTENT (NOI)
PROJECT INFORMATION
The information that a public agency must file when applying for authority to impose a PFC and for authority to use PFC revenue on a project is specified in 14 CFR Part 158. In accordance with 49 U.S.C. 40117(l), a public agency that chooses to apply for authority to impose a PFC and for authority to use PFC revenue on a project must do so by using FAA Form 5500-1, PFC Application (latest edition) and all applicable attachments.
The Amendment request form is found on the System of Airport Reports Airports External Portal. This report will prepopulate the currently approved project information.
Enter the requested amount(s) into the yellow shaded fields. Only populate the fields for projects to be amended. Do not include enter information for projects not requesting an amendment.
Project Information PFC Level: Enter the PFC level if the amendment is to change the PFC level for this project. Pay-As-You-Go: Enter the requested amount of Pay-As-You-Go. Bond Capital: Enter the requested amount of Bond Capital. Financing and Interest: Enter the requested amount of Financing and Interest. Project Total: Enter the total amount of the project including all sources of funding. Description of Proposed Amendment: Enter any changes in scope to the project or the reason for the amendment.

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Sheet 3: 5500-2 Amendment Form

Amendment Form

{Selection Criteria Variables}

{LOCID CD}

{Airport Name}

{Airport City and State}

Application Number:

{Application Number}

Application Status:

{Application Status}

Project Information

Project Number Abbreviation

Amendment Number

PA Title

Project Status

Project Type

Application Status

PFC Level

Pay-As-You-Go

Bond Capital

Financing & Interest

PFC Total

Project Total

Description of Proposed Amendment

{Project 1 Abbrv}

{Project 1 Sequence Nbr}

{Project 1 Title}

{Project Status Code}

{Project Type}

Current

{PFC Level}

{Pay-As-You-Go Approved Amt}

{Capital Approved Amt}

{Financing Approved Amt}

{Total Approved Amt}

{Total Project Amt}

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

Amended Request

{PFC Level}

{Amendment Pay-As-You-Go Amt}

{Amendment Capital Amt}

{Amendment Financing Amt}

{Amendment Total Approved Amt}

{Amendment Total Project Amt}

{Description of Proposed Amendment: Cost increase/decrease or change in funds}

{Project 2 Abbrv}

{Project 2 Sequence Nbr}

{Project 2 Title}

{Project Status Code}

{Project Type}

Current

{PFC Level}

{Pay-As-You-Go Approved Amt}

{Capital Approved Amt}

{Financing Approved Amt}

{Total Approved Amt}

{Total Project Amt}

N.A.

N.A.

N.A.

N.A.

N.A.

N.A.

Amended Request

{PFC Level}

{Amendment Pay-As-You-Go Amt}

{Amendment Capital Amt}

{Amendment Financing Amt}

{Amendment Total Amt}

{Amendment Total Project Amt}

{Description of Proposed Amendment: Cost increase/decrease or change in funds}

Totals

{Total Pay-As-You-Go Amt Requested}

{Total Bond Capital Amt Requested}

{Total Financing Amt Requested}

{Total Amt PFC Requested}

N.A.

N.A.