Form DOT Form DOT Form U.S. DOT Serive Air Transportation Form

OMB Control Number: 2105-0576

Expiration Date:__/__ /2027

U .S. Department of Transportation Service Animal Air Transportation Form

Warning: It is a Federal crime to make materially false, fictitious, or fraudulent statements, entries, or representations knowingly and willfully on this form to secure disability accommodations provided under regulations of the United States Department of Transportation (18 U.S.C. § 1001).

PLEASE REFER TO THE U.S. DEPARTMENT OF TRANSPORTATION SERVICE ANIMAL AIR TRANSPORTATION FORM INSTRUCTIONS WHEN COMPLETING THIS FORM

1. Service Animal Handler Information

Service Animal Handler’s full Name:

Phone: Email:

☐ I attest that a service animal is required to accompany me, or the passenger with a disability traveling with me, in air transportation.

2. Service Animal Identification and Health Information

Animal’s Name: Animal’s Description (including weight and color):

☐ I attest that the animal:

• Does not have fleas or ticks or a disease that would endanger people or other animals.

• Is vaccinated for rabies.

Date vaccination expires in the animal_________________

(mm/dd/yyyy)

Veterinarian’s Name (signature not required): Phone:

3. Service Animal Task Training

☐ I attest that the animal has been individually trained to perform a task to assist with a disability.

Name of Task Trainer or Training Organization: Phone:

4. Service Animal Behavior Training

☐ I attest that the animal has been trained to behave in a public setting.

Name of Behavior Trainer or Training Organization: Phone:

☐ I understand that:

• The animal must be under the control of the Handler at all times.

• A properly trained service animal does not act aggressively by biting, barking, jumping, lunging, or injuring

people or animals, and does not urinate or defecate on the aircraft or in the gate area.

• If the animal shows that it has not been properly trained to behave in public, then the airline may treat the animal as a pet by charging a pet fee and requiring that the animal be transported in a pet carrier, or denying transport.

☐ I attest that, to the best of my knowledge, the animal has not behaved aggressively or caused serious injury to another person or

animal. If you are unable to make this attestation, please explain why:

5. Other Assurances

☐ I understand that:

• The animal must be harnessed, leashed, or tethered at all times in the airport and on the aircraft.

• If the animal causes damage, then the airline may charge the Handler for the cost to repair it, as long as the airline would also charge passengers without disabilities to repair similar kinds of damage.

• I am signing an official document of the U.S. Department of Transportation, and if I knowingly make false statements on this document, I can be subject to fines and other penalties.

Handler’s Signature: Date: ______________________________ (mm/dd/yyyy)

INSTRUCTIONS FOR COMPLETING THE U.S. DEPARTMENT OF TRANSPORTATION SERVICE ANIMAL AIR TRANSPORTATION FORM

General instructions:

1. What is a Service Animal for the purpose of this form? A service animal means a dog, regardless of breed or type, that is individually trained to do work or perform tasks for the benefit of a qualified individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Animal species other than dogs, emotional support animals, comfort animals, companionship animals, and service animals in training are not service animals for purpose of this form. 14 CFR 382.3.

2. What is a Service Animal Handler for the purpose of this form? A Service Animal Handler is a passenger in air transportation who is a qualified individual with a disability who receives assistance from a service animal(s) that does work or performs tasks that are directly related to the individual’s disability, or a third party who accompanies the individual with a disability traveling with a service animal such as a parent of a minor child or a caretaker. The service animal Handler is responsible for keeping the animal under control at all times, and caring for and supervising the service animal, which includes toileting and feeding. 14 CFR 382.3.

3. What if I need assistance completing the form? An airline must provide assistance in completing the form to individuals with a disability who state to the airline that they are unable to complete the form due to a disability. This assistance must be provided as part of the airline’s general obligation to modify its policies, practices, and facilities when needed to provide nondiscriminatory service to individuals with a disability under 14 CFR 382.13.

4. Do I submit the form to the airline or DOT? Do not submit the form to DOT. If an airline requires a passenger traveling with a service animal to submit the form, the completed form must be submitted directly to the airline. 14 CFR 382.75(f).

5. How often can an airline require me to submit the form? Airlines can require passengers with a disability who are traveling with a service animal to submit the form once each trip, but not each time the passenger travels. This means that an airline can only require the form be submitted once if the passenger with a disability purchased a roundtrip ticket as that would be considered one trip. 85 FR 79742, 79764 (December 10, 2020).

6. Must I submit the form to the airline in advance? An airline can require a passenger with a disability who is traveling with a service animal to submit the form up to 48 hours in advance of the passenger’s flight if the passenger’s reservation was booked more than 48 hours before the passenger’s departure. However, if the passenger fails to submit the form in advance, the airline cannot refuse to transport the service animal without trying to make reasonable efforts to accommodate the passenger. 14 CFR 382.75(g)(1) and 14 CFR 382.75(h).

7. Can an airline require me to submit my form in advance if I purchase last minute travel? An airline is not permitted to require a passenger with a disability who is traveling with a service animal and purchased a ticket within 48 hours of the flight to provide the form in advance. If the ticket is purchased within 48 hours of the flight, the airline must allow the passenger to submit the completed form at the gate on the date of travel. 14 CFR 382.75(g)(3).

8. Must airlines accept either a hard copy or electronic version of the form? An airline must provide passengers with a disability the option of submitting an electronic or hard copy version of the form if the person is required to submit the form in advance of the passenger’s travel date. If a passenger is not required to submit the form in advance of the date of travel, the passenger may submit a hard copy of the form to the airline at the passenger’s departure gate on the date of travel. 14 CFR 382.75 (f) and (g). Passengers are encouraged to contact the airline to familiarize themselves with the airline’s process for receiving the form.

Section A Instructions:

Section A, titled Service Animal Handler Information, requires the Service Animal Handler completing the form to provide their full first and last name, phone number, and email address so that the airline or its contractor may contact the Handler about the information provided on the form if needed.

The Handler completing this form must be the passenger with a disability receiving assistance from the service animal, or a third party accompanying the passenger with a disability traveling with the service animal such as a parent of a minor child or a caretaker. 14 CFR 382.3. This section requires the Handler to check a box attesting that a service animal is required to accompany the Handler, or the passenger with a disability traveling with the Handler.

Section B Instructions:

Section B, titled Service Animal Identification and Health Information, requires the Handler to provide the name of the service animal accompanying the Handler in air transportation and a description of the animal (including the animal’s weight and color). The airline or its contractor may use the description of the animal provided by the Handler on the form to verify the identity of the service animal at the airport on the day of travel.

In this section, the Handler must provide the airline assurances that it is safe to transport the animal on an aircraft by checking a box to attest that the animal is free of fleas, ticks, or disease, and that the animal has been vaccinated for rabies. The Handler must also provide the month, day, and year that the animal’s rabies vaccination expires. The Handler must provide the name of the animal’s veterinarian, and the veterinarian’s phone number, but the animal’s veterinarian is not required to sign the form.

The airline or its contractor may contact the animal’s veterinarian to verify the vaccination information provided on the form. The Handler should verify that the contact information on the form is current and correct to ensure that there are no delays when the airline or its contractor attempts to process the form.

Section C Instructions:

In Section C, titled Service Animal Task Training, the Handler must check a box attesting that the animal is a service animal because it has been trained to perform a task to assist the passenger with a disability.

Task training means that the dog is trained to take a specific action when needed to assist the person with a disability. Dogs can be trained to perform many important tasks to assist people with disabilities, such as providing stability for a person who has difficulty walking, picking up items for a person who uses a wheelchair, helping a person who has epilepsy detect the onset of a seizure and stay safe during the seizure, or alerting a person who has hearing loss when someone is approaching from behind. Task training is different from behavior training because task training is focused on mitigating the effects of a person’s disability.

The Handler is not required to provide a training certificate or other evidence that the animal has been trained to perform a task, but the Handler must provide the name and phone number of the person or organization that trained the service animal to perform the disability-mitigating task. If the Handler trained the animal, the Handler may provide their name and contact information. The airline or its contractor may contact the task trainer to verify that the animal has been trained to perform a task to assist with a disability. The Handler should verify that the contact information on the form is current and correct to ensure that there are no delays when the airline attempts to process the form.

Section D Instructions:

In Section D, titled Service Animal Behavior Training, the Handler must provide the airline assurances that the service animal traveling in air transportation will not harm other people or animals on the aircraft by checking a box to attest that the animal has been trained to behave in public. The behavior training attestation in this section is different from the task training attestation required in Section C on this form. A service animal that has been trained to behave in public does not act aggressively by biting, barking, jumping, lunging, or injuring people or animals. Further, a service animal that has been trained to behave in public does not urinate or defecate on the aircraft or in the gate area of the airport.

This form does not require the Handler to provide the airline with a training certificate or other evidence that the animal has been trained to behave in a public setting. However, the airline may observe the animal on the day of travel, and if it is evident that the animal has not been trained, the animal may be treated like a pet and/or the animal may be denied transportation on the aircraft.

In this section, the Handler must provide the name and phone number of the person or organization that trained the service animal to behave in public. If the Handler trained the animal, the Handler may provide their name and contact information. The airline or its contractor may contact the behavior trainer to verify that the animal has been trained to behave in public. The Handler should verify that the contact information on the form is current and correct to ensure that there are no delays when the airline attempts to process the form.

Section D also requires the Handler to check a box attesting that the Handler understands that the service animal must be under the Handler’s control at all times, that properly trained service animals must act appropriately, and that if it shows that it has not been properly trained to behave in public, the animal may be treated like a pet, which includes being charged a pet fee to transport the animal, requiring the animal to be transported in a carrier, or denying the animal transport.

The Handler must also check a box attesting that the animal has not behaved aggressively or caused serious injury to another person or animal. If the Handler is unable to make this attestation, the Handler must describe, in the space provided on the form, the reasons why it cannot attest that the animal has not behaved aggressively or caused serious injury to another person or animal. Animals that have a history of aggressive behavior may be denied transport on the aircraft and the airline may contact the animal’s trainer or veterinarian to verify the animal’s behavioral history.

Section E Instructions:

Section E, titled Other Assurances, requires the Handler to check a box to confirm that the Handler understands that the service animal traveling must be harnessed, leashed, or tethered at all times in the airport and on the aircraft; that the airline may charge the Handler a fee if the animal causes damage; that the Handler is signing an official document of the U.S. Department of Transportation; and that the Handler may be subject to Federal fines and other penalties for knowingly making false statements on the form. Handlers must also sign and date the form before submitting the form to the airline.

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 currently valid OMB Control Number. The OMB Control Number for this information collection is 2105-0576. Public reporting for this collection of information is estimated to be approximately 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing and reviewing the collection of information.

All responses to this collection of information are mandatory if an airline requires the submission of the forms (14 CFR 382.75(a) and (b)). 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, U.S. Department of Transportation, 1200 New Jersey Ave., S.E., West Building Ground Floor Room W12-140, Washington, D.C. 20590.