Approved by OMB OMB No. 2120-0633 Expires: 2/28/09
PAPER WORK REDUCTION ACT OF 1995 This information is collected to determine whether air taxi operations meet the Department's criteria for an operating authorization under 14 CFR Part 298. We estimate that it will take approximately 30 minutes to complete. The use of this form is mandatory. Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. The OMB Control Number for this collection is 2120-0633. Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the FAA at: 800 Independence Ave. SW, Washington, DC, 20591, Attn: Information Collection Clearance Officer, AIO-20
FOR USE BY DOT ONLY
U.S. Department of Transportation Office of the Secretary of Transportation
AIR TAXI OPERATOR REGISTRATION AND AMENDMENTS UNDER PART 298 OF THE REGULATIONS OF THE DEPARTMENT OF TRANSPORTATION
Where to file: Submit this form, in duplicate, along with a Certificate of Insurance (OST Form 6410) evidencing required liability insurance coverage for the aircraft listed in Block 6 of this registration, to the Federal Aviation Administration (FAA), Air Transportation Division, AFS-200, Room 831, 800 Independence Avenue, S.W., Washington, D.C. 20591. Exception: For air taxis located in the State of Alaska, submit this form and the OST Form 6410 to the Federal Aviation Administration (FAA), Alaskan th Region Headquarters, AAL-230, 222 West 7 Avenue, Box 14, Anchorage, Alaska 99513. Fees: The fee for the initial registration of an air taxi is $8. There is no filing fee for amendments to registrations previously filed.
Effective date of registration/amendments
1a. Name (and DBA, if applicable) and Mailing Address of the Registering Carrier:
3a. Federal Aviation Administration certificate number:
3b. Address of local FAA office:
1b. Telephone No. ____________________________ Fax No. ________________________________ 2a. Address of principal place of business (if different from above):
3c. FAA Telephone No.:
3d. FAA Principal Operations Inspector:
2b. Telephone No. ___________________________ Fax No. ________________________________ 4. This filing is the carrier's: Initial Registration Amendment to reflect changes since previous filing (Complete item 9)
If initial registration, give proposed date of commencement of operations: _____________________________________________ 5. Check type or types of service the carrier intends to perform upon commencement of operations, or, for amendments, service the carrier is currently performing: Scheduled passenger* Scheduled cargo Mail under a U.S. Postal Service contract On-demand passenger On-demand cargo Air ambulance Seasonal
Other (Please specify)** _________________________________________________
* Check only if service is limited to less than five (5) round trips per week on at least one route between two or more points and is operated pursuant to published flight schedules which specify the times, days of the week, and places between which such flights are performed. Companies proposing or operating scheduled passenger services of five (5) or more round trips per week on at least one route between two or more points pursuant to published flight schedules which specify the times, days of the week, and places between which such flights are performed may not conduct such operations under this registration. Instead, such companies must be found "fit, willing, and able" to provide such services as a commuter air carrier. See 14 CFR 298, Subpart E. ** For example, if the carrier performs other services such as fire fighting operations for the U.S. Forest Service, it should be indicated here. OST Form 4507 (Rev. 2-06)
6. Aircraft which the carrier proposes to operate in air taxi service or, for amendments, aircraft currently operated: Aircraft Make and Model 1. _______________________________ 2. _______________________________ 3. _______________________________ 4. _______________________________ 5. _______________________________ FAA Registration Number ____________________________________ ____________________________________ ____________________________________ ____________________________________ ____________________________________ Passenger Seats Installed* ________________ ________________ ________________ ________________ ________________
7. Is the registering carrier a U.S. citizen? YES NO
Note: An air taxi or commuter registered under Part 298 must be a citizen of the United States. 49 USC 40102(a)(15) defines a U.S. citizen as (a) an individual who is a U.S. citizen: (b) a partnership of which each member is a U.S. citizen; or (c) a corporation or association organized under the laws of the United States or a state, the District of Columbia, or a territory or possession of the United States, of which the president and at least two-thirds of the board of directors and other managing officers are citizens of the United States, which is under the actual control of citizens of the United States, and in which at least 75 percent of the voting interest is owned or controlled by persons that are citizens of the United States.
(Add additional sheets if necessary) * This does not include seats occupied by the pilot or co-pilot unless the latter is available for passenger use.
8. If this is an amendment, has the carrier carried passengers in foreign air transportation, that is, between any point in the United States and any point outside thereof, during the past 12 months: YES NO
9. REPORT CHANGES OR AMENDMENTS TO INFORMATION PREVIOULSLY FILED WITHIN 30 DAYS OF THE EFFECTIVE DATE: a. Change in Carrier's Name and/or Address (Please specify): Former Name and Address: Current Name and Address:
b. Description of Any Other Changes or Amendments (Including additions or deletions of aircraft, change in type of operations, registration numbers, etc.):
I certify that the information contained in this application is complete and accurate to the best of my knowledge. The carrier subscribes to the IATA Intercarrier Agreement; the IATA Agreement on Measures to Implement the IATA Intercarrier Agreement, and the ATA Agreement on Provisions Implementing the IATA Intercarrier Agreement to be Included in Conditions of Carriage and Tariffs (see OST Form 4523-A), and in accordance with those Agreements agrees under Article 22(1) of the Warsaw Convention or the Warsaw Convention as amended by the Hague Protocol that the liability limits for passenger injury or death in international transportation as defined in the Convention are waived in their entirety.
Signature: ______________________________________________________ (See note) Date: _________________________________________________________ Name: _________________________________________________________ (Please type)
Place: ________________________________________________________ (City and State)
Note: This registration must be signed by a responsible officer, such as the President, Vice President, Secretary or Treasurer, or partner or owner of the carrier.
TO ENSURE PROPER PROCESSING OF THIS REGISTRATION, PLEASE COMPLETE THIS FORM IN ITS ENTIRETY.