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Agency/Organization	Federal   Non Federal   PIM   FCC
	Admin Office of the United States Courts Agency for international development Agriculture Air Force Architect of the Capitol Army Broadcasting Board of Governors Central Intelligence Agency Coast Guard Court Services and Offender Surpv. Agn Dept. of Commerce Dept. of Education Dept. of Energy Dept. of Health and Human Services Dept. of Homeland Security Dept. of Housing and Urban Development Dept. of Interior Dept. of Justice Dept. of Labor Dept. of State Dept. of Transportation Dept. of Treasury Dept. of Veterans Affairs Environmental Protection Agency Equal Employment Opportunity Commission Federal Deposit Insurance Corporation Federal Housing Finance Agency Federal Reserve System Federal Trade Commission General Accounting Office Government Printing Office House of Representatives International Trade Commission Library of Congress NASA National Science Foundation National Security Agency Natl. Archives and Records Admin. Natl. Endowment for the Arts Natl. Gallery of Art Natl. Geospatial Intelligence Agency Natl. Labor Relations Board Natl. Telecom and Information Admin. Navy Nuclear Regulatory Commision Office of Personnel Management Securities and Exchange Commission Small Business Administration Smithsonian Institution Social Security Administration Supreme Court TRK sequence prefix Tennessee Valley Authority U.S. Capitol Police U.S. Int. Boundary and Water Commission U.S. Marine Corps U.S. Peace Corps U.S. Postal Service U.S. Senate U.S. Trade Representative U.S. Trade and Development Agency US Chemical Safety Board US Commodity Futures Trading Commision  *
	Central Service Area Eastern Service Area Western Service Area  *
If you are a non-federal entity and the frequency you are coordinating requires an FCC license, please select “Non-Federal”, as your agency type. If you are a non-federal contractor supporting DOD or any other federal agency, and the frequency you are coordinating requires NTIA approval, please select the agency you are supporting, as your agency type.

This statement is provided pursuant to the Privacy Act of 1974, 5 USC § 552a: The authority for collecting this information is contained in 49 United States Code (USC) Sections 44718 & 47101. Title 14 of the Code of Federal Regulations (14 CFR), parts 77 & 157 authorizes FAA to collect this information. The principal purpose for which the information is intended to be used is to administer and engineer concurrence for the proponent to use a radio frequency that impacts civil aviation. Submission of the data is voluntary; however, failure to furnish the requested information may result in an inability of the FAA to process the frequency request or administer a FAA concurrence to use a radio frequency proposed which impacts civil aviation. The information collected on this form will be included in a Privacy Act System of Records known as DOT/FAA 826 “Petitions for Exemption, Other than Medical Exemption-Public Dockets” and will be subject to the routine uses published.

OMB Control Number 2120-0786

Expiration Date: 05/31/2026