ACR Electronics elt, noaa User Manual
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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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 _________________________
Multi-engine Jet Helicopter Other _________________________
Aircraft Manufacturer ______________________________
Model ___________________Color __________________
Seating Capacity _________________________________
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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________________________ ________________________
Additional Data ___________________________________
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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
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