OMB control number
Aviation Insurance
OMB 2120-0514 · DOT/FAA.
OMB 2120-0514
This is a renewal request. Air carriers, operators that are members of the Civil Reserve Air Fleet (CRAF), or direct contractors to DoD supporting the President's initiatives are required to respond to this collection and in return receive the benefit of insurance. The FAA uses information submitted by applicants for chapter 443 insurance to identify the eligibility of parties to be insured, the amount of coverage required, and insurance premiums. The information is a voluntary submission but is necessary for an operator or air carrier to obtain FAA insurance coverage. The data is collected on an as-needed basis for each carrier requesting insurance. The information collected is as follows: -Air Carrier POC -Name -Signature -Title -Air Carrier -Name -Business address -Business phone number -Business fax -Business email address -DoD contract number -Insurance policy and certification information: -Type and amount of coverage -Aircraft type -Tail number -Aircraft registration number -Serial number The information is used to issue war risk insurance to air carriers because they cannot obtain insurance through the commercial market. All information is maintained for records to issue policies and in the event of an accident involving one of the air carrier’s aircraft. The collected information is not publicly disseminated.
The latest form for Aviation Insurance expires 2029-09-30 and is listed under ICR 202501-2120-001.
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OMB Details
Application for Non-Premium Insurance
Federal Enterprise Architecture: Transportation - Air Transportation
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form 2120-0514 | Application for FAA Non-Premium War Risk Hull and Liability Insurance | aidms.faa.gov/ApplicationMoa | Form and instruction |
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