Privacy Act from FAA form 8710-1 (4/00)

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 elligibility 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:

1. To provide basic airmen certification and qualification information to the public upon request.
2. To disclose information to the national Transportation Safety Board (NTSB) in connection with its investigation responsibilities.
3. To provide information about airmen to Federal, state, and local law enforcement agencies when engaged in the investigation and apprehension of drug violators.
4. 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.
5. 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 the 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.