12/22/2014 09:43 4252271007

Jeffrey M. Harper FAA Office of Regional Counsel 1601 Lind Avenue Southwest Renton, Washington 98057 T (425) 227c216l F (425) 227c1007 ANM7



### UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION OFFICE OF HEARINGS

WASHINGTON, D.C. 

### Jn the Matter of: Air Medical Resource Group, lnc. DMS No. FAA-2014-0551 FAA Case No. 2014WP9l0076 Honorable Richard C. Goodwin 

### MOTION TO TAKE JUDICIAL NOTICE In accordance with l4 C.P.R.§ 13.218 and Federal Rule ofEvidence 201, Complainant asks thatju.dicia\ notice be taken of: 

### 1. 

### fAA Order 2150.3B, Chapter 7;"' 1 

### 2. FAA Order 2150.3B, Appendix B, Pages B-1 to B-3"' and B-31 to B-40;"' 2 

### 3. 40 C.P.R. 

### § 40.ll(b),"' establishing that employers are responsible for the actions oftheir agents in carrying out the requirements ofDOT agency drug and alcohol testing regulations. 4. 74 F.R. 22653,"" recodifying 

### .14 C.P.R. Part 121, Appendices I and 

### J as 14 C.F.R. Part 120. 5. 69 F.R. 1840,= in pardoular paragraph 

### VA on page 1845, discu.ssing the FAA's deliberate intention ofchanging the pre·employ:rnent drug testrequirement from a pre-performance requirement to a pre-hire requircroent. 6. FAA Office ofChiefCounsel Legal Interpretation, datedNovel)'lber 19,2014, addressed to Mr. .Edward**Schaff,'~** 

### reiterating that the 14 C.P.R.§ l20.109(a)(l) requirement requires testing prior to hire, 7. FAA Office ofChiefCounsel Legal Interpretation, dated May 31, 2005, addressed to Ms. Deborah McElroy, affirming that the pre-employment drug test

1 

### A vailable at http://www.faa.gov/documcntLibrary/mec\ia!Ordor/2150.3B_ W

-C.hg__6.pdf 2 !d. PAGE 02/12

### 12/22/2014 09:43 4252271007 ANM7



### requirement is a pre-hire requirement, not a pre-perfonnance requirement. Enclosure \ .""' 8. That U.S. Department ofJustice, Financial Statement ofDebtor (Business) is a six-page 

## form, requiring attachments documenting 

## and substantiating the debtor's responses, which must 

### be signed by a 

### representative ofthe 

### debtor. Enclosure 2."" 

### Respectfully submitted this22°cl day 

### of December, 2014. Digitally signed by JEFFREY M HARPER



# .d 4 

# &··· ·. DN: 

## c,us, o=U.S. Government,

### /~·, 

## //:1;.**'~..----~-~ ou~ANM,** **ou~ANM,** 

## I,!- ----<:P"'-JHFREY M HARPER

## !'~M. . Harper 

### Dote: 

### 21)14, 12.19 16:18:1 

### B FAA Attorney

_ 08,00,

Motion to Take JudlciBI Notice In the Matter of Air Medical Re$ource Group, lnc. OMS No. FAA-2014-055).; FAA Case No. 2014WP910076**~8ge?.:** of 3 Jeffrey M- Harper. FAA Attorney T (425) 227-2J.61 F (425) 227·1007 

### PAGE 03/12

### 12/22/2014 09:43 4252271007 

### ANM7



## CERTIFICATE OF SERVICE I hereby certify that the foregoing Motion to take Judicial Notice has been served via facsimile and Certified Mail- Return Receipt Requested this date, to 

### the following: Attn: Hearing Docket Clerk, AGC-430 Wilbur Wright Building- Suite 2W1 000 

### Fedcral Aviation Administration 800 Independence Avenue SW Washington, DC 20591 Fax: (202) 267-1293 I 

### hereby certify that the foregoing Motion to take Judicial Notice has been served via facsimile, Certified Mail- Return Receipt Requested, and e-mail this date, to the foUowing: Tb.e Honorable Richard C. Goodwin 

### Office ofHearings, M-20 1200 New Jersey Avenue, 

### S.E. (EJ 1-310) Washington, DC 20590 Fax: (202) 366-7536 richard.goodwin@dot.gov Jared M. Allen, Esq. The Aviation LawFirm 1997 Annapolis Exchange Parkway, Suite 300 Annapolis, .MD 21401 Tel: (301) 294-8550 Fax: (866) 568-9886 jaUen@aviationlawexperts.com Dated this 22"d day ofDecember, 2014. 

# {ta£

# 'c'lZ~Z\tCz\.... lf5ana Stephenson ···' 

### Offi.ce ofRegional Counsel (ANM-7) Federal Aviation Administration 1601 Lind Ave. SW Renton, WA 98057 (425) 227-2164 PAGE 04/12

Mollon to Take Judicial Notice In the Maner oi· Alr Medical Resource Group, Inc.. DMS No. FAA-20H-0551; FAA Case No. 2014WP9l0076 Page 3 of 3 Jeffrey M. Harper, FAA Attorney T (425) 227·216:1. F (425) 227-1007

### 12/22/2014 09:43 4252271007



### U.S. Department of Tmnsportatklh Federal Aviation:**A<lrnlnl~!n>tl<on** 

## MAY 3 1 2005 Deborah McElroy P:rcsidcnl 

### Regional Airline Association Suite 800 2025 M Street, NW Washington, DC 20036 

### Dear Ms, McElroy: ANH7 

### PAGE 05/12**•-•\""1'··:,·-~·''''·'·,·:·** · ·

BOO**ln(J~p<ll160n"'** AV2., S.W, Washinl)lon, O.C, Z0591



### As you k."loW, 

### on, January I

# z .. 2004,**w~** 

### hE,d issued a fmal rule changing the pre-employm.ent testi,ng requiiemeiJt to 1t 

### "prior to hire'' requirement lnl4 CFR part, 121, appendix I; sectionV.A Prior to the February !I, 2004, effective date ofthe regulatrJry cbange, you had asked for guidance to assist 

## i!'l implementing the prior to hire requirement. On. Feb:ruary 3, 2004, Patrice M. Kelly, ofmy staff, sent you an email discussing the changes to the pre-employment testing requirements. The:.:e has been confusion among some employers regarding the guidance 

### in the 

## February 

## 3, 2004 email, andthdr 

### actions have rc8tilted 

### in noncompliance with 

### the pte-employment testing requirement. As 

### you know, 

### lthas been more than a year**sine~** 

### thl" regulation. !4 CFR part

### 121, appendix 

# r, cbanged the pre-employment testing requirement to a "prior to hire" requirement. We believe that 

### the wording ofthe regula.tion is vcry clear and employers must follow the 

### language ofthe regulation, Therefore, 

### this letter rescinds the email sent to you un F 

### ebmary 

### :1, 2004. As y<>u know, 14 CFR part 121, appendix I, section 

### V.A. clearly stares pre-employment testing must bt: conducted and a neg<ltiVe drug test result received before an individual is hired for a safety-sensitive futiction 

# or tJ:ansferred 

### from a non-safety-sensithre function to a safety-sensitive function. As we 

### stated in 

### the preamble 

### to the final rule changing the 

### prc,employ;ment testing 

### req_uir<:ment back to "prior to hire":. 

### "Pre-employment tc.'lting is directly tied to 

### aviation safuty, 

### in that it is a gateway to**snfety~en:Jitiv<:** 

### positions. Fall(Ire ofa proe<employrnent test is adirectbamer 

### to an individual's entry into safety-sensitive positions," 69 Fcd9;al**Regl!ite~:** 

### 1840, 1845 (Jan. 12, 2004) 

### We consider pre-employment testing to be**parti~ularly** 

### critical because 

### ithas been**th~** 

### source ofthe largest nUlilbor ofpositive drug test results in the aviation industry, Between the inception of d1'Ug testing in 

### 1990 and 

### calendar yeat 

### 2003, the aviation industry hasreported 21,583 positive pre" employment drug test result,>. The reports 

### received to 

### date fur 2004 show 84S**mor~** 

### positive preemployment drug test results. 

# Enclosure 1

'•'. ' 

## 180

### 12/22/2014 09:43 4252271007 ANM7 

### PAGE 05/12 ' '..**~** . . ' .. ; ' . . ···.·.·

### .... ·.··,


### 2 

### In

### the 2004 

### final rule, we explained we were restoring the pre-1994 regulatory language of tooting "prior 

### to hire" because pre-employment testing violations had become OU!.' 

### most frequent em?loyer violation after the 1994 regulatory change. By 

### going back to the "'prior to hire" language, we 

### were re-establishing a**~lear** 

### event fur the pre-employment tQsting. ThlL'l, we believe more than ev<:t 

### "it isvital that the language requiring pre-employment testing

### be as clear as possible 

### in orderto ma,xirnize the 

### efficiency ofits 

### llJle." .69 

### Federal**Regi~ter** 

### at I845 Since the February 1

## t, 2004 effective date ofthe final rule, employers have been required to conductp•e·empioyrnent testing before 

### :m indlviduaJ 

### is hired for 

### a safety-sensitive fu:oction. 

### !t is 

## a:n employer's responSibility to 

### determine**when~** 

### individual is hired for a**safety-sensitiv~:~** 

### function. 

### 'The employer is in the bestposition to know whether the ipdividu.al has beenhired :fur a safetysensitive function (e.g., pilot, flight attendant, etc.), or has been lilled fur anon-safety-seusitive function (e.g., reservationists, ticket agent, ctc.), 

### We e;>;pect each employer 

### to pnHmployrrttlllt 

### test :md

### receive the negative testresultprior to an employee being bi{cl 

### fur 

### safoty-scrusitlve functions, 

### even 

### ifthe individual hM not yet 

### begtm 

### trllin±ug. , · In 

### some cases, employers have now created a new ''trainee" position to 

### circumvent the rule by

### blmrlng tlle understandi:og of"hire," Some 

## employers have deci.gnedmultiple vmati.ons ofthis 

### newly qeatcd ''trainee" position, 

### even though the "trainees" m'e being tQrined ex:clusjvely 

### for safety

### sensitive oositivns 

### (e.g., pilot, 

### flight attendaut, mechanic). 

# m most ofthe cases we have seen**wher~** 

### employers have created a "trainee"position, we 

## have not seen a clear Blld documented distinction between

# an individqal's "trainee" Stl<tus 

### and the individual'S status as a safetycsensitive employee. As a result, these employers ate 

### in violation ofthe rule by

### not perfonniog a**p~-employrnent te~t**  

### and receiving a negative drug test result prior 

### to the iriitiation oftraining these individuals who have**b~n** 

### hired for safety-sensitive positions. These air carriers mU.St chl!1lg<.; their practices 

### in order

# to be in compliance with the regulations, ' We hope this clarifies tbe F M position regarding the regulatory requircmepls, 14 CFR part 121, appendili:. I, 

### Section V.A. If

### you have any further questions about pre-employment testing prior to hiring 

## inindividoal fur a safety-sensitive position, please contact Patr:k:e M. Kelly at (202) 267·8442. 

### Sincerely,

# ~~t:¥- Assistant

### ChiefCounsel 

### Regulations Divisian, AGc-200

1 B 112/22/2014 09:43 4252271007 ANM7 PAGE 07/12

U.S. Departmen.t ofJustice Financial Statement ofDebtor**(.~ubmittedfor** GovernmentActiott on Claims l)ue the United States) NOTE: Use additional sheets where space on this form is insufficient or continue on baok oflast page, FINANCIAL STATEMENT FOR BUSINESS Authority for the solicitatil"rtl oftbc requested infurmat:i.o;n i;;; one or mo:re Drthe following; 5 U.S.C. JOJ, 901 (see NClte,**Ex~;cutivc** Order 6J66, June 1.0, 1933); 2& U.S,C, 501, et seq,; 31 U.S.C,**9~1,** et s.aq,; M U.S.C 3J.01; 4 CFR J()1, et seq.; 2S CFR 0,160, 0. 171 sndAJ?pcndix to Subpart Y. Fed,R,Civ.P_ 33(a), 28 U.S.C. l6;il, .3201 et seq. 'Tbe**prino~pal** p1ll'posc for gnlhering this iDforrnation is to**cvsluat~;** yo,tr ability to pay lhe Government's claim orjudgment against you. Routine uses oftbc infbnn(l.tion are esUiblhhed in tbc fu11uwing US. Departrocnt ofJusti.cc Case File Systems P'tblis"hed in Vot 42 oftbc Federal**Rcgi~er;** .lust:i.oc/CfV-001 at**p~gc** 5332: .TusticcffAX-001 nt page l5347;**.lusticc!1JSA~005 ::.~t**  rrages**53406~53407:** .lllStice/USA-007 rrt**p;:~gc:;: 53408-~341**  0; Ju.<:tice/CRIM-016 at pa.gc: 12274, bisdosurc (lfthe infomation is vohmtary. Ift1Jc rcquestc:d.**infnrm~tion** is l'lOt furnished, tile U.S. Department of**Justi~X** ha'i the: right to such d.i!;'closure oftlm information by legal methods_ 

### Section 1 Business 

### Infom1ation



### Section 2 Business Personnel and



### Section 3 AccOl ..mts/ Notes Receivable

Bvsiness l. Business Name ______________ _ Street Address Cily State___Zip___ _**Councy.-~~~-~-~-----------­** la. Business Telephone 

### L.J**---------~** 2a Type ofenticy: (check one) D Partnership 0 Corporation D Other ____ _ 2b. Type ofBusiness'.,.--;--,.----------- 

### 2c. Other names that the business uses_______ _ 3. Contact Name'-:---::::--;---;---:--:--· 3a, Contact's Busi,oess Telephone L__) ____ _ Extension

# -=--=-o=---- Best Time To Call a.m. ___ y.m. 3b. Contllct's Home Telephone (___)____ _ Be<t Time To Call a.m. ___ 

### y.m. 3c. Contact's Other Telephone 

### (__J, _____ _ Telephone Type (i.e. cellular, pa@r),_____ _ 3d. Contact's E-mail __________ _ 4. PERSON RESPONSIBLE .FOR DEPOSffiNG PAYROLL TAXES 

### 4a. Full Name Title Social Security Number _________ _ Home Street Address Home Telephone**(__J.,-.,.---~------** Cicy State ___Zip___ Ownership Percentage & Shares or Interest'---- 5. J'ARTNERS, OFFlCERS, MAJOR SHAREHOLDERS, ETC. 5a. Full Name Title Social Securicy Number _________ _ Home Street Address Home Telephone 

### Ll·.,---------- Cicy State ___Zip___ Ownernhip Percentage 

### & Shares or**In.terest~---** Sb. Full**Name·-~..,..-------Title** Social Sccmity Number _________ _ Horne Street Address Home Telephone L._),_,.-c=----c------ City State___Zip___ Ownership Percentage & Shares or Interest.___ _ Sc. Full Name Title Social Security Number _________ _ Horne Slre-et-:-A-:-:cdd 7

# re-,-,------ Home Telephone (___)_,_ ________ _ City State ___Zip___ Owne!$hip Percentage & Sbares or Interest ___ _ Sd. Full Name--,...,..-;.,-------Titlc Social Security Number_________ _ Home Street Address Home Telephone**L-J.,..-~--~------** City State___ Zip___ Ownership Perc<11tage & Shares or**Interest~·**__ _ 6. A.CCOUNTS!NOTES RECEJV ABLE. Ustall**contr~ct_., ~eparately,**  including controcts awardod., bLit not yet**stnrt~d,** Dcscriotion Amount Due Date Due Age ofAccount 6a. Name $ o 0-30 doys Street Address D 30-60 days City/State/Zip D 60-90 days D 90+days 

# Enclosure 2

### 12/22/2014 09:43 4252271007 PAGE 08/12

.Business Name ElN !'age 2 

### Section 3 6b. Name $ 0 0-30days continued Street Address 0 30-60 days City/State/Zip 0 60-90 days Ifadditional 0 90+ days space is ner;!dcd use separate 

### 6c. Name $ 0 0-30 days sheet. Street Address 0 30-60 days City/State/Zip 0 60-90 days 0 90+ days 6d. Name $ 0 0-30 days Street Address 0 30-60 days City/State/Zip 0 60-90 days 0 90+ days 6e. Name $ 0 0-30 days Street Addres; 0 30-60 days City/State/Zip 0 60-90 days 0 90+ days 6f. Name $

# - 0 0-30 days Street Address 0 30-60 days City/State/Zip 0 60-90 days 0 90+ days 6g. Name $ r:J 0-30 days Street Address D 30-60 days City/State/Zip 0 60-90 days 0 90+ days 6h. Name $ 0 0-30 days Street Address 0 30-60 days City/State/Zip D 60-90 days 0 90+ days 6i. Name 

### $ 0 0-30 days Street Address 0 30-60 days Ci\y/State!Zip 0 60-90 days 0 90+ days 6j. Name $ 0 0-30 days Street Address 0 30"60 days City/Sta±e/Zip 0 60"90 days 0 90+ days 

### 6k. Name $ 0 0"30 days Street Address 0 30-60 days City/State/Zip 0 60-90 days 0 90+ days 6a+6k=61 $**Amou~t** from any separate sheet +$ Total Accounts/ Notes Receivable $ suerness

### 12/22/2014 09:43 4252271007 ANM7 

### PAGE 09/12
Business Name. __________________ _ ElN _____________ _ Page 3 

### Section 4 Other Financial Information



### Section 5 Business Assets *Indicate the amoun.t you could sell the asset for today. 7. OTHER F!NANClA.L INFORMATION: Respond to the following business questions. 7a. Does this business have other business relationships (e.g. subsidiary or parent, corpomti.cn, partnersh'p etc)7 0 No DYes, list ElN Additional ETN________________ _ 7b, Does anyone (e,g. officer. stockho.lder, partner or employees) have an outstanding loan from the business? 0 No DYes, amount $ Date oflosn Current Balan.ee $ _____ _ 7c. Arc there :myjudgments or Hens against your business? 0 No 0 Yes, who is creditor?______ _ Dale 

### ofJudgment/Lien Amount 

### ofDebt$ _______ _ 7d. Is your business a party in. a lawsuit'? 

### 0 No DYes, amount ofsuit$,_______ _ Possible completion dote'----------- Subject matter 

### of suit ________ , ___ _ Court filed 

### in___________ _ 7e. Has your business ever 

### filed banlmlptcy? 

### 0 No 

### D Yes, date 

### filed_____ _ Date discharged_____ _ Case No•. ____ _ 7f_ In the past 10 years, have you transferred a.oy assets from yourbusiness name for less than their actual value? 

### D No 

### DYes, what asset Value at time oftransfer. ______ _ When was it transferred To whom \Va,'llt transfer:red,________ _ 7g. Do you anticipate any increase In busin.ess i:ncomc (e.g. contracts bid on but notyet awarded) 

### 0 No 0 Yes, why 

### the i:ncreasc.__________ --;;c;;----,,-,:-;--,.-:-:-------- How much will it increase When 

### wi11 

### it increase'-------- 7h_ Is your business a. beneficiary ofa trust, an estate or a life .insurance policy? 

### D No DYes, uame oftrust, e>latc or policy Anticipated amount to be received --------""Wc;;-he_n_t:-:o'b_e_r_e-ce""i-v-ed.,------ 8. PURCHASED AUfOMOBILES, TRUCKS AND OTHER LICENSED ASSETS, Include boats.• RV's, etc, Current Loan Name of Purchase Monthly Descriruion**Vahle~** 

### Ba.lance Lender Price Pymt Sa. YeM__________ __ Make c-------- Modol,_______ _ $____ _ $__ _ $__ _ 8b. Year _____ _ Make. ______ _ Model.____ _ $. __ _ $ __ _ $ __ _ 8c. Year Make ______ _ Model______ _ $ __ _ 

### $.__ _ $____ _ $ __ _ 9. LEASED AUTOMOBILES, TRliCKS AND OTHERL!CllNSED ASSETS. lnclude

### boats, RV's, etc.
9a. 9b. Lease Name of Lease Monthly Description BatarJce Lessor 

### Date Payment Year____________ __ Make Model.------- Year___________ _ Make. _____ _ Model______ _ $c__ __ $___ _ $



# ·--- $___ _ 

### J&ATTACHMENTS REQUtR.ED: Plea<;e prm·lde your cuNent s1:3tcmcnt frorn lender with monthly pnyn1cnt amnunt anO current bal<.\1'"/Cf: ofthc 1oM fO'I" each \'el:lic:le purchfise<;l or**lca~ed.** Business

### 12/22/2014 09:43 4252271007 ANM7 

### PAGE 10/12 

### Business Name. __________________ _ 

### EJN Pag< 4**Se~tiQn** 

### 5 conlinued



### Section 6 Investment, Banking and Cash 

### Informatiort

6us.iness.10. REAL ESTAT:t.List all real estate owned by the business. (Ifyou need additional space, usa a separate sheet) Street Address, City Date Purchase CutTent 

### Loan Lender/ Slate. Zip. County Purchased 

### Price Value* Ball!DCC 

### Lien Holder lOa. $ $ $ lOb. $ $ $

### ~A:rTACHJ\.tEN'J'S REQlTJREJ): Plc.asc provide your currcmt statement from lender with rnon1:hly p<JYTilent amount and current b:al<lnce for cacb piece o:frcal csttlte 0\:vned. Monthly Payment $ $



### 11. BUSINESS ASSETS. Ust 

### all business assets 

### an.d encumbrances below, include Uniform Commercial Code filings. (fyou need additional**space~** use a separate sheet) Note: Ifattaching a depreciation**schedule~** the attachment

### must include all ofthe 

### information requested below. Current 

### Loan Monthly Description Value* Balaoce Lender Payment lla. Machinery $ $**--~-** $ $ $ $ $ $____ $ $ $ $ 

# --- Equipment $ ___ $



# ----- $ $ $ $ $ $ ____ $ 

### M.erchandise $ $____ $ Other Assets· (List below) 1\b. $ $ $ 

### llc. $ $ $ 

# ----**~**A"rTAC:H:MENi.S REQlTTRED: Please prcyvide your

### c~1rrcnt sta1:crr1ent :8-om lcndc:t with m{)nthly payme11t: amount and currcn1. b•lancc for assets listed which hav<l an encumbrance. 12. INV.ESTMENTS. List all 

### investment assets below. Include stocks, bonds, mutual funds, stock options, etc. Number of Current Used as collateral Name ofCompany Shares/Units Value Loan Amount on 

### a. Joan? 12a. $.__ _ $__ _ 

### DNo DYes 12b. $__ _ $__ _ 

### DNo DYes 12c. Tollll InvesC:ments $ ____ _12/22/2014 09:43 4252271007 ANM7 PAGE 11/12

Business Name·------------------- EIN Page 5 

### Section 6**CQnt'inu~d 6usin~ss**  13. BANK ACCOUNTS. List checking and savings accounts, (Jfyou need additional space) use a separate sheet.)

l3a. 

### 13b.

13c. Type of Account 

### Full name ofBank, Credit Union or Institution Name________**~ Address·~-------**  City/State/Zip _____ _ Namt; ___________ __ Address.__,-c--------- 

### City/Statc/Zip·_____ _ 'J'otal Other Account Balances Bank 

### Account No.

## ~**ATTACHME~IS** REQlllRED:

## Ple;J...~e**lnclud~** your cuttet\{ bo.n'k statcmc:nt.'l (chcck-illg and savings) [or 1he pa<;t 3 months for**t~U** accQunt'l. Current Account 

### Balance $____ _ $.___ _ $____ __

H.

### OTHERACCOUNTS. List all acC<lunts including brokerage accounts, money market, additional checking, 

### and savings accounts, etc. not listed on line#13.



### 14a. 14b, Type of Account Full name ofBank, 

### Credit Upion or Institution 

### Name,___________**~ Address·~~-----­**  City/State/Zip.
------ 

### Name, ________ _**Address·~~-------** 

### Chy/State/Zip,_____ _ .14c. Total Other Accounts 

### Bank Account No. 

### Current Account Balance $.___ __ $,___ _ $. ___ _ 

## iB1f' ATl'ACH'MEN'fS REQUIRED: Pka.<lc include yOlif current bank !ltatc:mcnts fut the past 3

## month~ for allllccounts. 15, CASH 

### ON HAND. Include any money that you have that 

### is not inthe bank. l5a. Total Cash on Hand 

### !6. AVAILABLE CREDJT. List alllin.es ofcredit, including credit cards.

16a.
l6b. 

### Full Name of Credi.t T 

### nstitution Namo>_____________ _ Address.__________ __ 

### City/State/Zip>_______ _ Nrume.___________ _ 

### Address,_________ _ City/State/Zip>________ _ I6c. Tota.l .Minimum**P~ymcnts** 

### Credit Limit Amount Owed $



### Minimmn Payment $.___ _ $.___ _ $.

### 12/22/2014 09:43 4252271007 ANI.-17 

### PAGE 12/12 }<amc.__________**~~----------------~-** SSN ______________ _ Page 6 

### Section 7 Monthly 

### Income and Expenses 17. The following information applies to income and expenses from your most recently filed Form 1120 or Form 1065. Fiscal Year Period to ______ __ 18. Accounting Method used: DCash D Accrual Tbc infonnation included on lines 1_9 through 39 should reconcile to your business federal ta.x return. 

### Total Income Source 

### 19. Gross Receipts 

### 20. Gross Rental Income 21. Interest 22. Dividends Other Inc:omc (lines 23·2.5) 23. 24. _____ _ Gross monthly $ ___ _

25. =-...,.-c--=-c= 26. Total Income (19-25) $___ __ 

### Total Living**Emeg~e;<** Expense Item!' 27. Materials Purchased 28. Inventory Purchased 

### 29. Gross Wages & Salaries 30. Rent 

### 3J_ Supplies 32. Utilities/Telephone 33. Vehicle Gasoline/Oil 34. Repairsl1v!aintenance 35. 

### Jn.sumncc 36. Current Taxes Other Expenses (lines 37-38) 

### 37.--------- Actn•l Monthly $ ____ _



### 38. ::;;-:----;c;;---:;;;;;-= 39. Total Expenses (27-38)**$----~--**

### ~ATTACH:M'F.NTS REQUlREll: Please

### inc)\l~k proofofall curr1.mt expenses ih<lt you ps.id for the last 3 month.c;., il'lchlding.utilitics, rertt, il.'lsurancc, pro-perty taXc!,>:, otc. CERTIFICArJON I declare that I have examined the information given in. this statement and, to the best ofmy knowledge and bdicf. it is true, correct, and complete, and I further declare that I have n.o assets, owned either directly or 

### ind.irect.1y. or income ofany nature other that as shown in this statement, including any attachment_ Signature SociaJ. Security No. Date Title WARNING False st•tements are punishable liP to five ye•rs imprisonment, a fine o.f $250,000, or both pul"Suant to 18 U.S.C. §1001..**Buslnes~**

### 12/22/2014 09:43 4252271007 ANM7



### FACSIMILE MESSAGE FEDERAL AVTATION ADMINTSTRATION OFFICE OF REGIONAL COUNSEL ANM-7 1601 LIND AVENUE S.W. RENTON, WASIDNGTON 98057 PAGE 01/12



### The infon:nation contained in this facsimile message is legalJy privileged. and confidential infon:nation and is intended only for the use ofthe individual named onthis cover sheet. Ifthe reader ofthis message is not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copy ofthis facsimile is strictly prohibited. Ifyou have received this facsimile in enor, please immediately notify us by telephone at 425-227-2007. 

## DATE: TO: 

## FAX 

## NO.: PHONE NO.: 

## RE: Decembcr22, 2014 Docket Clerk AGC-430 

## 202-267-1293 Air Medical Resources Group, Inc. DMS No FAA- 2014- 0551 

# Motion to take Judicial Notice. NO. PAGES: FROM: 

## FAX NO.: PHONE NO.: EMAIL: 12 

# including cover Jeffrey M. Harper 425-227-1007 425-227-2161 JEFFREY.HARPER.@FAA.GOV