APPENDIX A to Part 1511

**Aviation Security Infrastructure Fee**

**[Instructions:]{.underline}**

***General guidance:***

When filling out this form, the responding air carrier or foreign air
carrier shall include all costs incurred in calendar year 2000 by that
air carrier for the screening of passengers and property. Costs are
those attributed to the screening of passengers and property in the
United States for both flights within the United States and flights from
the United States to foreign destinations. Reported costs must be
consistent with the air carrier's financial accounting information
reported in accordance with generally accepted accounting principles.

Where actual costs of screening passengers and property cannot be
directly identified through an air carrier's accounting system, the air
carrier shall use an appropriate alternate cost assignment methodology.
Documentation that explains and supports the assignment methodology
used, the applicable pool and the allocation basis must be made
available upon request. For costs related to capitalized property,
please report the associated depreciation expense incurred during
calendar year 2000. Capitalization policy must also be made available
upon request.

To the extent necessary, the reporting air carrier may aggregate those
specific costs that have been incurred but cannot be stated in the
detailed cost categories requested by this form. However, all of the
costs identified by this form must be included in the total
calculations. In addition, explanations regarding costs that have been
aggregated need to be provided. Costs reported in Appendix A do not need
to include costs that may have been incurred for a position higher than
those of the air carrier's director of security (or equivalent). Costs
incurred for higher positions, such as those of the air carrier's chief
executive officer, do not need to be included.

When including cost information on acquired and/or merged air carriers,
the successor air carrier must specify the names of all of such entities
whose calendar year 2000 passenger and property screening costs are
included in that air carrier's submission as Appendix A.

The costs listed below are to be in US dollars, rounded to the nearest
dollar. Place a zero in the appropriate box to indicate cost categories
in which the air carrier did not incur costs for passenger and property
screening in calendar year 2000.

***Supporting Notes:***

Examples of cost types that appear in the supporting notes below are for
illustrative purposes only and are not intended to set forth all
relevant costs that must be reported by air carriers and foreign air
carriers. In submitting information to TSA, air carriers and foreign air
carriers must submit all of their relevant costs, regardless of whether
those cost have been specifically illustrated in the notes.

***Submission of Data:***

This form will be available electronically from the Department of
Transportation's website at [www.dot.gov](http://www.dot.gov/). Air
carriers are asked to return the completed form by certified mail to:
Chief Financial Officer, Transportation Security Administration,
Department of Transportation, 400 Seventh Street SW, Washington, DC
20590. Please also submit the same information in Microsoft Word either
on a computer disk or by e-mail to TSA-Fees@ost.dot.gov.

***Confidentiality of Data:***

Consistent with 49 CFR § 1511.5(f), information submitted in Appendix A
is deemed to be Sensitive Security Information and will be so protected
from public disclosure under 49 U.S.C. 40119(b). In addition,
confidential business information and economic information provided in
Appendix A will be protected from public disclosure, as appropriate,
under 5 U.S.C. § 552 (the Freedom of Information Act), 14 CFR § 302.12,
and 18 U.S.C. § 1905. Requests for confidentiality must be filed with
the Office of the General Counsel, Department of Transportation (C-10),
400 Seventh Street, SW, Room 10102, Washington, DC 20590.

**[Calendar Year 2000 Costs for Passenger and Property
Screening:]{.underline}**

Air Carrier name(s):
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date Form Completed: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+-------+---+---------------+---------+----------+----------+---------+
| #     | # | **[Cost       | *       | **[Costs | **[Costs | *       |
|       |   | Categories]{  | *[Costs | Incurred | Incurred | *[Total |
|       |   | .underline}** | I       | Through  | Through  | Costs   |
|       |   |               | ncurred | Security | Other    | In      |
|       |   |               | D       | Firm     | Means]{. | curred] |
|       |   |               | irectly | Cont     | underlin | {.under |
|       |   |               | by Air  | racts]{. | e}**[^3] | line}** |
|       |   |               | Carrie  | underlin |          |         |
|       |   |               | rs]{.un | e}**[^2] |          |         |
|       |   |               | derline |          |          |         |
|       |   |               | }**[^1] |          |          |         |
+=======+===+===============+=========+==========+==========+=========+
| ***A) | 1 | Checkpoint    |         |          |          |         |
| Scre  |   | Screening     |         |          |          |         |
| ening |   | Personnel     |         |          |          |         |
| Pers  |   |               |         |          |          |         |
| onnel |   |               |         |          |          |         |
| and   |   |               |         |          |          |         |
| Super |   |               |         |          |          |         |
| visor |   |               |         |          |          |         |
| s:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Exit Lane     |         |          |          |         |
|       |   | Monitors      |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 3 | Cargo         |         |          |          |         |
|       |   | Screeners     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 4 | Checked       |         |          |          |         |
|       |   | Baggage       |         |          |          |         |
|       |   | Screeners     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 5 | Baggage       |         |          |          |         |
|       |   | Runners       |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 6 | Supervisory   |         |          |          |         |
|       |   | Personnel     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 7 | Non-Labor     |         |          |          |         |
|       |   | Costs         |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 8 | Background    |         |          |          |         |
|       |   | Checks        |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 9 | Training and  |         |          |          |         |
|       |   | Testing       |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Training      |         |          |          |         |
|       | 0 | Records       |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Evaluations   |         |          |          |         |
|       | 1 |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Drug and      |         |          |          |         |
|       | 2 | Alcohol       |         |          |          |         |
|       |   | Testing and   |         |          |          |         |
|       |   | Treatment     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Uniforms      |         |          |          |         |
|       | 3 |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | ### Canines   |         |          |          |         |
|       | 4 |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | ##            |         |          |          |         |
|       | 5 | # Cost of Obt |         |          |          |         |
|       |   | aining Securi |         |          |          |         |
|       |   | ty Clearances |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       |   | #### Total    |         |          |          |         |
|       |   | for Section A |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
| ***B) | 1 | Screening     |         |          |          |         |
| Equi  | 6 | Equipment     |         |          |          |         |
| pment |   | Installation  |         |          |          |         |
| and   |   |               |         |          |          |         |
| Proc  |   |               |         |          |          |         |
| edure |   |               |         |          |          |         |
| s:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Operating,    |         |          |          |         |
|       | 7 | Operational   |         |          |          |         |
|       |   | Maintenance   |         |          |          |         |
|       |   | and Testing   |         |          |          |         |
|       |   | of Installed  |         |          |          |         |
|       |   | Screening     |         |          |          |         |
|       |   | Equipment     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Maintenance   |         |          |          |         |
|       | 8 | of Sterile    |         |          |          |         |
|       |   | Areas         |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 1 | Checkpoint    |         |          |          |         |
|       | 9 | Signs and     |         |          |          |         |
|       |   | Related       |         |          |          |         |
|       |   | Equipment     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Exceptional   |         |          |          |         |
|       | 0 | Screening for |         |          |          |         |
|       |   | Persons and   |         |          |          |         |
|       |   | Property      |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Security      |         |          |          |         |
|       | 1 | Company       |         |          |          |         |
|       |   | Contracts     |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       |   | #### Total    |         |          |          |         |
|       |   | for Section B |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
| ***C) | 2 | Real Estate   |         |          |          |         |
| Pro   | 2 |               |         |          |          |         |
| perty |   |               |         |          |          |         |
| and   |   |               |         |          |          |         |
| Plan  |   |               |         |          |          |         |
| t:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Utilities     |         |          |          |         |
|       | 3 |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       |   | #### Total    |         |          |          |         |
|       |   | for Section C |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
| ***D) | 2 | Ground        |         |          |          |         |
| Pr    | 4 | Security      |         |          |          |         |
| ogram |   | Coordinators  |         |          |          |         |
| Man   |   |               |         |          |          |         |
| ageme |   |               |         |          |          |         |
| nt*** |   |               |         |          |          |         |
|       |   |               |         |          |          |         |
| *     |   |               |         |          |          |         |
| **and |   |               |         |          |          |         |
| Con   |   |               |         |          |          |         |
| tract |   |               |         |          |          |         |
| Ove   |   |               |         |          |          |         |
| rsigh |   |               |         |          |          |         |
| t:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Security      |         |          |          |         |
|       | 5 | Program       |         |          |          |         |
|       |   | Management    |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Security      |         |          |          |         |
|       | 6 | Contract      |         |          |          |         |
|       |   | A             |         |          |          |         |
|       |   | dministration |         |          |          |         |
|       |   | and Oversight |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Screen        |         |          |          |         |
|       | 7 | er/Supervisor |         |          |          |         |
|       |   | Background    |         |          |          |         |
|       |   | Check Audits  |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Legal Support |         |          |          |         |
|       | 8 |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 2 | Accounting    |         |          |          |         |
|       | 9 | Support       |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 3 | Other         |         |          |          |         |
|       | 0 | A             |         |          |          |         |
|       |   | dministrative |         |          |          |         |
|       |   | Support       |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 3 | Insurance     |         |          |          |         |
|       | 1 |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 3 | Law           |         |          |          |         |
|       | 2 | Enforcement   |         |          |          |         |
|       |   | Costs         |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       | 3 | Recruitment   |         |          |          |         |
|       | 3 | Expenses      |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       |   | #### Total    |         |          |          |         |
|       |   | for Section D |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
| ***E) | 3 | Management    |         |          |          |         |
| Sec   | 4 | Fees for      |         |          |          |         |
| urity |   | Oversight of  |         |          |          |         |
| Conso |   | Consortium    |         |          |          |         |
| rtium |   | Contracts     |         |          |          |         |
| Cost  |   |               |         |          |          |         |
| s:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       |   | #### Total    |         |          |          |         |
|       |   | for Section E |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
| ***F) | 3 | Other         |         |          |          |         |
| Othe  | 5 |               |         |          |          |         |
| r:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
|       |   | #### Total    |         |          |          |         |
|       |   | for Section F |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+
| ***   |   |               |         |          |          |         |
| Total |   |               |         |          |          |         |
| for   |   |               |         |          |          |         |
| all   |   |               |         |          |          |         |
| Se    |   |               |         |          |          |         |
| ction |   |               |         |          |          |         |
| s:*** |   |               |         |          |          |         |
+-------+---+---------------+---------+----------+----------+---------+

**Supporting Notes**

a.  These are costs that the air carrier incurred directly. Includes
    costs incurred for air carrier personnel salaries and benefits,
    equipment owned, leased or rented directly by that air carrier and
    any other costs directly incurred.

b.  These are costs that the air carrier incurred through contracts with
    security firms. Includes personnel, equipment and other costs
    incurred through contracts with third party security companies.

c.  These are costs that the air carrier incurred through other means.
    Includes costs incurred through air carrier security consortiums.

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1.  Salary, benefits, overtime, retirement and other costs of checkpoint
    screening personnel.

2.  Salary, benefits, overtime, retirement and other costs of exit lane
    monitors.

3.  Salary, benefits, overtime, retirement and other costs of cargo
    screeners.

4.  Salary, benefits, overtime, retirement and other costs of checked
    baggage screeners.

5.  Salary, benefits, overtime, retirement and other costs of all
    baggage runners who move property such as baggage to and from
    screening areas.

6.  Salary, benefits, overtime, retirement and other costs of all
    supervisory personnel, including Checkpoint Screening Supervisors.

7.  All associated expensed non-labor costs including computers,
    communications equipment, time management systems, supplies,
    parking, identification badging, furniture, fixtures, and travel.

8.  All costs of performing required background investigations on all
    screening personnel and supervisors. Screening personnel and
    supervisors includes checkpoint screening personnel, exit lane
    monitors, cargo screeners, checked baggage screeners, baggage
    runners, and their supervisors.

9.  All costs incurred for the training and testing of all screening
    personnel and supervisors, including initial, recurrent and remedial
    training. Includes any computer-based training and the development
    of training programs for the screening of persons and property as
    well as any travel, room and board, and all other such expenses
    related to training.

10. The costs of implementing and maintaining training records for all
    screening personnel and supervisors.

11. The costs of completing evaluations for all screening personnel and
    supervisors.

12. All costs for drug and alcohol testing as well as any associated
    counseling and/or treatment for all screening personnel and
    supervisors.

13. All costs of renting, purchasing, maintaining, and/or cleaning of
    uniforms and any related equipment such as flashlights and batons
    for all screening personnel and supervisors.

14. All costs incurred by air carriers for the use of canines and their
    handlers used for the screening of persons and property.

15. All costs associated with obtaining security clearances for
    personnel relating to the screening of persons and property.

16. All costs associated with the purchase, installation, and testing of
    all screening equipment. In instances where the equipment is
    capitalized, provide the depreciation expense in lieu of costs
    associated with purchase, installation, and final acceptance
    testing. This includes such equipment as Metal Detection Devices,
    Hand Wands, X-ray screening machines, Explosives Trace Detection
    Devices, Explosives Detection Systems, or any other such similar
    technologies. Includes any costs incurred or depreciation costs
    recognized in calendar year 2000 for the modification and/or
    construction of any facility needed to accommodate screening,
    including architecture and engineering. Also includes the costs of
    any refurbishment and/or modernization of the equipment.

17. Costs of operating, maintaining, and calibrating installed screening
    equipment. This includes such equipment as Metal Detection Devices,
    Hand Wands, X-ray screening machines, Explosives Trace Detection
    Devices, Explosives Detection Systems, or any other such similar
    technologies. Includes such costs as test objects and X-ray
    radiation surveys, electricity costs and maintenance contract costs
    incurred for the operations of such equipment.

18. Costs of maintaining integrity of sterile areas. Includes costs of
    opening sterile areas, emergency evacuations of sterile areas, and
    re-screenings not included elsewhere.

19. The cost of purchase or rent, installation, testing, and maintenance
    of checkpoint signs, barriers, lane markers, and exit lane doors.

20. Any additional costs for special screening such as for disabled
    passengers, VIP passengers, classified and/or high value items.

21. All security company contract costs for the screening of persons and
    property that cannot be detailed into any other cost category.

22. All direct costs for the real estate utilized for the screening of
    persons and property. Includes space at airports for the performance
    of these functions, as well as such space used for break rooms,
    private screening rooms, storages space, training rooms, and office
    space. Also includes appropriate space for the oversight of the
    screening functions outside of airports such as in headquarters or
    regional offices.

23. All costs for utilities used for screening. Includes electricity,
    heating/ventilation/cooling, and telecommunications costs not
    elsewhere specified.

24. All costs incurred for the Ground Security Coordinator's oversight
    of the screening functions. Includes personnel salaries, benefits,
    retirement, training, and non-labor costs.

25. All air carrier head office, regional, or airport specific costs
    associated with the administration and oversight of screening not
    elsewhere specified. Includes personnel salaries, benefits,
    retirement, training, and non-labor costs.

26. All costs associated with the administration and oversight of
    screening contracts. Includes personnel, benefits, retirement,
    training, and non-labor costs.

27. All costs not elsewhere specified for background audit checks for
    all screeners and supervisors.

28. All legal support costs incurred during calendar year 2000 relating
    to aviation security screening. Includes legal assistance for the
    implementation and execution of security screening contracts.

29. All costs for accounting and financial services incurred for the
    support of the screening functions.

30. Includes all labor and non-labor costs for such items as human
    resource administration, clerical assistance, information
    technology, and other support functions related to screening.

31. All insurance costs relating to screening. Includes worker's
    compensation and general liability insurance.

32. All costs incurred by the air carriers for law enforcement personnel
    costs that were reimbursed by the air carriers for services
    performed in connection with the screening of persons and property.

33. All costs associated with the recruitment of screening personnel and
    supervisors. Includes signing bonuses, travel, and other recruitment
    expenses.

34. Any costs incurred for fees charged by other organizations for the
    management of contracts for the screening of persons and property.

35. Any costs incurred not elsewhere specified during calendar year 2000
    for the screening of passengers and property. These costs should be
    itemized on a separate sheet. Includes any fines or monetary
    penalties incurred for screening as well as any profit/bonuses paid
    to contractors for screening services not included elsewhere on the
    form.

***Certification:***

I certify that the information contained in this form (Appendix A-Part
1511) is true and accurate under penalty of law. Willful falsification
of any information contained in this form under Part 1511 in Title 49,
Chapter XII may be prosecuted criminally and result in a fine and/or
imprisonment. (18 U.S.C. 1001)

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Certifying Officer (signature) Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Print Name and Title (CEO, CFO or COO) Telephone Number

***Contact Information:***

Listed below are the contact name, title, address and telephone number
of the person responsible for the payment of the Aviation Security
Infrastructure Fees to the Transportation Security Administration:

Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Telephone:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***Person Who Prepared Document:***

Listed below are the contact name, title, address and telephone number
of the person who prepared this document:

Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Title:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Telephone:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

[^1]: ^a^

[^2]: ^b^

[^3]: ^c^