ACR Electronics elt, noaa User Manual

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Telephone
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Area Code
Area Code
Area Code
Area Code
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Telephone
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(
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(
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(
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Area Code
Area Code
Area Code
Area Code
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
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 ___________________________________
________________________________________________
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Telephone
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(
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(
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(
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Area Code
Area Code
Area Code
Area Code
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Home
Work
Cellular
Fax
Other
Signature __________________________________________     Date ____________________________________________
Describe and List Quantity
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