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Form 41 Schedule B-1.1 - Balance Sheet

Form 41 Schedule B-1.1 - Balance Sheet

OMB No.: 2138-0013, Expiration Date: 10/31/2011

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Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2138-0013. Public reporting for Schedule B-1.1, Balance Sheet is estimated to be approximately 2 hours per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are mandatory. This report is released to the public unless the respondent receives confidentiality. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Bernie Stankus, OAI/BTS/RITA, RTS-42, 1200 New Jersey Avenue, SE, SW, Washington, D.C. 20590 or e-mail bernard.stankus@dot.gov.

Air Carrier                 _____________________

Operation                 _____________________

Six Months Ended  _____________________, 20_____________________

  ASSETS  
  CURRENT ASSETS  
Line 1 Cash and cash equivalents ________________________
Line 2 Net Notes & Accounts Receivable ________________________
Line 3 Other Current Assets ________________________
Line 4 Total Current Assets ________________________
  PROPERTY & EQUIPMENT  
Line 5 Owned Property and Equipment ________________________
Line 6 Less Accumulated Depreciation ________________________
Line 7 Leased Property - Capital Leases ________________________
Line 8 Less Accumulated Amortization ________________________
Line 9 Total Property & Equipment ________________________
Line 10 OTHER ASSETS ________________________
Line 11 TOTAL ASSETS ________________________
  LIABILITIES & STOCKHOLDER'S EQUITY  
  CURRENT LIABILITIES  
Line 12 Notes and Accounts Payable ________________________
Line 13 Accrued Taxes ________________________
Line 14 Other Current Liabilities ________________________
Line 15 Total Current Liabilities ________________________
Line 16 LONG TERM DEBT ________________________
Line 17 OTHER LIABILITIES ________________________
Line 18 DEFERRED CREDITS ________________________
  STOCKHOLDER'S EQUITY:  
Line 19 Preferred Shares Outstanding ________________________
Line 20 Common Shares Outstanding ________________________
Line 21 Other Paid in Capital ________________________
Line 22 Retained Earnings ________________________
Line 23 Total Stockholders' Equity ________________________
Line 24 Less Treasury Stock ________________________
Line 25 Net Stockholders' Equity ________________________
Line 26 TOTAL LIABILITIES & STOCKHOLDERS' EQUITY ________________________

I, the undersigned, (Title) __________________________________________________ of the above-named air carrier certify that the above report and the attached Financial Schedules, Statement of Operations, and Traffic and Capacity Statistics, including the T-100 report and Passenger Origin-Destination Survey, have been examined by me and to the best of my knowledge and belief are true, correct and complete reports for the period stated.

Signature: ____________________________________ Date: _______________

Name (Please Type or Print) ________________________________________

BTS Form 41 Schedule B-1.1