APPLICATION UNDER

SMALL COMMUNITY AIR SERVICE DEVELOPMENT PROGRAM

DOCKET DOT-OST-2014-0133 

SUMMARY INFORMATION1

All applicants must submit this Summary Information schedule, as the application 

coversheet, a completed standard form SF424 and the full application proposal on 

www.grants.gov. 

For your preparation convenience, this Summary Information schedule is located at 

http://www.dot.gov/policy/aviation-policy/small-community-rural-air-service/SCASDP

A. PROVIDE THE LEGAL SPONSOR AND ITS DUN AND BRADSTREET (D&B) DATA UNIVERSAL 

NUMBERING SYSTEM (DUNS) NUMBER, INCLUDING +4, EMPLOYEE IDENTIFICATION NUMBER 

(EIN) OR TAX ID.

Legal Sponsor Name: 

Name of Signatory Party for Legal Sponsor:

DUNS Number:

EIN/Tax ID:

B. LIST THE NAME OF THE COMMUNITY OR CONSORTIUM OF COMMUNITIES APPLYING: 

1.____________________________________________________ 

2.____________________________________________________ 

3.____________________________________________________ 

4.____________________________________________________ 

C. PROVIDE THE FULL AIRPORT NAME AND 3-LETTER IATA AIRPORT CODE FOR THE 

APPLICANT(S) AIRPORT(S) (ONLY PROVIDE CODES FOR THE AIRPORT(S) THAT ARE ACTUALLY 

SEEKING SERVICE).

1. 2.

3. 4.

 

1 Note that the Summary Information does not count against the 20-page limit of the SCASDP application.
DOES THE AIRPORT SEEKING SERVICE HOLD AN AIRPORT OPERATING CERTIFICATE ISSUED BY 

THE FEDERAL AVIATION ADMINISTRATION UNDER 14 CFR PART 139? (IF “NO”, PLEASE 

EXPLAIN WHETHER THE AIRPORT INTENDS TO APPLY FOR A CERTIFICATE OR WHETHER AN 

APPLICATION UNDER PART 139 IS PENDING.) 

Yes No (explain)

______________________________________________________________________________

______________________________________________________________________________ 

D. LIST THE 2-DIGIT CONGRESSIONAL DISTRICT CODE APPLICABLE TO THE SPONSORING 

ORGANIZATION, AND IF A CONSORTIUM, TO EACH PARTICIPATING COMMUNITY.

1. 2.

3. 4.

E. APPLICANT INFORMATION: (CHECK ALL THAT APPLY) 

Not a Consortium Interstate Consortium Intrastate Consortium

Community currently receives subsidized Essential Air Service

Community (or Consortium member) previously received a Small Community Air 

Service Development Program Grant

If previous recipient: Provide year of grant(s):_______________________________; and, 

the text of the grant agreement section(s) setting forth the scope of the grant project:

_________________________________________________________________________ 

_________________________________________________________________________ 

_________________________________________________________________________ 

_________________________________________________________________________ 

_________________________________________________________________________ 

F. PUBLIC/PRIVATE PARTNERSHIPS: (LIST ORGANIZATION NAMES) 

PUBLIC PRIVATE

1. 1.

2. 2.

3. 3.

4. 4.

5. 5.
G. PROJECT PROPOSAL:

 1. GRANT GOALS: (CHECK ALL THAT APPLY) 

Launch New Carrier Secure Additional Service Upgrade Aircraft

First Service New Route Service Restoration

Regional Service Surface Transportation Professional Services2

Other (explain below)

2. FINANCIAL TOOLS TO BE USED: (CHECK ALL THAT APPLY) 

Marketing (including Advertising): promotion of the air service to the public 

Start-up Cost Offset: offsetting expenses to assist an air service provider in setting up a 

new station and starting new service (for example, ticket counter reconfiguration)

Revenue Guarantee: an agreement with an air service provider setting forth a minimum 

guaranteed profit margin, a portion of which is eligible for reimbursement by the 

community 

Recruitment of Air Carrier: air service development activities to recruit new air service, 

including expenses for airport marketers to meet with air service providers to make the 

case for new air service

Fee Waivers: waiver of airport fees, such as landing fees, to encourage new air service; 

counted as in-kind contributions only 

Ground Handling Fee: reimbursement of expenses for passenger, cabin, and ramp (below 

wing) services provided by third party ground handlers 

Travel Bank: travel pledges, or deposited monetary funds, from participating parties for 

the purchase of air travel on an air carrier, with defined procedures for the subsequent use 

of the pledges or the deposited funds; counted as in-kind contributions only 

 

2 “Professional Services” involve a community contracting with a firm to produce a product such as a marketing 

plan, study, air carrier proposal, etc.
Other (explain below) 

______________________________________________________________________________ 

______________________________________________________________________________ 

H. EXISTING LANDING AIDS AT LOCAL AIRPORT: 

Full ILS Outer/Middle Marker Published Instrument Approach 

Localizer Other (specify)

I. PROJECT COST: DO NOT ENTER TEXT IN SHADED AREA

LINE DESCRIPTION SUB TOTAL TOTAL AMOUNT

1 Federal amount requested

2 State cash financial contribution

Local cash financial contribution

3a Airport cash funds

3b Non-airport cash funds

3 Total local cash funds (3a + 3b)

4 TOTAL CASH FUNDING (1+2+3)

In-Kind contribution

5a Airport In-Kind contribution**

5b Other In-Kind contribution**

5 TOTAL IN-KIND CONTRIBUTION 

(5a + 5b) 

6 TOTAL PROJECT COST (4+5)

J. IN-KIND CONTRIBUTIONS**

For funds in lines 5a (Airport In-Kind contribution) and 5b (Other In-Kind contribution), please 

describe the source(s) of fund(s) and the value ($) of each.
K. IS THIS APPLICATION SUBJECT TO REVIEW BY AN AFFECTED STATE UNDER EXECUTIVE 

ORDER 12372 PROCESS? 

a. This application was made available to the State under the Executive Order 12372 

Process for review on (date) _____________. 

b. Program is subject to E.O. 12372, but has not been selected by the State for review.

c. Program is not covered by E.O. 12372. 

L. IS THE LEAD APPLICANT OR ANY CO-APPLICANTS DELINQUENT ON ANY FEDERAL DEBT?

(IF “YES”, PROVIDE EXPLANATION) 

No Yes (explain)

______________________________________________________________________________

______________________________________________________________________________ 

APPLICATION CHECKLIST

INCLUDED? ITEM

For Immediate Action

Determine Eligibility

New Grants.gov users must register with www.grants.gov.

Existing Grants.gov users must verify existing www.grants.gov account has not expired 

and the Authorized Organization Representative (AOR) is current.

For Submission by 5:00 PM EDT on July 31, 2014

Communities with active SCASDP grants: notify DOT/X50 of intent to terminate 

existing grant in order to be eligible for selection in FY2014 

Complete Application for Federal Domestic Assistance (SF424) via www.grants.gov

Summary Information schedule complete and used as cover sheet (see Appendix B)

Application of up to 20 one-sided pages (excluding any letters from the 

community or an air carrier showing support for the application), to include:

• A description of the community’s air service needs or deficiencies.

• A strategic plan for meeting those needs under the Small Community Program.

• A detailed description of the funding necessary for implementation of the 

community's project. 

• An explanation of how the proposed project differs from any previous projects 

for which the community received SCASDP funds (if applicable). 

• Designation of a legal sponsor responsible for administering the program.

• A motion for confidential treatment (if applicable) – see Appendix D below.