CERTIFICATION OF THE PUBLIC CHARTER OPERATOR,

DIRECT AIR CARRIER, AND ESCROW BANK

_______________ , _______________, and _______________ certify that we will comply with all the

(Public Charter Operator) (Direct Air Carrier) (Escrow Bank )

regulatory requirements in 14 CFR Part 380. In particular

, we certify that the following statements are true

and accurate. If your Public Charter program is secured by an escrow account pursuant to 14 CFR 380 .34(b),

you should begin at item number 1. Go directly to item number 4 if your Public Charter program is covered by

a security agreement pursuant to 14 CFR 380.34(a))

.

1) The Public Charter Operator and Direct Air Carrier c ertify that the contract between the charter operator

and the direct air carrier covers the full pr ice of the air transportation, including the cost of aircraft, crew,

maintenance, insurance, fuel, ground handling, landing fees, passenger fees and taxes, and all other costs

associated with the direct air transportation.

Yes__ __ (Go directly to item number 3 ) No____ (You must complete item number 2)

N/A ( e.g., for Direct Sales Programs conducted under 14 CFR 212.7 )

2) The Public Chart er Operator certifies that all passenger funds in the charter program will be deposited in

the Public Charter Operator’s escrow bank (less travel agent and credit card fees under 14 CFR 380.34

(b)) and that it will provide sufficient instructions to the escrow bank in order for the bank to comply with

the requirements of 14 CFR 380.34(b); t he Escrow B ank certifies that it will maintain a full and accurate

accounting of disbursements to all vendors , fuel or ground handling providers

, and other expense

categories, e.g

. , taxes, in accordance with 14 CFR 380.34(b)

.

Yes___ __ (Go directly to item number 3 ) No________ (Stop

– this filing will not be accepted)

3) The Public Charter Operator certifies that no debit cards will be accepted from passengers for air

transportation payments unless the Public Charter Operator receives an assurance from the merchant

bank ( s ) that the c redit card/debit card processors will provide the same chargeback p rotections to those

passengers using debit cards that are provided to credit card users

.

Yes_____ (Go directly to item number 5 ) No________ (Stop

– this filing will not be accepted)

4) The Public Charter Operator certifies that the security instrument maintained for the charter program

pursuant to 14 CFR 380.34(a) is unlimited or at least equal to the full cost of the air transportation. 1 The

full cost of the air transportation includes the cost of aircraft, crew, maintena nce, insurance, fuel, ground

handling, landing fees, passenger fees and taxes, and all other costs associated with the air transportation.

Yes___ __ (Go directly to item number 5 ) No________ (Stop

– this filing will not be accepted)

1 For programs being conducted pursuant to a waiver from the full bonding requirement, check “yes” and include

waiver number

.5) The Public Charter Operator certifies that it will maintain access to the reservation records as required by

existing rules and share this information with the direct air carr ier in case of a disruption in the charter

program in order to assist the direct air carrie r in complying with its regulatory obligation s under 14 CFR

212.3 (f)

. The Direct Air C arri er certifies that it will request from the Public Charter Operator all the

information necessary to return passengers that it transported on the outbound flight and has a regulatory

responsibility to return to their point or origin in the event of a disruption of the Public Charter program.

Yes___ __ (Go directly to item number 6 ) No________ (Please Explain below 2 then go directly to

i tem number 6 )

6) The Public Charter Operator certifies that it does not sell vouchers to passenger s for travel at unspecified

dates in the futu re. Purely gratuitous or compli mentary vouchers distributed for passenger goodwill are

not covered by this certification

.

Yes_____ No________ (Stop

– this filing will not be accepted)

[ CHARTERER] [ CARRIER]

By: _____________________________________ By: _____________________________________

[name and title

— if applicable] [name title

— if applicable]

Date: ___________________________________ Date: ___________________________________

[ BANK]

By: _____________________________________

[name and title

— if applicable]

Date: ___________________________________

2 This obligation does not apply to direct air carriers that are not subject to section 212.3 (f)

.