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U.S. Department of TransportationU.S. Department of Transportation IconUnited States Department of TransportationUnited States Department of Transportation
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PART 234 Mishandled Baggage Report Certification


OMB N0: 2138-0041


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 2138-0041. Public reporting for on-time performance, and mishandled baggage is estimated to be approximately 20 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, as authorized by 14 CFR, Part 234. 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, Cecelia Robinson, OAI/BTS/RITA, RTS-42, Room E34, 1200 New Jersey Avenue, SE, Washington, D.C. 20590, or e-mail –


RECORD DESCRIPTION/INSTRUCTIONS: ASQP – Mishandled Baggage Report Certification

A certification statement for the Mishandled Baggage Report is required identifying an appropriate official of the reporting carrier. The certification statement will read:

I, (Name) and (Title), of the above named carrier, certify that the Mishandled Baggage Report file is to the best of my knowledge and belief, true, correct and a complete report for the period stated.

Month and Year of Data:

Number of Domestic Scheduled Passengers Enplaned:

Number of Mishandled Baggage Reports Filed:


Name (Please Print or Type):



Once signed, the Mishandled Baggage Report Certification must be published as an electronic “portable document format” file format, for uploading to the eSubmit application.

The portable document format file MUST BE indicated when naming the file, by using the letters [PDF] or [pdf] following the file name, as the file name extension. You must have Adobe Reader software downloaded on your computer in order to “save as/print” your document as a ‘pdf’ file.

While the file name is flexible and may be determined by the individual air carrier, the portable document format (pdf) file format is required, as outlined in the rule entitled, Submitting Airline Data via the Internet.

Suggested file name: XX201003-234mbrCert.pdf

NOTE: For OAI support, please email: