Aircraft Owner Request To Delete Registration/receive Refund Form printable pdf download

OMB Control No. 2120-0765 - PENDING

Section 336 Aircraft Owner Request to Delete Registration/Receive Refund

This form is for owners of model aircraft who would like to delete their registration record in the

small UAS registration database maintained under the Privacy Act System of Record DOT/FAA-

801, Aircraft Registration Records, in accordance with the ruling in Taylor v. Huerta by the Court

of Appeals for the District of Columbia Circuit on May 19, 2017. In order to enable the deletion of

your registration record in the small UAS registration database, the following stipulations must be

applicable. Please ensure they are properly marked as part of your certification. Once your request

is accepted, all registrant information will be deleted. Should you wish to register your small UAS

in the future, a new application and identifier will be required.

I hereby certify that I always operate exclusively in compliance with all of the following

provisions of section 336:



My sUAS is flown strictly for hobby or recreational use;



My sUAS is operated in accordance with a community-based set of safety guidelines and

within the programming of a nationwide community-based organization;



My sUAS does not weigh more than 55 pounds unless it is otherwise certified through a

design, construction, inspection, flight test, and operational safety program administered

by a community-based organization;



My sUAS is operated in a manner that does not interfere with and gives way to any

manned aircraft; and



When flown within 5 miles of an airport, I provide the airport operator and the airport air

traffic control tower (when an air traffic facility is located at the airport) with prior notice

of the operation.



I understand that if I do not always operate exclusively in compliance with the above

provisions of section 336, I am operating without a valid registration, which can result in

civil and criminal penalties.



I also understand that if I already received a refund during the grace period (December

21, 2015 – January 20, 2016) I am not eligible for another refund.

[ ] Expunge my record only, no refund required

(information on the second page not required, see second page for mailing address)

[ ] Expunge record and request refund

(include all required financial institution information on the second page)

Owner Name:

Owner Unique Identifier:

Signature:

Aircraft Owner Request To Delete Registration/receive Refund Form