ACR Electronics ELT, NOAA Manuel utilisateur

Telephone

( )_____________________

Area Code

Home Work Cellular Fax Other

Telephone

( )_____________________

Area Code

Home Work Cellular Fax Other

Beacon ID (Unique Identifier Number)

ELT Information

(15 digit character ID provided by ELT manufacturer)

ELT Manufacturer ________________________________ Model No. ___________________________________________

New ELT Registration Replacement of ELT Decal

Renewal of ELT Registration Check here if this ELT is a replacement for a previously registered ELT.

Change of ELT Information or Ownership Please enter the old ELT unique ID number ______________________

Official 406 MHz ELT Registration Form

Aircraft Information

Emergency Contact Information (Please indicate someone other than the owner)

Name of Primary 24-Hour Emergency Contact: Name of Alternate 24-Hour Emergency Contact:

__________________________________________________ ________________________________________________

If you have any questions about this form or with ELT registration in general, please call 1-888-212-SAVE (7283) or 301-457-5678.

For information on the U.S. Search & Rescue Satellite-Aided Tracking system, please visit: www.sarsat.noaa.gov

OMB 0648-0295/exp. 30 Nov. 2004

Owner/Operator Information

Name______________________________________________

Mailing Address______________________________________

___________________________________________________

City _____________________ State/Province _____________

ZIP (Postal) Code __________ Country ___________________

(Last, First, Middle Initial) E-mail ___________________________________________

Registration (Tail) Number__________________________

Usage

Commercial Non- commercial

Government Military Government Non-military

Type

Single-engine Propeller Single-engine Jet Multi-engine Propeller

Multi-engine Jet Helicopter Other _________________________

Aircraft Manufacturer ______________________________

Model ___________________Color __________________

Seating Capacity _________________________________

Radio Equipment (Check all that apply)

VHF MF HF SSB Other ___________________

Survival Equipment

Deployable _____________________________________

Fixed __________________________________________

Principal Airport _________________________________

________________________ ________________________

Additional Data ___________________________________

________________________________________________

_________________________________________________

Telephone

( )_____________________

Area Code

Home Work Cellular Fax Other

Signature __________________________________________ Date ____________________________________________

Describe and List Quantity

Save Time! Register your beacon online at: www.beaconregistration.noaa.gov

City State

Mail or Fax to: NOAA/SARSAT E/SP3, Room 3320, FB-4, 5200 Auth Road, Suitland, MD 20746-4304 Fax No. 301-568-8649

ELT Registration

A1-20-1180 Rev. A

Important Notice - Please Read Before Completing Registration

The information you furnish is mandatory and is intended to assist search and rescue teams in locating you or your craft in

the event of beacon activation. The information will be provided to the United States Coast Guard, United States Air Force,

and other Search and Rescue (SAR) teams as appropriate in the event of beacon activation. It will also be used to

conserve SAR resources by helping to eliminate false alert deployments, as an inadvertent activation can be resolved with

a phone call.

Failure to register, re-register, or to notify NOAA of a change in the status for a 406 MHz beacon could result in penalties

and/or fines being issued to the owner. An owner is required to notify NOAA of any changes to the registration

information. Please note, NOAA will complement or update the datebase accordingly when a beacon owner’s registration

expires and credible information is provided from SAR sources. NOAA will also seek information from other databases to

update and/or complement the existing information for a beacon registration. Solicitation of this information is authorized

by Parts 80 and 87, Title 47 of the Code of Federal Regulations (CFR).

There is no charge for beacon registration. This is a service provided by the U.S. Government.

All online registrations will be entered into the National 406 MHz Beacon Registration Database on the same day of entry.

Registration forms received via the postal mail service will be entered into the National 406 MHz Beacon Registration

Database within 2 business days of receipt. For online registrations, a letter with an attached registration information sheet

will be sent immediately via e-mail or fax (if provided), or via postal mail within two weeks. Once your registration

confirmation is received, please review all information. Any changes or updates to your registration information can be

done via the internet, fax, e-mail or postal mail. If you do not receive your registration confirmation from NOAA on the

same day you submit it over the internet or within two weeks if you submit it by postal mail, please call NOAA toll-free at:

1-888-212-SAVE (7283) or 301-457-5678 for assistance.

After initial registration (or re-registration) you will receive a NOAA Proof of Registration Decal by postal mail. It is required

that you affix the registration decal to your beacon. If for some reason you do not receive the registration decal within two

weeks, please call NOAA toll-free at: 1-888-212-SAVE (7283) or 301-457-5678, for assistance. Additional registration

forms can be found on the NOAA SARSAT website at: www.sarsat.noaa.gov or at: www.beaconregistration.noaa.gov.

Although the information provided will become a matter of public record, there is no intent to circulate the data furnished

beyond its intended purpose, i.e., to assist SAR forces in carrying out their mission of rescue assistance and false alert

abatement. Public reporting burden for the collection of this information is estimated to average 15 minutes per response,

including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,

and completing and reviewing the collection of information. Comments regarding this burden estimate or any other aspect

of this collection of information, including suggestions for reducing this burden should be sent to:

NOAA/SARSAT

E/SP3, FB4, Room 3320

5200 Auth Rd

Suitland, MD 20746-4304

Or call: 1-888-212-SAVE (7283) or 301-457-5678

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