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U.S. Department

of Transportation

Federal Aviation

Administration

FAA Form 8710-1, Airman Certificate

and/or Rating Application

Supplemental Information and Instructions

Paperwork Reduction Act Statement:

The information collected on this form is necessary to determine applicant eligibility for airman ratings. We estimate it

will take 15 minutes to complete this form. The information collected is required to obtain a benefit and becomes part of

the Privacy Act system of records DOT/FAA 847, General Air Transportation Records on Individuals. Please note that

an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it

displays a currently valid OMB control number. The OMB control number associated with this collection is 2120-0021.

Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the

FAA at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ABA-20.

Privacy Act

The information on the accompanying form is solicited under authority of Title 14 of the Code of Federal Regulations

(14 CFR), Part 61. The purpose of this data is to be used to identify and evaluate your qualifications and eligibility for

the issuance of an airman certificate and/or rating. Submission of all requested data is mandatory, except for the Social

Security Number (SSN) which is voluntary. Failure to provide all the required information would result in you not

being issued a certificate and/or rating. The information would become part of the Privacy Act system of records

DOT/FAA 847, General Air Transportation Records on Individuals. The information collected on this form would be

subject to the published routine uses of DOT/FAA 847. Those routine uses are: (a) To provide basic airmen

certification and qualification information to the public upon request. (b) To disclose information to the national

Transportation Safety Board (NTSB) in connection with its investigation responsibilities. (c) To provide information

about airmen to Federal, state, and local law enforcement agencies when engaged in the investigation and

apprehension of drug violators. (d) To provide information about enforcement actions arising out of violations of the

Federal Aviation regulations to government agencies, the aviation industry, and the public upon request. (e) To

disclose information to another Federal agency, or to a court or an administrative tribunal, when the Government or

one of its agencies is a party to a judicial proceeding before the court or involved in administrative proceedings before

the tribunal.

Submission of your Social Security Number is voluntary. Disclosure of your SSN will facilitate maintenance of your

records which are maintained in alphabetical order and cross-referenced with your SSN and airman certificate number

to provide prompt access. In the event of nondisclosure, a unique number will be assigned to your file.

See Privacy Act Information above. Detach this part before submitting form.

Instructions for completing this form (FAA 8710-1) are on the reverse.

If an electronic form is not printed on a duplex printer, the applicant's name, date of birth, and certificate number

(if applicable) must be furnished on the reverse side of the application. This information is required for identification

purposes. The telephone number and E-mail address are optional.

Tear off this cover sheet before submitting this form.

FAA Form 8710-1 (4-00) Supersedes Previous Edition

NSN: 0052-00-682-5007

Faa Form 8710-1 - Airman Certificate And/or Rating Application Supplemental Information And Instructions