Aviation Safety Action Program

Aviation Safety Action Program
Memorandum of Understanding - Version 2.0.1, May 27, 2020
Note: All fields on the MOU form are required.

1.	Eligible Entity Name
2.	FAA Air Designator
3.	Applicable FAR Part
4.	Number of Aircraft
5.	Number of Employees
6.	Employee Group Type
7.	Name of Company Signatory (signature page)
8.	Company Position Title (signature page)
9.	Employees representated by Labor Association
10.	Name of Employee Labor Association (signature page)
11.	Name of Employee Labor Association Representative (signature page)
12.	Title of Labor Association Representative (signature page)
13.	Facilitator
14.	Name of Facilitator (signature page)
15.	Name of Facilitator Representative (signature page)
16.	Title of Facilitator Representative (signature page)
17.	Name of FAA Manager (signature page)
18.	Title of FAA Manager (signature page)

*MOU Template - Version 2.0.1, May 27, 2020*