FAA Records Request (PRIA)
FAA Records Request (PRIA) Form. This is a Official Federal Forms form and can be use in Federal Aviation Administration (FAA).
Tags: FAA Records Request (PRIA), FAA 8060-10, Official Federal Forms Federal Aviation Administration (FAA),
Form Approved: OMB No. 2120-0607 06/30/2007 FAA RECORDS REQUEST (PRIA) Pilot Records Improvement Act Of 1996 (PRIA) Title 49 U.S.C. § 44703(h), RECORDS OF EMPLOYMENT OF PILOT APPLICANTS, as amended Requests for FAA records should be addressed as follows: Regular mail through the United States Postal Service (USPS): Expedited mail service through the USPS or private carrier: Federal Aviation Administration Attn: Aviation Data Systems Branch, AFS-620 (PRIA) PO Box 25082 Oklahoma City, OK 73125-0082 Federal Aviation Administration Attn: Aviation Data Systems Branch, AFS-620 (PRIA) 6500 S. MacArthur Blvd., ARB Room 313 Oklahoma City, OK 73169 NOTICE Request will not be deemed valid unless Parts I and II are completed as specified in the instructions. Pursuant to 49 U.S.C. § 44703(h)(5), the FAA, as a person who receives a request for records under 49 U.S.C. § 44703(h)(1)(A), shall furnish a copy of the requested FAA records to ALL applicants, not later than 30 days after receiving the request. PART I: FAA RECORDS REQUEST (PRIA) , , hereby requests records pertaining (Air Carrier Name) (Air Carrier Certificate #) to the airman consenting in Part II below concerning: (i) current airman medical certificate; (ii) current airman certificates indicating level, category, class, and associated type ratings, including any limitations to those certificates and ratings; and, (iii) summaries of legal enforcement actions resulting in a finding by the Administrator of a violation of Title 49 U.S.C. or a regulation prescribed or order issued under this Title that was not subsequently overturned [as provided by 49 U.S.C. § 44703(h)(1)(A)]. Name: (Print – Air Carrier Representative) Signature: (Air Carrier Representative) Title: (Print—Title of Air Carrier Representative) Date: Mailing address: Telephone FAX PART II: AIRMAN CONSENT FOR THE RELEASE OF RECORDS I , consent to and authorize the Federal Aviation Administration (Print – Airman’s First, Middle, and Last Name) to release records concerning: (i) my current airman medical certificate, (ii) current airman certificates indicating level, category, class, and associated type ratings, including any limitations to those certificates and ratings; and, (iii) summaries of legal enforcement actions resulting in a finding by the Administrator of a violation by me of Title 49 U.S.C. or a regulation prescribed or order issued under this Title that was not subsequently overturned, to the air carrier named in Part I above. Airman Certificate Number(s): Signature: Date: (Not valid unless signed and dated) *Mailing address: (*Indicates required information. See Instructions: Part II, item 4) Telephone: FAA Form 8060-10 (10-05) American LegalNet, Inc. www.FormsWorkflow.com INSTRUCTIONS FAA FORM 8060-10, FAA RECORDS REQUEST (PRIA) Pilot Records Improvement Act Of 1996 (PRIA) Title 49 U.S.C § 44703(h), RECORDS OF EMPLOYMENT OF PILOT APPLICANTS, as amended Air carriers should use this form to request FAA Records from the Federal Aviation Administration as contemplated under 49 U.S.C. § 44703(h). Requests may be mailed or FAXED to 405-954-4655, ATTN: PRIA. NOTICE Request will not be deemed valid unless Parts I and II are completed as specified below. This form may be photocopied for use. This form is available at http://www.faa.gov/pilots/lic_cert/pria/ or http://forms.faa.gov/ A separate form must be used for each airman whose records are requested. DO NOT enter information on this form such as date of birth, social security number, or other information for which the airman may have a reasonable expectation of privacy. *Mailing address – See Part II Item 4. Part I – FAA Records Request (PRIA): To be completed by the hiring Air Carrier. All entries must be completed legibly with black or dark blue ink. 1. Name, title, and signature – enter the name, title, and signature of the person making the request on behalf of the air carrier. 2. Date – enter the date of the request. 3. Mailing address – provide a complete company mailing address to which FAA will mail the requested records. Part II – Airman Consent For The Release Of Records: To be completed by the Airman/Applicant. All entries must be completed legibly with black or dark blue ink. 1. Name – enter your name as it is shown on your airman certificate(s). 2. Airman Certificate Number – enter your airman certificate number(s). In parenthesis after the certificate number, indicate the type of certificate by using C (Commercial), A (Airline Transport Pilot), F (Flight Instructor), or G for (Ground Instructor). If you have multiple certificates with the same certificate number, list the certificate number once and indicate the types of certificates in parenthesis. For example, if you hold an Airline Transport Pilot Certificate as well as Flight Instructor and Ground Instructor Certificates using the same number, you should indicate as follows: Certificate No. 456231234 (A, F, G). 3. Signature and Date – Sign in ink using your legal signature, then enter the date of the request. 4. *Mailing Address – All applicants must ensure that their mailing address, as maintained in FAA records, is complete, accurate, and current. All FAA records mailed to the applicant as the result of a PRIA request, will, for security purposes, be mailed to the address as maintained by the FAA. The applicant, however, should still enter their current mailing address in Part II for confirmation of the valid address. PAPERWORK REDUCTION ACT STATEMENT Title 49 United States Code (49 U.S.C.) § 44703(h), Records of Employment of Pilot Applicants, as amended, requires all air carriers to request FAA records and Air Carrier and Other Records concerning an individual before allowing that individual to begin service as a pilot. 49 U.S.C. § 44703(h)(8) requires the FAA Administrator to promulgate standard forms to request records. The information entered on the standard forms will be used to facilitate the search and retrieval of the required records. It is estimated that the average burden per respondent associated with this collection of FAA Records is 10 minutes. The requirement to collect and evaluate background information on the pilot, before allowing that pilot to begin service, is mandatory; however, the use of this form is not, although it is highly recommended. An agency may not conduct or sponsor, and a person is not required to respond to, this request for information unless a current and valid OMB control number is prominently displayed. The OMB control number assigned to this collection is 2120-0607. 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. FAA Form 8060-10 (10-05) American LegalNet, Inc. www.FormsWorkflow.com