Appendix B B-1 Appendix B. Example of Completed DOC Form
Unmanned Aircraft Remote Identification Declaration of Compliance [ X ] Unmanned Aircraft or [ ] Broadcast Module The remote identification of unmanned aircraft is necessary to ensure public safety and the safety and efficiency of the airspace of the United States. Once your information is officially processed, you will receive an email notification from the FAA automated mailbox, stating that we have received your Declaration of Compliance.
Please note, UAS certificated under Part 21 (in any equipped operation under this rule) must show compliance in accordance with Part 21 type certification procedures and the applicable airworthiness standards for all systems aboard the aircraft, including remote identification.
Complete the application below and receive acceptance for your Declaration of Compliance to 14 CFR part 89, Remote Identification of Unmanned Aircraft. To submit a Declaration of Compliance, you must be 13 years of age or older.
1. PRODUCER INFORMATION First Name Last Name OR Company Name Alpha Aircraft Company Physical Address (P.O. Boxes Not Allowed) Mailing address (if different from physical address) Address 1 1234 Alpha St. Address 1 5678 Beta St.
Address 2 Address 2 City Kansas City State KS Postal Code 12345 City Market City State MO Postal Code 67890 Country United States Country United States
2. POINT OF CONTACT INFORMATION First Name Jane Last Name Doe Email Address janedoe@alphaaircraftco.com Telephone Number (1)-555-123-4567 Is this declaration of compliance an initial or amended declaration? Initial X Amended If this is an amended declaration of compliance, provide the initial DOC Tracking number assigned: DOC # 12-5-2018-0001 If this is an amended declaration of compliance, is the re-submittal a result of a safety issue or a noncompliance with a prior declaration of compliance?
YES X NO If answered yes above, please briefly explain the safety issue:
4. STANDARD REMOTE ID UNMANNED AIRCRAFT OR REMOTE ID BROADCAST MODULE(S) Make A-1 MOC Tracking Number(s) NOA MOC 123-456 Model Proflight Serial Number(s) MFRA41000 to MFRA41010 FCC Identifier ABCDE1234
5. DECLARATION OF COMPLIANCE WITH APPLICABLE REGULATIONS X Pursuant to § 89.530(b)(7) or § 89.530(c)(7), as applicable, I declare that the standard remote identification unmanned aircraft or remote identification broadcast module(s) with serial numbers listed on this Declaration of Compliance comply with all applicable requirements of 14 CFR part 89 for remote identification of unmanned aircraft, as identified in the following means of compliance: [List applicable MOC tracking number(s) used for compliance in Section 4 above].
X Pursuant to § 89.515(b) or § 89.520(b), as applicable, I declare that the person responsible for the production of the standard remote identification unmanned a ircraft or remote identification broadcast module listed on this Declaration of Compliance will allow the Federal Aviation Administ ration to inspect the facilities of the producer identified in the Declaration of Compliance, as well as any associated technical data and any produced standard remote identi fication unmanned aircraft or remote identification broadcast module, and to witness any tests necessary to determine compliance with part 89.
X Pursuant to § 89.515(b) or § 89.520(b), as applicable, I declare that the producer listed on this Declaration of Compliance will conduct independent audit s of the facilities, technical data, and any standard remote identification unmanned aircraft or remote identification broadcast mo dules that are produced and listed under this Declaration of Compliance on a recurring basis to ensure compliance with the requirements of part 89, or if the FAA notifies the producer of non-compliance concerns of any standard remote identification unmanned aircraft or remote identification broadcast modules listed on this Declaration of Compliance.
X Pursuant to § 89.515(b) or § 89.520(b), as applicable, I declare that the producer listed on this Declaration of Compliance has product support and notifi cation procedures for the purpose of notifying the public and the FAA of any defect or condition that causes the standard remote ide ntification unmanned aircraft or remote identification broadcast module listed under the Declaration of Compliance to no longer meet the requirements of part 89.
X Pursuant to § 89.530(b)(8) or § 89.530(c)(8), as applicable, I declare that the radio frequency equipment used in the standard remote identification unmanned aircraft or remote identification broadcast module(s) listed on this Declaration of Compliance are 47 CFR part 15-compliant and have been integrated into the unmanned aircraft or remote identification broadcast module(s) without modification to its/their authorized radio frequency parameters.
For Remote Identification Broadcast Module(s) ONLY: Pursuant to § 89.530(c)(8), I declare that instructions have been provided for installation of 47 CFR part 15-compliant remote identification broadcast module without modification to the broadcast module’ s authorized radio frequency parameters.
If the FAA has designated that you need additional information to support your Declaration of Compliance, please attach to this form.
Name: Jane Doe Title: Chief Engineer Signature/Date: JaneDoe 12/01/2020
OMB Control Number:
2120-0746 (Expiration Date: 08/31/2021) 12/22/20 FAA Form 1320-73 (06-2020) C-1 Appendix C. Advisory Circular Feedback Form
If you find an error in this AC, have recommendations for improving it, or have suggestions for new items/subjects to be added, you may let us know by (1) emailing this form to 9-AWA-AVS-AIR- DMO@faa.gov or (2) faxing it to the attention of the LOB/SO (202) 267-1813.
Subject: AC 89-2, Declaration of Compliance Process for Remote Identification of Unmanned Aircraft.
Date:
Please mark all appropriate line items:
□ An error (procedural or typographical) has been noted in paragraph on page .
□ Recommend paragraph on page be changed as follows:
□ In a future change to this AC, please cover the following subject:
(Briefly describe what you want added.)
□ Other comments:
□ I would like to discuss the above. Please contact me.
Submitted by: Date:
Paperwork Reduction Act Burden Statement: A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a 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 tha t collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120 - 0746. Public reporting for this collection of information is estimated to be approximately 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. All responses to this collection of information are voluntary to obtain or retain benefits per 14 CFR 77. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177 - 1524.