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Form 41, Schedule B-1 - Balance Sheet: Liabilities and Stockholders' Equity

Form 41, Schedule B-1 - Balance Sheet: Liabilities and Stockholders' Equity

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, Balance Sheet is estimated to be approximately 7 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 respondent receives a grant of 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, Washington, D.C. 20590 or e-mail bernard.stankus@dot.gov.

Air Carrier         _____________________

Operation         _____________________

Quarter Ended _____________________, 20_____________________

  CURRENT LIABILITIES  
2000 Current Maturities of Long Term Debt ____________________
2005 Notes Payable - Banks ____________________
2015 Notes Payable - Others ____________________
2021 Trade Accounts Payable ____________________
2025 Accounts Payable - Other ____________________
2080 Current Obligations Under Capital Leases ____________________
2110 Accrued Salaries & Wages ____________________
2120 Accrued Vacations ____________________
2125 Accrued Interest ____________________
2130 Accrued Taxes ____________________
2140 Dividends Declared ____________________
2160 Air Traffic Liability ____________________
2190 Other Current Liabilities ____________________
2199 Total Current Liabilities ____________________
  NON-CURRENT LIABILITIES  
2210 Long Term Debt ____________________
2240 Advances from Associated Companies ____________________
2250 Pension Liability ____________________
2280 Non-Current Obligations - Capital Leases ____________________
2290 Other Non-Current Liabilities ____________________
2299 Total Non-Current Liabilities ____________________
  DEFERRED CREDITS  
2340 Deferred Income Taxes ____________________
2345 Deferred Investment Tax Credits ____________________
2390 Other Deferred Credits ____________________
2399 Total Deferred Credits ____________________
  STOCKHOLDERS' EQUITY  
2820 Preferred Shares Issued ____________________
2840 Common Shares Issued ____________________
2860 Subscribed and Unissued ____________________
2869 Total Capital Stock ____________________
2890 Additional Capital Invested ____________________
2899 Total Paid in Capital ____________________
2900 Retained Earnings ____________________
2959 Total Stockholders' Equity ____________________
2990        Less Treasury Stock ____________________
2995 Net Stockholders' Equity ____________________
2999 TOTAL LIABILITIES & STOCKHOLDERS' EQUITY ____________________

BTS Form 41 Schedule B-1