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+------------+------------+----------------+---------+---------------+
| Submission |            |                |         |               |
| Date:      |            |                |         |               |
|            |            |                |         |               |
| (completed |            |                |         |               |
| by         |            |                |         |               |
| submitting |            |                |         |               |
| civil      |            |                |         |               |
| agency)    |            |                |         |               |
|            |            |                |         |               |
| **[CONTACT |            |                |         |               |
| INFORMA    |            |                |         |               |
| TION:]{.un |            |                |         |               |
| derline}** |            |                |         |               |
|            |            |                |         |               |
| Submitting |            |                |         |               |
| Official:  |            |                |         |               |
| **     **  |            |                |         |               |
| Title:     |            |                |         |               |
| **     **  |            |                |         |               |
|            |            |                |         |               |
| O          |            |                |         |               |
| rganizatio |            |                |         |               |
| n/Address: |            |                |         |               |
|            |            |                |         |               |
|            |            |                |         |               |
|            |            |                |         |               |
| Office     |            |                |         |               |
| Phone:     |            |                |         |               |
| **     **  |            |                |         |               |
|            |            |                |         |               |
| Cell       |            |                |         |               |
| Phone:     |            |                |         |               |
| **     **  |            |                |         |               |
|            |            |                |         |               |
| A          |            |                |         |               |
| uthorizing |            |                |         |               |
| Official   |            |                |         |               |
| (Airport   |            |                |         |               |
| Mgr or     |            |                |         |               |
| Eq         |            |                |         |               |
| uivalent): |            |                |         |               |
|            |            |                |         |               |
| E-mail     |            |                |         |               |
| address:   |            |                |         |               |
|            |            |                |         |               |
+------------+------------+----------------+---------+---------------+
| A/FD       |            |                |         |               |
| (Public    |            |                |         |               |
| Use        |            |                |         |               |
| Airports   |            |                |         |               |
| Only),     |            |                |         |               |
| E-MAIL     |            |                |         |               |
| Supplement |            |                |         |               |
| and        |            |                |         |               |
| Airport    |            |                |         |               |
| /Facility  |            |                |         |               |
| Directory  |            |                |         |               |
| (A/FD)     |            |                |         |               |
| Revisions  |            |                |         |               |
| TO:        |            |                |         |               |
| <9-ATOR-   |            |                |         |               |
| HQ-AIS-Air |            |                |         |               |
| portChange |            |                |         |               |
| s@faa.gov> |            |                |         |               |
| **Include  |            |                |         |               |
| Airport    |            |                |         |               |
| Ident and  |            |                |         |               |
| State      |            |                |         |               |
| (e.g.,     |            |                |         |               |
| KBVI, PA)  |            |                |         |               |
| in E-mail  |            |                |         |               |
| Subject    |            |                |         |               |
| Line.**    |            |                |         |               |
|            |            |                |         |               |
| Note:      |            |                |         |               |
| Airport    |            |                |         |               |
| Sketches   |            |                |         |               |
| and        |            |                |         |               |
| Airport    |            |                |         |               |
| Diagrams   |            |                |         |               |
| are        |            |                |         |               |
| submitted  |            |                |         |               |
| TO:        |            |                |         |               |
| 9-AWA-     |            |                |         |               |
| ATS-diagra |            |                |         |               |
| ms@faa.gov |            |                |         |               |
+------------+------------+----------------+---------+---------------+
| airport    | SUPP /     | LOCATION IDENT | STATE   | ## REGION     |
| name       | A/FD       | CONUS/ICAO     |         |               |
|            |            |                |         | (e.g.         |
|            | Page       | (e.g. BVI /    |         | NORTHEAST)    |
|            | number     | KBVI)          |         |               |
+------------+------------+----------------+---------+---------------+
| **     **  | **     **  | **     **      | **      | **     **     |
|            |            |                |      ** |               |
+------------+------------+----------------+---------+---------------+

Bottom of Form

+-----------------------------------------------------------------------+
| Use standard abbreviations found in A/FD General Information and FAA  |
| Order 7340.1. See format examples below. (Add pages as necessary).    |
|                                                                       |
| **[FORMAT EXAMPLES]{.underline}**                                     |
|                                                                       |
| See Airport/Facility Directory (A/FD) Legend Items 1-34.              |
|                                                                       |
| **TO ADD:** RMKS: ACTVT MIRL RY 01/19 AND PAPI RYS 01 & 19 ‑ CTAF.    |
|                                                                       |
| **TO DELETE:** RMKS: REIL RY 25 OTS INDEFLY.                          |
|                                                                       |
| **TO REVISE:** RADIO/NAV/WX RMKS: TOWER HRS 0600 -- 2100 LCL **TO:**  |
| 0600 -- 2200 LCL; APCH CTL 0600 -- 2100 LCL **TO:** 0600 -- 2200 LCL  |
+-----------------------------------------------------------------------+
| **ADD:** FORMTEXT                                                     |
|                                                                       |
| ######                                                                |
+-----------------------------------------------------------------------+
| **DELETE:      **                                                     |
+-----------------------------------------------------------------------+
| **REVISE:      **                                                     |
+-----------------------------------------------------------------------+

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