LAW ENFORCEMENT AGENCY (LEA)

AIRCRAFT REQUEST 

ORI:

AGENCY NAME:

STATE:

EMAIL:

FAX:

Version: November 2022 

TYPE OF AIRCRAFT AND QUANTITY OF EACH TYPE

ROTARY OH-58 OH-6 UH1H UH1L UH1N

Flyable Quantity

Non-Flyable Quantity

FIXED C12 C172 C182

Flyable Quantity

Non-Flyable Quantity

OTHER (State type)

Quantity

If something other than the marked/stated above aircraft becomes

available, would you like to be offered it? 

Yes No

DODAAC: 

AIRCRAFT POC:

AGENCY PHYSICAL ADDRESS (as it appears in FEPMIS): 

CITY:

ZIP:

PHONE:

1. Please thoroughly explain the intended use and impact the resource will have upon your jurisdiction and/or neighboring jurisdiction support to other agencies 

(examples may include SWAT, active shooter, barricaded suspect, emergency response, first responder, critical incident, hostage rescue, natural disaster response,

homeland security, or counter terrorism). List additional information as needed to explain the intended use of the resource.

Page 1 of 3
Page 2 of 3 Version: November 2022

2. Is the requesting agency located within an office of National Drug Control Policy designated High Intensity Drug Trafficking Area (HIDTA)? If yes, please describe.

4. State the population within the requesting agencies jurisdiction and describe the geographical size of the area of responsibility.

5. Describe the type of facility that will be used to store and secure the resource.

3. Is the requesting agency involved by mutual agreement with multi-agency associations/task forces of a counter-drug/counter-terrorism/border security nature?

6. Provide the estimated usage/mission requirements for the requested aircraft.

7. List all Federal Aviation Administration (FAA) certified pilots, type of certification (for what type of aircraft) does the pilot hold.
Page 3 of 3

By signing this document, the Chief Law Enforcement Official or Head of Local Federal Agency (Supervisor/Regional Agent in Charge/Special Agent in Charge 

[RAC/SAC]) certifies that: a) the requesting agency listed above has the appropriate funds, license (s), safety, and operational training required to operate and maintain 

the requested aircraft, b) that the agency is abiding by the current version of the LESO approved State Plan of Operation (SPO) and any SPO Addendum(s), c) that the agency 

has a signed copy of the SPO and any SPO Addendum(s) on file, d) the agency certifies that all information contained above is accurate, e) the request for aircraft (s) is 

warranted and f) the request for aircraft has been approved/is endorsed by the agency signatory listed below.

CHIEF LAW ENFORCEMENT OFFICIAL

OR HEAD OF LOCAL FEDERAL

AGENCY (SUPERVISOR/RAC/SAC):

PRINTED NAME:

SIGNATURE:

DATE: 

STATE OR FEDERAL COORDINATOR USE ONLY

By signing this application, I certify that as the State Coordinator/State Point of Contact, I have determined that: a) the agency meets the definition of a "Law 

Enforcement Agency/Activity", b) that all information contained in this application is valid and accurate, c) that the LEA is abiding by the current version of the LESO 

approved SPO and any SPO Addendum(s) and d) that the LEA has a signed copy of the SPO and any SPO Addendum(s) on file. 

PRINTED NAME:

SIGNATURE:

DATE: 

LESO USE ONLY

# OF OFFICERS: 

No

DATE: 

STATE OR FEDERAL COORDINATOR: 

LESO BRANCH CHIEF (SIGNATURE): DATE: 

LESO DIVISION CHIEF (SIGNATURE):

COMPLIANCE LIAISON SPECIALIST (SIGNATURE): DATE:

Is agency on the Department of Justice (DOJ) Active Case List?: Yes 

Is agency on the LESO Suspension List?: Yes No

DOJ 

Liaison 

notes:

ADDITIONAL NOTES:

AIRCRAFT SPECIALIST (SIGNATURE):

TOTAL # OF 

AIRCRAFT:

LESO OFFICIALS:

8. (OPTIONAL) Provide any additional information pertinent to aircraft request.

DATE: 

Version: November 2022