Free Preapplication Statement of Intent - Federal

Form Approved OMB No. 2120-0593 01/31/2008

PREAPPLICATION STATEMENT OF INTENT

US Department of Transportation Federal Aviation Administration
Paperwork Reduction Act Statement: Title 49 U.S.C., Section 44702 empowers the Secretary of Transportation to issue air carrier operating certificates and to establish minimum safety standards for the operation of the air carrier to whom such certificates are issued. The completed Preapplication Statement of Intent (PASI) denotes an intent by the applicant to continue the certification process. The local FAA Flight Standards District Office (FSDO) uses the PASI to evaluate the complexity of the proposed operation. The FAA will use the information it collects and reviews to ensure compliance and adherence to regulations and, if necessary, take enforcement action on violators of the regulations. The FAA estimates the average burden for this certificate application process, to include processing of this form, is 96 hours. Respondents have been given no assurance of confidentiality. An agency may not conduct or sponsor, and a person is not required to respon to a collection of information unless it displays a currently valid OMB control number. The OMB control number associated with this collection is 2120-0593. 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, ABA-20.

Section 1A. To Be Completed By All Applicants 1. Name and mailing address of company 2. Address of principal base where operations will be conducted (do not use post office box)

3. Proposed Start-up date 5. Management Personnel
Name (Last, first, middle)

4. Requested three-letter company identifier in order of preference
1. 2. Title 3. Telephone (including area code)

Section 1B. To Be Completed By Air Operators 6. Proposed type of operation (check as many as applicable)
Air Carrier Certificate Operating Certificate Part 121 Part 125 Part 135 Passengers and Cargo Cargo Only Scheduled Operations Nonscheduled Operations Single Pilot Operator Single Pilot-in-Command Operator Basic Part 135 Operator

Section 1C. To Be Completed By Air Agencies 7. Proposed type of agency and rating(s)
Part 145 Repair Station Domestic Foreign Satellite Airframe Powerplant Propeller Radio Instrument Accessory Specialized Service Part 149 Parachute Loft New Renew Part 147 Maintenance Technical School Airframe Powerplant Both

Section 1D. To Be Completed By Air Operators 8. Aircraft Data
Numbers and types of aircraft (by make, model, and series) Number of passenger seats or cargo payload capacity

9. Geographic area of Intended operations

FAA Form 8400-6 (6-95) Supersedes Previous Edition

NSN: 052-00-889-4002 0

Section 1E. To Be Completed By All Applicants 10. Additional information that provides a better understanding of the proposed operation or business (attach additional sheets, if necessary)

11. The statements and information contained on this form denote an intent to apply for FAA certification. Signature Date Name and Title

Section 2. To Be Completed By FAA District Office Received by (district office): Date: Remarks Date forwarded to Region:

For:

Action

Information only

Section 3. To Be Completed By Regional Office Received by: Date: District office assigned responsibility: Remarks Precertification Number: Date coordinated with AVN-120: Date forwarded to district office:

FAA Form 8400-6 (6-95) Supersedes Previous Edition

NSN: 0052-00-889-4002