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Form 291-A - Statement of Operations and Summary Statistics for Section 41103
Word
Carrier _____________________
Year Ended December 31, __________
Operating Revenues and Expenses
| Transport Revenue: |
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| Property |
1 ________________________ |
| Mail |
2 ________________________ |
| Transport Related Revenue |
3 ________________________ |
| Total Operating Revenue |
4 ________________________ |
| Total Operating Expense |
5 ________________________ |
| Operating Profit or (Loss) |
6 ________________________ |
| Net Income or (Loss) |
7 ________________________ |
I, the undersigned, (Title)__________________________ of the above-named air carrier certify that the above report has been examined by me and to the best of my knowledge and belief is a true, correct and complete report for the period stated.
Date _____________________
Signature: _____________________
Name (Please Type or Print) _____________________
BTS Form 291-A
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