Part 65 Forms-Details of IC

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Overview

8610-1 Blocks
8610-2 Blocks
8610-3 Blocks

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Sheet 1: 8610-1 Blocks

						Differences from previous form revision
Page	Section/Block #	Block Type	Block Title	Block Help Text	Business Need Describes the Business need for collecting this information from the public.	8610-1 (07-10)	8610-1 (09-20)	Description of Differences	Additional comments	Block Completed By: A=Applicant F=FAA O=Other	Instructions to Applicant
i	Supplemental Pages	Text	Table of Contents Printing instructions Paperwork Reduction Action Burden Statement	None	Information for applicant on the proper completion and submission of the form. Paperwork Reduction Act (PRA) of 1995	Y	Y	Added - Table of contents, Printing Instructions. Since repairman do not take any FAA tests, IACRA registration instructions have been removed. Added - PRA statement - most recent verbiage from PRA office.	PRA Burden statement must be updated upon OMB approval of the form to reflect the expiration date issued by OMB, and the burden calculated within the Information Collection (IC) supporting statement. i.e. for this form the burden was estimated at 20 minutes per response. Verbiage for IACRA instructions is based on information from: https://www.faa.gov/training_testing/testing/acts/	N/A
ii	Supplemental Pages	Text	Privacy Act Statement	None	5 U.S.C. § 552(a) Privacy Act	Y	Y	Revised - revised the Privacy Act statement. Coordinated with Privacy office who had AGC review and approve on XXXXXXX.	Revisions needed to the Privacy Statement must be coordinated with the FAA's Privacy Office.	N/A
iii	Supplemental Pages	Text	Pilot's Bill of Rights Written Notification of Investigation	None	Public Law (PL) 112‑153, Pilot’s Bill of Rights Act (PBR)	N	Y	Added - Pilots Bill of Rights Written Notification of Investigation	Verbiage for this page came from 8900.1, Volume 14, Chapter 1, Section 3, Figure 14-1-3B. (8900.1 CHG566)	N/A
iv	Supplemental Pages	Text	Instructions for Completing FAA Form 8610-1	None	To provide applicants with guidance on how to appropriately complete the form.	N	Y	Revised - revised instructions to assist applicant in form completion.	The instructions included in the supplemental pages are directed to the applicant. Instructions for FAA employees or Designees are provided within agency guidance.	N/A	GENERAL INFORMATION • An electronic, fillable, printable version of FAA Form 8610-1 is available at www.faa.gov. • Make all entries using permanent dark blue or black ink, or a typewriter or printer. All signatures must be original, with the name printed or typewritten below or beside the signature. • Unless otherwise specified, enter all dates using eight-digit numeric characters, MM/DD/YYYY (e.g., 03/29/2019). • Read all supplemental information provided with this form including the Paperwork Reduction Act Burden statement, the Privacy Act statement, the Pilot’s Bill of Rights Written Notification of Investigation, and the Instructions for Completing FAA Form 8610-1. Remove and retain the supplemental information before submitting the application. IMPORTANT NOTE: The applicant’s signature on FAA Form 8610-1 confirms the applicant has received the Privacy Act statement and the Pilot’s Bill of Rights Written Notification of Investigation at the time application was made.
1	Form Title	Text	FAA Form 8610-1, Mechanic's Application for Inspection Authorization (14 CFR Part 65)	None	The title of the Form/Information Collection approved by OMB	Y	Y	No differences.		N/A
1	1	Text	Name	(Last, First, Middle)	Required to determine who the applicant is.	Y	Y	No differences.		A	Enter your name as shown on your mechanic’s certificate. Use commas to separate names, i.e. Last, First, Middle.
1	2	Text	Mechanic Certificate No.		Required to determine applicant identification and eligibility for an inspection authorization. 65.91	Y	Y	No differences.		A	Enter your Mechanic Certificate number as shown on your mechanic’s certificate.
1	3	Text	Mailing Address.	(Number/Street/PO Box, City, State, Zip Code)	Required to be able to deliver the inspection authorization to the mechanic applicant upon approval -	Y	Y	No differences.		A	Enter your mailing address. A post office box is acceptable. If the address is outside of the U.S., include the Country.
1	4	Text	Fixed Base of Operations	(Address at which you may be located in person during normal working week)	Required to determine eligibility. 65.91(c )(3)	Y	Y	No differences.	This address could differ from the address on file with airman records.	A	Enter the address of your fixed base of operations at which you may be located in person during a normal work week.
1	4a	Text	Telephone Number	(At which you may be contacted during a normal working week)	Required to determine eligibility. 65.91(c )(3)	Y	Y	No differences.		A	Enter your telephone number at which you can be contacted during a normal work week.
1	4b	Text	Email Address	(Enter email address or NONE)	Optional entry - assists the FAA in contacting the applicant with applications issues	N	Y	Added: assists in keeping local office VIS database current.		A	Enter your email address. If you do not have an email address or choose not to provide one, enter “NONE”. Providing this information will assist the local FAA office in disseminating renewal and other information applicable to holders of an Inspection Authorization.
1	5	Checkbox	Do you hold a currently effective mechanic certificate with both airframe and powerplant ratings, and have each of those ratings been in effect for a total of at least 3 years? Yes/No	65.91(c)(1)	Required to determine applicant eligibility IAW 65.91(c )(1)	Y	Y	Revised: Previous wording of this question was not consistent with the requirement specified in 65.91(c )(1). This also incorporates the question previously asked on #7 of the old form: HAS YOUR MECHANIC CERTIFICATE AND/OR RATINGS BEEN REVOKED OR SUSPENDED DURING THE 3-YEAR PERIOD PRECEDING THIS APPLICATION?		A	Blocks 5-9. Eligibility Questions. Answer these questions regarding your eligibility for Inspection Authorization. (reference § 65.91)
1	6	Checkbox	Have you been actively engaged, for at least the 2‐year period before the date of application, in maintaining certificated aircraft in accordance with Title 14 CFR?	§65.91(c)(2)	Required to determine applicant eligibility IAW 65.91(c )(2)	Y	Y	No differences.		A	Blocks 5-9. Eligibility Questions. Answer these questions regarding your eligibility for Inspection Authorization. (reference § 65.91)
1	7	Checkbox	Do you have available to you the equipment, facilities, and inspection data necessary to properly inspect airframes, powerplants, propellers, or any related part or appliance?	§65.91(c)(4)	Required to determine applicant eligibility IAW 65.91(c )(4)	Y	Y	Added: Reflects the requirements of 65.91(c )(4).		A	Blocks 5-9. Eligibility Questions. Answer these questions regarding your eligibility for Inspection Authorization. (reference § 65.91)
1	8	Checkbox	Have you attempted the Inspection Authorization written test within 90 days previous to making this application?	§65.91	Required to determine applicant eligibility IAW 65.91 - last sentence: An applicant who fails the test prescribed in paragraph (c)(5) of this section may not apply for retesting until at least 90 days after the date he failed the test.	Y	Y	Revised: Revised to better reflect how answering this question with a YES would affect the applicants eligibility for testing endorsement.	Answering YES to this question would make the applicant ineligible for another testing endorsement until 90 days have passed since the applicants last IA test failure.	A	Blocks 5-9. Eligibility Questions. Answer these questions regarding your eligibility for Inspection Authorization. (reference § 65.91) Block 8 – This question identifies the following situations: • Retest Applicants – An applicant must wait 90 days after failure of the IA written/knowledge test and return to a Flight Standards office for a newly endorsed FAA Form 8610-1. The applicant is required to submit the applicable failed Airman Knowledge Test Report (AKTR) and new endorsed FAA Form 8610-1 to the testing center prior to retesting. • IA Recent Issuance - Applicants applying for renewal within 90 days of Inspection Authorization issuance are renewed using the recent issuance provisions of §65.93(b). In block 10, check “Recent Issuance” and enter the date your authorization was last issued.
1	9	Checkbox	Have you met the minimum requirements for renewal of Inspection Authorization and documented your renewal basis in block 10.	(FOR RENEWAL ONLY)	Provides an indication from the applicant that they have met the minimum renewal requirements and completed Block 10.	Y	Y	Revised: Revised wording to remind applicants that the basis for renewal Block 10 must be completed when applying for a renewal.		A
1	10	Text	Basis For Renewal	Refer to form instructions for activity recording requirements for renewal of Inspection Authorization.		Y	Y	Revised - See below blocks for description of revised blocks in this section.		A	Block 10. BASIS FOR RENEWAL – Complete only when renewing Inspection Authorization. An Inspection Authorization expires on March 31 of each odd-numbered year. A renewal year/period is based on April 1st of the first year through March 31st of the next year. RECENT ISSUANCE – Check this block when you have been issued an Inspection Authorization in effect for: • Less than 90 days before the Inspection Authorization expiration date - Do not record any renewal activity in Block 10. • Less than 90 days before March 31st of a non-renewal year – Record your 2nd year renewal activity. Enter N/A in the 1st year activity blocks. Renewal Activity - Reference § 65.93 for renewal activity requirements for each year. • Enter the number of annual inspections, repairs, alterations, or progressive inspections you have performed, if your renewal will be based on one of these activities. You cannot use a mixture of activities as the basis for renewal within a renewal period because § 65.93(a) does not provide for this. Each renewal year/period must be based on the required number of either: annual inspections, major repairs/alterations, or progressive inspections specified in § 65.93.  The FAA will review evidence of renewal activity at the time of renewal, e.g. activity sheet, log(s), etc. • If renewal is based on attendance and completion of a refresher course, enter the FAA accepted course/seminar number, the course location/provider, number of course hours, and the date of course completion. For technical training conducted by a manufacturer, enter the course title, in place of the course/seminar number.  The FAA will review evidence of training course attendance at the time of renewal, e.g. certificate(s) of course completion. • If renewal is based on the passing of an oral test conducted by an FAA inspector, enter the date the test was passed.  The FAA will review evidence of oral test results at the time of renewal, e.g. FAA letter documenting oral test completion and results.
1	10	Checkbox	Recent Issuance	Enter date only if the recent issuance requirements of §65.93(b) apply, refer to Block 10 Instructions.	Required to assist in determining if applicant must show renewal activity. If the IA was issued less than 90 days before March 31, then certain renewal activity does not need to be shown. Reference 65.93(b)	N	Y	Added - Applicants check this box to indicate they meet the recent issuance requirements of 65.93(b).		A
1	10	Text	Enter Date of Issuance	Enter date only if the recent issuance requirements of §65.93(b) apply, refer to Block 10 Instructions.	Required to assist in determining if applicant must show renewal activity. If the IA was issued less than 90 days before March 31, then certain renewal activity does not need to be shown. Reference 65.93(b)	N	Y	Added: Applicants entry of the date their IA was issued will allow the inspector to determine what activity needs to be entered in block 10.		A
1	10	Text	Annual Insp	§65.93(a)(1)	Required to determine renewal eligibility based on the activities stated in 65.93.	Y	Y	Reformatted		A
1	10	Text	Major Repairs	§65.93(a)(2)	Required to determine renewal eligibility based on the activities stated in 65.93.	Y	Y	Reformatted		A
1	10	Text	Major Alters.	§65.93(a)(2)	Required to determine renewal eligibility based on the activities stated in 65.93.	Y	Y	Reformatted		A
1	10	Text	Prog. Insp.	§65.93(a)(3)	Required to determine renewal eligibility based on the activities stated in 65.93.	Y	Y	Reformatted		A
1	10	Text	Refresher Course	§65.93(a)(4) FAA Course/Seminar No., Location/Provider, Hours, Completion Date – Use separate sheet if needed.	Required to determine renewal eligibility based on the activities stated in 65.93.	y	Y	Reformatted		A
1	10	Text	Oral Test	§65.93(a)(5) Enter date tested	Required to determine renewal eligibility based on the activities stated in 65.93.	N	Y	Added: Previously this information was recorded in the remarks block.		A
1	10	Text	1ST Year Renewal Period (Apr 1st odd – Mar 31st even)	None	Required to determine renewal eligibility based on the activities stated in 65.93.	Y	Y	Reformatted		A
1	10	Text	2ND Year Renewal Period (Apr 1st even – Mar 31st odd)	None	Required to determine renewal eligibility based on the activities stated in 65.93.	Y	Y	Reformatted		A
1	11	Text	AIRCRAFT MAINTENANCE ACTIVITY DURING THE LAST 2 YEARS	Continue activity on a separate sheet if needed.	Required to determine issuance and renewal eligibility based on 65.91(c )(2) Have been actively engaged, for at least the 2-year period before the date he applies, in maintaining aircraft certificated and maintained in accordance with this chapter;	Y	Y	No differences.		A	Block 11. AIRCRAFT MAINTENANCE ACTIVITY DURING THE LAST 2 YEARS. – Complete for renewal and initial application of Inspection Authorization. Enter the aircraft maintenance activity showing you are actively engaged in maintaining aircraft certificated and maintained in accordance with Title 14 CFR. All applications (initial or renewal) must enter applicable information in these blocks. Attach additional sheets if necessary to record activity. Date From. Enter your employment start date in a six-digit (MM/YYYY) numeric format. Date To. Enter your employment end date in a six-digit (MM/YYYY) numeric format. Facility Where Activity Performed. Enter the name of your employer and the city and state of your employment. Description of Activity. Enter the type of work performed with the employer. Job and/or position titles are not a description of work performed.
1	11	Text	DATES	MM/YYYY	Required to determine issuance and renewal eligibility based on 65.91(c )(2) Have been actively engaged, for at least the 2-year period before the date he applies, in maintaining aircraft certificated and maintained in accordance with this chapter;	Y	Y	No differences.		A
1	11	Text	From:		Required to determine issuance and renewal eligibility based on 65.91(c )(2) Have been actively engaged, for at least the 2-year period before the date he applies, in maintaining aircraft certificated and maintained in accordance with this chapter;	Y	Y	No differences.		A
1	11	Text	To:		Required to determine issuance and renewal eligibility based on 65.91(c )(2) Have been actively engaged, for at least the 2-year period before the date he applies, in maintaining aircraft certificated and maintained in accordance with this chapter;	Y	Y	No differences.		A
1	11	Text	FACILITY WHERE ACTIVITY PERFORMED	Employer Name, City, State)	Required to determine issuance and renewal eligibility based on 65.91(c )(2) Have been actively engaged, for at least the 2-year period before the date he applies, in maintaining aircraft certificated and maintained in accordance with this chapter;	Y	Y	No differences.		A
1	11	Text	DESCRIPTION OF ACTIVITY	(Describe work performed, not job titles)	Required to determine issuance and renewal eligibility based on 65.91(c )(2) Have been actively engaged, for at least the 2-year period before the date he applies, in maintaining aircraft certificated and maintained in accordance with this chapter;	Y	Y	No differences.		A
1	12	Text	Remarks		Required so that applicant or FAA may enter other pertinent information regarding application or renewal of an inspection authorization.	Y	Y	No differences.		A F	If needed, enter any additional information regarding your initial application or renewal in this block.
1	13	Text	Applicants Certification	I certify that all statements and answers provided by me on this application form are complete and true to the best of my knowledge and I agree that they are to be considered as part of the basis for issuance of any FAA certificate, rating or inspection authorization to me. I have received the Pilot’s Bill of Rights Written Notification of Investigation that accompanies this form. I have also read and understand the Privacy Act statement that accompanies this form.	The statement notifies the applicant of the information they are certifying.	Y	Y	Revised: Revised statement to be consistent with FAA form 8610-2 and -3, to include reference to the pilots bill of rights written notification and the privacy act.		A	Sign your name. Enter the date you signed the application, in the MM/DD/YYYY format.
1	13	Text	Applicants Signature	(Print Name and Sign)	The applicants signature indicates they have read and agree to the certifying statement.	Y	Y	No differences.		A	Sign your name. Enter the date you signed the application, in the MM/DD/YYYY format.
1	13	Text	Dates	(MM/DD/YYYY)	Indicates date application was signed by applicant.	Y	Y	No differences.		A	Sign your name. Enter the date you signed the application, in the MM/DD/YYYY format.
1	14	Text	Record of Action		Records FAA action relative to the application	Y	Y	No differences.		F
1	14	Checkbox	Endorsement	(Expires in 30 Days)	Records FAA action relative to the application	Y	Y	No differences.		F
1	14	Text	FAA Signature	(Print Name and Sign)	FAA signature here indicates the FAA's endorsement to allow the applicant to test for an inspection authorization.	Y	Y	No differences.		F
1	14	Text	Date	(MM/DD/YYYY)	Records the date of the FAA action was approved.	Y	Y	No differences.		F
1	14	Text	FAA Office/Designation No.		Records the FAA office approving the action.	Y	Y	No differences.		F
1	14	Checkbox	Issuance		Records FAA action relative to the application	Y	Y	No differences.		F
1	14	Checkbox	Renewal		Records FAA action relative to the application	Y	Y	No differences.		F
1	14	Checkbox	Voluntary Surrender		Records FAA action relative to the application	Y	Y	No differences.		F
1	14	Text	FAA Signature	(Print Name and Sign)	Records the FAA's approval of either initial IA issuance, renewal, or a voluntary surrender of the inspection authorization.	Y	Y	No differences.		F
1	14	Text	Date	(MM/DD/YYYY)	Records the date of the FAA action was approved.	Y	Y	No differences.		F
1	14	Text	FAA Office/Designation No.		Records the FAA office approving the action.	Y	Y	No differences.		F

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Sheet 2: 8610-2 Blocks

						Differences from previous form revision
Page	Section	Block Type	Block Title	Block Help Text	Business Need Describes the Business need for collecting this information from the public.	8610-2 (2-15)	8610-2 (09-20)	Description of Differences	Additional comments	Block Completed By: A=Applicant D = Designee F=FAA O=Other	Instructions to Applicant
i	Supplemental Pages	Text	Table of Contents Printing instructions IACRA instructions Paperwork Reduction Action Burden Statement	None	Information for applicant on the proper completion and submission of the form. Paperwork Reduction Act (PRA) of 1995	Y	Y	Added - Table of contents, Printing Instructions, and IACRA instructions. Moved - PRA statement moved from page 1 to page 2 Revised - Updated the PRA statement with most recent version from FAA PRA office.	PRA Burden statement must be updated upon OMB approval of the form to reflect the expiration date issued by OMB, and the burden calculated within the Information Collection (IC) supporting statement. i.e. for this form the burden was estimated at 20 minutes per response. Verbiage for IACRA instructions is based on information from: https://www.faa.gov/training_testing/testing/acts/	N/A
ii	Supplemental Pages	Text	Privacy Act Statement	None	5 U.S.C. § 552(a) Privacy Act	Y	Y	Revised - revised the Privacy Act statement. Coordinated with Privacy office who had AGC review and approve on XXXXXXX.	Revisions needed to the Privacy Statement must be coordinated with the FAA's Privacy Office.	N/A
iii	Supplemental Pages	Text	Pilot's Bill of Rights Written Notification of Investigation	None	Public Law (PL) 112‑153, Pilot’s Bill of Rights Act (PBR)	N	Y	Added - Pilots Bill of Rights Written Notification of Investigation	Verbiage for this page came from 8900.1, Volume 14, Chapter 1, Section 3, Figure 14-1-3B. (8900.1 CHG566)	N/A
iv	Supplemental Pages	Text	Instructions for Completing FAA Form 8610-2	None	To provide applicants with guidance on how to appropriately complete the form.	N	Y	Added - previous versions of this form did not include instructions to the applicant on form completion.	The instructions included in the supplemental pages are directed to the applicant. Instructions for FAA employees or Designees are provided within agency guidance.	N/A	GENERAL INFORMATION • An electronic, fillable, printable version of FAA Form 8610-2 is available at www.faa.gov. • Make all entries using permanent dark blue or black ink, or a typewriter or printer. All signatures must be original, with the name printed or typewritten below or beside the signature. • Complete two (2) originals of FAA Form 8610-2 when submitting a printed application. • Unless otherwise specified, enter all dates using eight-digit numeric characters, MM/DD/YYYY (e.g., 03/29/2019). • Read all supplemental information provided with this form including the Paperwork Reduction Act Burden statement, the Privacy Act statement, the Pilot’s Bill of Rights Written Notification of Investigation, and the Instructions for Completing FAA Form 8610-2. Remove and retain the supplemental information before submitting the application. IMPORTANT NOTE: The applicant’s signature on FAA Form 8610-2 confirms the applicant has received the Privacy Act statement and the Pilot’s Bill of Rights Written Notification of Investigation at the time application was made. All applications must have the application TOP Section, Section I. APPLICANT INFORMATION and Section IV. APPLICANT’S CERTIFICATION completed. See the instructions below to determine the additional sections/blocks to be completed depending on the certificate requested and the basis for certification.
v	Supplemental Pages	Text	Instructions for Completing FAA Form 8610-2, continued	None	To provide applicants with guidance on how to appropriately complete the form.	N	Y	Added - previous versions of this form did not include instructions to the applicant on form completion.	The instructions included in the supplemental pages are directed to the applicant. Instructions for FAA employees or Designees are provided within agency guidance.	N/A
1	Form Title	Text	Airman Certificate and/or Rating Application – Mechanic and Parachute Rigger (14 CFR Part 65)	None	The title of the Form/Information Collection approved by OMB	Y	Y	Revised - Removed "Repairman" from the title of the form. Repairman applicants will now use FAA form 8610-3.		N/A
1	Top Section	Section	Top Section	None	Section	y	y	Revised - Changes to the top section were made as described below.
1	Top Section	Checkbox	Original Issuance	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.	Original Issuance, Added Rating, Other. Mark the appropriate box to indicate the reason application is being made. Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.	A	Mark the appropriate box to indicate the reason application is being made. Mark the “Added Rating” box only if you already have an airman certificate and are adding a rating to that certificate. Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.
1	Top Section	Checkbox	Added Rating	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.		A	Mark the “Added Rating” box only if you already have an airman certificate and are adding a rating to that certificate.
1	Top Section	Checkbox	Other	None	Indicates the purpose for which the applicant is making application.	N	Y	Added - Added checkbox to allow applicant to indicate if the application was being made for a reason other than original issuance or an added rating.		A	Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.
1	Top Section	Text	Other	None	Indicates the purpose for which the applicant is making application.	N	Y	Added - Added free text box to allow applicant to indicate the specific other reason application is being made.		A	Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.
1	Top Section	Checkbox	Mechanic Airframe, Powerplant	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.		A	Certificate Type and Ratings. Mark the appropriate box for the certificate type and the rating(s) being applied for. Apply for only one certificate type per application. Line through (cross out) ratings not applied for unless you currently hold that rating.
1	Top Section	Text	Specify Rating	N/A	Removed - need for this free text block on FAA form 8610-2, since mechanic and parachute riggers have specific check boxes for applicable ratings.	Y	N	Removed - The "Specify Rating" block was removed from the 8610-2 and incorporated into FAA Form 8610-3 as appropriate since it only applies to repairman applicants.		N/A	REMOVED THIS BLOCK - Applicable to repairman applicants only, refer to FAA form 8610-3.
1	Top Section	Checkbox	Parachute Rigger Master, Senior Seat, Back, Chest, Lap	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.		A	Certificate Type and Ratings. Mark the appropriate box for the certificate type and the rating(s) being applied for. Apply for only one certificate type per application. Line through (cross out) ratings not applied for unless you currently hold that rating.
1	I. Applicant Information	Section	I. Applicant Information	None	Section Title	y	y	No differences.
1	I. Applicant Information	Text	A. Name	(Last, First, Middle)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703. (b) Contents.-(1) An airman certificate shall- (A) be numbered and recorded by the Administrator of the Federal Aviation Administration; (B) contain the name, address, and description of the individual to whom the certificate is issued; Name changes can be done iaw 65.16.	Y	Y	Revised - The previous version of FAA form 8610-2 asked for the Name in the "First, Middle, Last" format. The new format is consistent with other FAA forms and with how names are listed in the airman records database.	49 USC 44703 requires the name address and description of the individual to who the certificate is issued. Name changes can be done IAW § 65.16.	A	Enter your full legal name. Use commas to separate names, i.e. Last, First, Middle. If your full legal name is more than 47 characters including the suffix and spaces, use no more than one middle name for record purposes. Do not change your name on subsequent applications unless it is done in accordance with 14 CFR § 65.16. If you have a middle initial only, enter the initial. If you do not have a middle name or middle initial, enter “NMN” (no middle name). Indicate if you are a Jr., II, or III, etc.
1	I. Applicant Information		Social Security No.	N/A	Removed-this has been removed from the application (2020).	Y	N	Removed - The FAA stopped requiring the collection of an applicant's SSN due to privacy concerns at a date prior to this revision. It is not needed for the FAA to issue an airman certificate.		N/A	REMOVED THIS BLOCK - The FAA does not need to collect an airman SSN for identification purposes. Each airman is given a unique FAA Tracking Number (FTN) by Airman records upon receipt of the application (in OKC for paper forms, or in IACRA registration).
1	I. Applicant Information	Date	B. Date of Birth	(MM/DD/YYYY)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Enter your date of birth in the MM/DD/YYYY format.
1	I. Applicant Information	Text	C. Place of Birth	(City and State) or (City and Country)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	If you were born in the USA, enter the city and state where you were born. If the city is unknown, enter the county and state. If you were born outside the USA, enter the name of the city and country, or province and country, of where you were born.
1	I. Applicant Information	Text	D. Height	(Inches)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Enter your height in inches. Example: 5’8” is entered as 68 in. No fractions, use whole inches only.
1	I. Applicant Information	Text	E. Weight	(Pounds)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Enter your weight in pounds. No fractions, use whole pounds only.
1	I. Applicant Information	Text	F. Hair color	(Spell out)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Spell out the color of your hair. Choose from the following: bald, black, blond, brown, gray, red or white. If you wear a wig or toupee, enter the color of your hair under the wig or toupee.
1	I. Applicant Information	Text	G. Eye color	(Spell out)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Spell out the color of your eyes. Choose from the following: black, blue, brown, gray, green, or hazel.
1	I. Applicant Information	Checkbox	H. Sex - Male, Female	None	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Mark either Male or Female.
1	I. Applicant Information	Checkbox	I. Citizenship/ Nationality - USA, Other		Assists in FAA evaluation of eligibility for certificate IAW § 65.3, Certification of foreign airmen other than flight crewmembers.	Y	Y	Revised - Added a checkbox to indicate US citizenship, and an "Other" checkbox and free text block to indicate other citizenship.		A	Mark the box for USA if you are a U.S. Citizen or legally naturalized U.S. Citizen. Otherwise, mark “Other” and enter the country where you are a legal citizen. Only show one citizenship reference in Block I. Annotate dual citizenship countries in the REMARKS section. Note: To claim Dual Citizenship, you must present appropriate citizenship documentation for each country upon application.
1	I. Applicant Information	Text	I. Citizenship/ Nationality - Other		§ 65.3 Certification of foreign airmen other than flight crewmembers. A person who is neither a U.S. citizen nor a resident alien is issued a certificate under subpart D of this part, outside the United States, only when the Administrator finds that the certificate is needed for the operation or continued airworthiness of a U.S.-registered civil aircraft.	Y	Y	Revised - Added a checkbox to indicate US citizenship, and an "Other" checkbox and free text block to indicate other citizenship.	Mechanic applicants (Subpart D) - FAA Guidance describes how the FAA determines when a mechanic certificate is needed. See V5 C5 S3.	A	...Otherwise, mark “Other” and enter the country where you are a legal citizen.
1	I. Applicant Information	Text	J1. Physical Location	(Required)	49 USC 44703 (g) - including a physical location of the applicant assists in preventing the used of fictitious addresses(A), and prevent the use by an applicant of a post office box or "mail drop" as a return address to evade identification of the applicants address.	N	Y	Added - A revision to 49 USC requires that the FAA have a physical address for airman certificate applicants/holders.		A	Enter your complete residential address including street number, city, state, and ZIP code. This block cannot be left blank. If you have a foreign address, the country must be stated. If a residential address does not exist, such as when the applicant resides on a rural route, a boat, or some other manner that requires the use of a P.O. Box, rural route, or personal mailbox, a map or written directions to the your physical address, 911 address, or Global Positioning System (GPS) coordinates must be attached to the application or entered in the Remarks block. Mark box for attached directions, if applicable. A map or written directions are not required for Army Post Office (APO)/Fleet Post Office (FPO)/Diplomatic Post Office (DPO) type addresses.
1	I. Applicant Information	Checkbox	J1. Directions are Attached		If this box is checked it indicates the applicant acknowledges that directions to a physical location are required if there is no physical address to describe the location, and allows the applicant to acknowledge the physical location block was not inadvertently left blank.	N	Y	Added - Added to support obtaining a physical address of an airman who's mailing address is not the same as the airman's physical address.		A	...Mark box for attached directions, if applicable.
1	I. Applicant Information	Text	J2. Mailing Address	(Will show on certificate)	This is the address of the applicant that will show on the certificate It is the address the certificate will be mailed to, unless the applicant indicates a different location in the remarks block.	Y	Y	No differences.		A	Enter your mailing address, if different from block J1. This address will be printed on the permanent airman certificate. You may leave the block blank if the “Same as J1” box is marked. A post office box, rural route, personal mailbox, commercial, or other mail drop can be used as your preferred mailing address. To have your airman certificate mailed to an address other than what is listed in blocks J1 or J2, provide mailing instructions on a separate attachment or in the remarks section of the form.
1	I. Applicant Information	Checkbox	J2. Same as J1.		If this box is checked it indicates the applicant acknowledges the mailing address is the same as the physical location, and the mailing address was not inadvertently left blank.	N	Y	Added - this block was added so that applicants do not have to enter the same information twice on the form, when the applicants mailing address is the same as the applicants physical address.		A	...You may leave the block blank if the “Same as J1” box is marked.
1	I. Applicant Information	Checkbox	K. Do you now hold or have you ever held an FAA airman certificate? - No, Yes		Assists airman registry in ensuring a single record is made for an airman.	Y	Y	No differences.		A	Mark yes or no. If yes, state the certificate type and number. Types of certificates include: pilot, mechanic, repairman, etc. A student pilot certificate is a pilot certificate.
1	I. Applicant Information	Text	K. Yes, Certificate type and number		Assists airman registry in identifying airman records and assists in ensuring a single record is made for an airman.	Y	Y	No differences.		A	...If yes, state the certificate type and number. Types of certificates include: pilot, mechanic, repairman, etc. A student pilot certificate is a pilot certificate.
1	I. Applicant Information	Checkbox	L. Have you ever had an FAA airman certificate suspended or revoked? - No, Yes		Assists FAA in determining if the applicant is eligible for certificate issuance - §§ 65.11(c) and (d)	Y	Y			A	Mark yes or no. If “YES” is marked, refer to §§ 65.11(c) and (d).
1	I. Applicant Information	Checkbox	Do you read, write, speak, and understand the English language? - No, Yes		Assists FAA in determining if applicant is eligible for the certificate, or if certain limitations must be placed on the certificate. § 65.71 (mechanic) § 65.113(a)(2) (parachute rigger)	N	Y	Added - Added to require the applicant to state if they read, write, speak, and understand the English language.	If the applicant answers NO, the applicant may be eligible for a certificate with limitations on validity; refer to § 65.71 (mechanic), § 65.113(a)(2) (parachute rigger).	A	Mark yes or no. Refer to § 65.71 and § 65.113(a)(2).
1	I. Applicant Information	Checkbox	N. Drug Conviction Question - No, Yes	Refer to § 65.12 and § 91.19(a)	Assist FAA in determining if applicant is eligible for a certificate iaw 65.12.	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b), and 91.19(a).	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
1	I. Applicant Information	Date	N. Drug Conviction Question - If yes, Date of Final Conviction	(MM/DD/YYYY)	Assist FAA in determining if applicant is eligible for a certificate iaw 65.12.	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b), and 91.19(a).	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
1	II. Application Basis	Section	Application Basis	Complete Section III, Record of Experience, when application is based on A, B or E (Master Rigger only) basis.	This is the title of the Section.	y	y	Revised - The title was changed from "II. Certificate or Rating Applied For On Basis Of-" to "Application Basis.
1	II. Application Basis	Checkbox	A. Mechanic-Civil Experience		Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	Y	Y	No differences.	Applicants may have both civil and military experience and could therefore check both block and enter appropriate additional information.	A	Mark this box when applying for a Mechanic certificate based on civil experience in accordance with § 65.77. If you gained practical experience in both civil activity and military activity, mark both item A and item B. Enter your experience in Section III.
1	II. Application Basis	Checkbox	B. Mechanic - Military Experience		Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	Y	Y	No differences.	Applicants may have both civil and military experience and could therefore check both block and enter appropriate additional information.	A	Mark this box when applying for a Mechanic certificate based on military experience. Enter your experience in Section III. All military applicants must complete blocks B1 - B3. Only JSAMTCC applicants complete blocks B4 - B6.
1	II. Application Basis	Text	B1. Military Service	(Branch)	Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	Y	Y	Moved - Moved from section III. Record of Experience to Section II. Application Basis.		A	If you gained all or part of the required experience in the military, enter the branch of service in which you gained your experience.
1	II. Application Basis	Text	B2. Military Rank/Grade		Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	Y	Y	Moved - Moved from section III. Record of Experience to Section II. Application Basis.		A	If you gained all or part of the required experience in the military, enter the highest rank or pay level you obtained.
1	II. Application Basis	Text	B3. Military Specialty Code(s)		Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	Y	Y	Moved - Moved from section III. Record of Experience to Section II. Application Basis.		A	If you gained all or part of the required experience in the military, enter the military specialty code(s) (or equivalent, depending on the applicable branch of service) in which your experience was gained.
1	II. Application Basis	Checkbox	B4. JSAMTCC Curriculum completed - Airframe, Powerplant, Airframe & Powerplant		Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	N	Y	Added - Previous form did not have a dedicated block for entry of this information, but FAA guidance required FAA inspectors to have the applicant enter this in the Work Experience Section.		A	If you completed the JSAMTCC program, mark the box of the corresponding JSAMTCC curriculum that was completed.
1	II. Application Basis	Date	B5. Completion Date	(MM/DD/YYYY)	Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	N	Y	Added - Previous form did not have a dedicated block for entry of this information, but FAA guidance required FAA inspectors to have the applicant enter this in the Work Experience Section.		A	Enter the date you completed the JSAMTCC program, as shown on the JSAMTCC completion certificate.
1	II. Application Basis	Text	B6. JSAMTCC Certificate Control No.		Supports FAA evaluation of experience IAW 65.77 Experience Requirements.	N	Y	Added - Previous form did not have a dedicated block for entry of this information, but FAA guidance required FAA inspectors to have the applicant enter this in the Work Experience Section.		A	Enter the certificate control number as shown on the JSAMTCC Certificate of Eligibility.
1	II. Application Basis	Checkbox	C. Mechanic- Graduate of an Approved Course		Verifies experience eligibility IAW 65.77 Experience requirements.	Y	Y	No differences.		A	Mark this box when applying for a Mechanic certificate based on graduation from a 14 CFR part 147 Aviation Maintenance Technician School (AMTS) FAA-Approved curriculum, including § 65.80 applicants. Complete blocks C1 through C9 as applicable.
1	II. Application Basis	Checkbox	C1. Select Basis - AMTS Graduate, AMTS 65.80 applicant		Verifies experience eligibility IAW 65.77 Experience requirements.	N	Y	Added - Applicants who have attended an AMTS will check the appropriate box to indicate whether they have graduated from the AMTS at the time of the application, or if they are testing under the authority of § 65.80.		A	Mark the appropriate box to indicate the basis of application for graduates of an approved course.
1	II. Application Basis	Text	C2. AMTS Certificate Number		Verifies experience eligibility IAW 65.77 Experience requirements.	Y	Y	Revised - "AMTS" is used to indicate that reference to "graduates of an approved course" is referring to Aviation Maintenance Technician Schools certificated under part 147.		A	Enter the certificate number of the AMTS from which you graduated.
1	II. Application Basis	Text	C3. AMTS Name		Verifies experience eligibility IAW 65.77 Experience requirements.	Y	Y	Revised - AMTS name was previously requested in a single block "Name and Location of School".			Enter the name of the AMTS from which you graduated.
1	II. Application Basis	Text	C4. AMTS Location	(City, State)	Verifies experience eligibility IAW 65.77 Experience requirements.	Y	Y	Revised - AMTS location was previously requested in a single block "Name and Location of School".		A	Enter the location (city and state) of the AMTS from which you graduated.
1	II. Application Basis	Checkbox	C5. AMTS Curriculum Graduated - Airframe, Powerplant, Airframe & Powerplant	(or Curriculum enrolled if §65.80)	Supports FAA evaluation of experience eligibility IAW 65.77 Experience requirements.	Y	Y	Revised - Check boxes replace a free text entry block to indicate the curriculum from which the applicant graduated.		A	Mark the appropriate box for the curriculum from which completed/graduated, as stated on the certificate. For § 65.80 applicants, mark the box for the curriculum you are currently enrolled in. Only mark “Airframe and Powerplant” if you have a single certificate showing graduation/completion of a combined airframe and powerplant curriculum. If applying for both ratings, but have graduated from separate curriculums and have separate completion certificates, mark both the airframe and the powerplant box.
1	II. Application Basis	Date	C6. Graduation Date	(MM/DD/YYYY) (Proposed Date if §65.80)	Supports FAA evaluation of experience and eligibility for early testing IAW 65.80.	Y	Y	No differences.		A	Enter the date of AMTS graduation as shown on the graduation certificate or certificate of completion. Enter dates using the MM/DD/YYYY format. If applying for both ratings, but have graduated from separate curriculums with separate completion certificates, enter the additional graduation date in the Remarks block on page 2. For § 65.80 applicants, enter the date you will graduate.
1	II. Application Basis	Checkbox	C7. AMTS 65.80 recommendation		Supports FAA evaluation of experience and eligibility for early testing IAW 65.80.	N	Y	Revised - Added verbiage to checkbox to clarify that this Is a certification made by the AMTS under the allowances of § 65.80.		O	An authorized AMTS official marks this block to indicate that the student meets the requirements to test under § 65.80.
1	II. Application Basis	Text	C8. School Officials Signature	(For § 65.80 authorization only) (Print Name and Sign)	Supports FAA evaluation of experience and eligibility for early testing IAW 65.80.	Y	Y	No differences.		O	The authorizing AMTS official must enter their signature above or beside their typed or printed name to indicate the student meets AMTS requirements for testing under § 65.80.
1	II. Application Basis	Date	C9. Date	(MM/DD/YYYY)	Supports FAA evaluation of experience and eligibility for early testing IAW 65.80.	N	Y	Added - Requiring a date to be entered by the school official supports the legitimacy of the school officials signature regarding the students eligibility to test under § 65.80.		O	The authorizing AMTS official must enter the date they sign block C8.
1	II. Application Basis	Checkbox	D. FAA 65.80 test authorization		Indicates FAA approval of experience IAW 65.77 Experience Requirements and early testing eligibility under 65.80	Y	Y	No differences.		FD	These blocks are for FAA use only.
1	II. Application Basis	Date	D1. Date Authorized	(MM/DD/YYYY)	Indicates FAA approval of experience IAW 65.77 Experience Requirements and early testing eligibility under 65.80	Y	Y	No differences.		FD	n/a
1	II. Application Basis	Date	D2. Date Auth. Expires	(MM/DD/YYYY)	Indicates FAA approval of experience IAW 65.77 Experience Requirements and early testing eligibility under 65.80	Y	Y	No differences.		FD	n/a
1	II. Application Basis	Signature	D3. FAA Signature	(Print Name and Sign)	Indicates FAA approval of experience IAW 65.77 Experience Requirements and early testing eligibility under 65.80	Y	Y	No differences.		FD	n/a
1	II. Application Basis	Text	D4. FAA Office/Desig. No.		Correlates the FAA individual who is authorizing testing to either an office (FAA employee) or a designation number (designee).	Y	Y	No differences.		D	n/a
1	II. Application Basis	Checkbox	E. Parachute Rigger	(For Master Parachute Rigger Only)	Indicates application basis to support FAA evaluation of experience, to determine eligibility.	N	Y	Added - Check box added to indicate that the application basis is regarding an application for a parachute rigger.		A	Mark this box when applying for a Parachute Rigger Certificate. For Master Parachute Rigger applicants only, enter your experience in Section III.
1	II. Application Basis	Text	E1. Number of Parachutes Packed - Seat, Chest, Back, Lap.	(For Master Parachute Rigger Only)	Verifies experience IAW 65.115 Experience requirements.	Y	Y	Moved - moved from Section III. Record of Experience to Section II. Application Basis.		A	Indicate the number of parachutes packed of each type.
1	II. Application Basis	Checkbox	E2. Packed as a: Military Parachute Rigger, Senior Parachute Rigger	(For Master Parachute Rigger Only)	Verifies experience IAW 65.115 Experience requirements.	Y	Y	Moved - moved from Section III. Record of Experience to Section II. Application Basis.		A	Master parachute rigger applicants must mark the appropriate box(es) to indicate if any of the parachutes were packed as a senior rigger and/or military rigger.
1	III. Record of Experience	Section	III. Record of Experience	Continue additional information on a separate sheet if necessary.	This is the title of the Section.	y	y	No differences.
1	III. Record of Experience	Checkbox	Mark this box if separate sheet attached for additional experience.		Indicates if additional experience records are attached as a separate sheet.	N	Y	Added - added to increase awareness that the applicant has included attachments with the application.		A	Enter your work experience related to the certificate and rating being applied for. Must be completed by Civil or Military Mechanic applicants and Master Parachute Rigger applicants. Continue additional information on a separate sheet if necessary. Mark the box if you have attached a separate sheet showing additional experience. Note: Mechanic applicants should provide dates of experience in the eight-digit (MM/DD/YYYY) numeric format if necessary to count the days to ensure eligibility based on 18 or 30 months of practical experience, as applicable. Dates can be handwritten in columns 1 and 2, or annotated in the Remarks block.
1	III. Record of Experience	Date	1. Date From	(MM/YYYY)	Support FAA evaluation of experience requirements applicable to certificate type.	Y	Y	No differences.		A	Enter your employment start date in a six-digit (MM/YYYY) numeric character format.
1	III. Record of Experience	Date	2. Date To	(MM/YYYY)	Support FAA evaluation of experience requirements applicable to certificate type.	Y	Y	No differences.		A	Enter your employment end date in a six-digit (MM/YYYY) numeric character format.
1	III. Record of Experience	Text	3. Employer and Location	Employer Name, City, State	Support FAA evaluation of experience requirements applicable to certificate type.	Y	Y	No differences.		A	Enter the name of your employer and the city and state of your employment.
1	III. Record of Experience	Text	4. Type of Work Performed	Describe work performed, not job title.	Support FAA evaluation of experience requirements applicable to certificate type.	Y	Y	No differences.		A	Enter the type of work performed with the employer, related to the certificate and rating requested.
1	IV. Applicants Certification	Section	IV. Applicants Certification	None	This is the title of the Section.	y	y	Difference described below.
1	IV. Applicants Certification	Statement	Text of the certifying statement - I certify that all statements and answers provided by me on this application form are complete and true to the best of my knowledge and I agree that they are to be considered as part of the basis for issuance of any FAA certificate to me. I have received the Pilot’s Bill of Rights Written Notification of Investigation that accompanies this form. I have also read and understand the Privacy Act statement that accompanies this form.		The statement notifies the applicant of the information they are certifying.	Y	Y	Revised - The new certification statement includes reference to the Pilots Bill of Rights Written Notification of Investigation and the Privacy Act statement which accompany the application form in the supplemental pages.	The Pilots Bill of Rights Written Notification of Investigation and the Privacy Act statement are made available to the applicant in the supplemental pages of the form.	N/A
1	IV. Applicants Certification	Signature	Applicant's Signature	(Print Name and Sign)	The applicants signature indicates they have read and agree to the certifying statement.	Y	y	No differences.		A	Sign your name.
1	IV. Applicants Certification	Date	Date	(MM/DD/YYYY)	Indicates date application was signed by applicant.	Y	Y	No differences.		A	Enter the date you signed the form, using the MM/DD/YYYY format.
1	V. FAA Endorsement	Section	V. FAA Endorsement	I find this applicant meets the experience requirements of 14 CFR part 65 and is eligible to take the required tests.	FAA endorsement for the statement : I find this applicant meets the experience requirements of 14 CFR part 65 and is eligible to take the required tests.	Y	Y	Differences described below.
1	V. FAA Endorsement	Signature	FAA Signature	(Print Name and Sign)	FAA testing endorsement statement: I find this applicant meets the experience requirements of 14 CFR part 65 and is eligible to take the required tests.	Y	Y	No differences.	"FAA" refers to both FAA employees and FAA designees. FAA policy will state specifically which of these entities has the authority to sign this block. POLICY OFFICE - need to ensure the guidance clearly states who can sign in this block. Currently only FAA ASI's have the authority to sign this block, and only when they meet certain other qualifications as specified in 8900.1 guidance.	D F	Block is for FAA Use only. Note: FAA endorsement for testing is required for applicants applying based on civil or military experience. AMTS and JSAMTCC graduates do not need FAA endorsement to test.
1	V. FAA Endorsement	Date	Date	(MM/DD/YYYY)	Indicates the date the application was signed by the FAA, thereby authorizing the applicant to take the FAA tests for the certificate being applied for.	Y	Y	No differences.		D F	n/a
1	V. FAA Endorsement - for testing eligibility.	Text	FAA Office/Designation No.		To provide the ability to correlate the FAA person endorsing the application back to an office designator or FAA designee designation.	Y	Y	Revised - Block title has been revised to support the entry of either an FAA office designator, or an FAA designee's designation number.	This block supports entry of either the FAA employees office designator, or the designees designation number. FAA policy will state which entity if authorized to use this block and specifically what information either of these entities must place in this block. POLICY OFFICE - need to ensure the 8900.1 guidance clearly states the format to be used by FAA ASIs when entering an office designator - confusion heightened due to recent reorganization of Flight Standards.	D F	n/a
2	Applicant Information	Section	Applicant Information	(Required if application is printed on 2 pages)	When page one and two of the application are printed on separate pages (i.e. not double sided) this information allows the FAA to ensure all pages can be identified to the applicant.
2	Applicant Information	Text	Name	(As shown on page 1 of application)	Ensures page 2 of application is identified with applicant on page 1.	N	Y	Added - FAA guidance previously instructed FAA inspectors to enter this information either at the top margin, or in the remarks block.			When the application is printed on 2 separate pages (i.e. not printed double‐sided), enter your name, date of birth, and your certificate number relating to this application. Leave the certificate number blank if this is an application for original issuance. Note: This ensures page 2 of the application is placed with the correct applicant on page 1 if the pages become separated.
2	Applicant Information	Date	Date of Birth	(MM/DD/YYYY)	Ensures page 2 of application is identified with applicant on page 1.	N	Y	Added - FAA guidance previously instructed FAA inspectors to enter this information either at the top margin, or in the remarks block.			When the application is printed on 2 separate pages (i.e. not printed double‐sided), enter your name, date of birth, and your certificate number relating to this application. Leave the certificate number blank if this is an application for original issuance. Note: This ensures page 2 of the application is placed with the correct applicant on page 1 if the pages become separated.
2	Applicant Information	Text	Certificate Number	(if any)	Ensures page 2 of application is identified with applicant on page 1.	N	Y	Added - FAA guidance previously instructed FAA inspectors to enter this information either at the top margin, or in the remarks block.			When the application is printed on 2 separate pages (i.e. not printed double‐sided), enter your name, date of birth, and your certificate number relating to this application. Leave the certificate number blank if this is an application for original issuance. Note: This ensures page 2 of the application is placed with the correct applicant on page 1 if the pages become separated.
2	Results of Oral and Practical Tests	Section	Results of Oral and Practical Tests	For FAA Use Only
2	Results of Oral and Practical Tests - Mechanic	Checkbox	Pass	None	Record of an applicants test results. Used to determine eligibility for certificate issuance.	Y	Y	No differences.		D F
2	Results of Oral and Practical Tests - Mechanic	Checkbox	Fail	None	Record of an applicants test results. Used to determine eligibility for certificate issuance.	Y	Y	No differences.		D F
2	Results of Oral and Practical Tests - Mechanic	Date	Expiration Date	None	Mechanic Test results expire after 24 months. If a certificate was not issued prior to the test expiration date, the expired tests must be retaken in order for an applicant to be eligible for certificate issuance. 65.71(a)(3) Have passed all of the prescribed tests within a period of 24 months; and	Y	Y	No differences.		D F
2	Results of Oral and Practical Tests - Mechanic	Text	Project Number	None	These blocks record the questions/projects failed by the applicant thereby showing a record of the applicants failure to qualify for certificate issuance.	Y	Y	Revised - Revised the number of blocks available to reflect the maximum number of wrong answers that could be given in that testing area.	Only failed questions/projects are entered into these blocks.	D F
2	Results of Oral and Practical Tests - Mechanic	Checkbox	Pass	None	Record of an applicants test results. Used to determine eligibility for certificate issuance.	Y	Y	No differences.		D F
2	Results of Oral and Practical Tests - Parachute Rigger	Checkbox	Fail	None	Record of an applicants test results. Used to determine eligibility for certificate issuance.	Y	Y	No differences.		D F
2	Results of Oral and Practical Tests - Parachute Rigger	Text	Parachute Seal Symbol Assigned	None	Record of the seal symbol provided to the parachute rigger at the time of certificate issuance. Seal symbol is used to identify who last packed the parachute.	Y	Y	Moved - Moved from "The FAA Inspectors Report" into the Results of Oral and Practical Test section.		D F
2	Remarks	Text	Remarks	None	Used to capture various additional information provided by either the applicant or the FAA, that cannot be captured in prescribed blocks on the application.	Y	Y	No differences.		D F	You may annotate attachments, dual citizenship, mailing, or other information related to the application, in this block. This block is also used by the FAA for annotating additional information regarding the application.
2	Applicants Certification	Title	Applicants Certification	This area is completed by the applicant at the time of issuance of the temporary airman certificate (FAA Form 8060‐4).	Section Title	Y	Y	Moved - This section was moved prior to the FAA Examiners report (Previously "Designated Examiners Report) because the FAA examiner must determine the applicant's eligibility for certificate issuance in order to appropriately complete the FAA Examiners Report.			Only complete this section at the time of issuance of a temporary certificate.
2	Applicants Certification	Checkbox	Airman Cert Question - Yes, No		Application and certificate issuance are not typically done on the same day, therefore certain eligibility questions must be asked at the time of certificate issuance to ensure the answer allows for certificate issuance. 2nd ask of the question, previously asked in Section I. Item L. on page 1.	Y	Y	No differences.	These questions must be asked at the time of certificate issuance to determine the applicants eligibility for the certificate requested.	A	Mark yes or no. If “YES” is marked, refer to § 65.11(c) and (d).
2	Applicants Certification	Checkbox	Drug Question - Yes, No		Application and certificate issuance are not typically done on the same day, therefore certain eligibility questions must be asked at the time of certificate issuance to ensure the answer allows for certificate issuance. 2nd ask of the question in previously asked in Section I. Item N.	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b) and § 91.19.	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
2	Applicants Certification	Date	Drug question - If yes enter date of final conviction		Application and certificate issuance are not typically done on the same day, therefore certain eligibility questions must be asked at the time of certificate issuance to ensure the answer allows for certificate issuance. 2nd ask of the question in previously asked in Section I. Item N.	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b) and § 91.19.	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
2	Applicants Certification	Statement	Text of the certifying statement		The statement notifies the applicant of the information they are certifying.	Y	Y	Revised - The new certification statement includes reference to the Pilots Bill of Rights Written Notification of Investigation and the Privacy Act statement which accompany the application form in the supplemental pages.		A	N/A
2	Applicants Certification	Signature	Applicant Signature		The applicants signature indicates they have read and agree to the certifying statement.	Y	Y	No differences.		A	Only complete this section at the time of issuance of a temporary certificate. Sign your name.
2	Applicants Certification	Date	Date	(MM/DD/YYYY)	Date applicant acknowledged and signed the certification statement.	Y	Y	No differences.		A	Only complete this section at the time of issuance of a temporary certificate. Enter the date you sign the application, using the MM/DD/YYYY format.
2	FAA Examiner's Report	Title	FAA Examiner's Report	None	Section Title			Revised - Combined the previous sections of "Designated Examiners Report" and "FAA Inspectors Report" into a new section "FAA Examiner's Report".
2	FAA Examiner's Report	Statement	I have tested this applicant…	I have tested this applicant in accordance with pertinent procedures and standards and I have indicated the result as:	Indicates what the FAA examiner is basing their report on.	Y	Y	Revised - removed the word "personally" from the certification statement. This would support future testing using organizational designees.		D F
2	FAA Examiner's Report - tested applicant	Checkbox	Result: Approved (Temporary Certificate Issued)	(Temporary Certificate Issued)	FAA certification results/record	Y	Y	No differences.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - tested applicant	Checkbox	Result: Approved (Temporary Certificate Not Issued)	(Temporary Certificate NOT Issued)	FAA certification results/record	Y	Y	No differences.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - tested applicant	Checkbox	Result: 14 CFR § 65.80 – Oral/Practical PASSED		FAA certification results/record	Y	Y	No differences.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - tested applicant	Checkbox	Result: Disapproved		FAA certification results/record	Y	Y	No differences.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - tested applicant	Signature	FAA Signature	(Print Name and Sign)	Signature of FAA examiner based on statement: I have tested this applicant in accordance with pertinent procedures and standards and I have indicated the result as:	Y	Y	No differences.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - tested applicant	Date	Date	(MM/DD/YYYY)	Date FAA signed FAA examiners report.	Y	Y	No differences.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - tested applicant	Text	FAA Office/Desig. No.		To provide the ability to correlate the FAA person endorsing the application back to an office designator or FAA designee designation.	Y	Y	Revised - Block title has been revised to support the entry of either an FAA office designator, or an FAA designee's designation number.	This block supports entry of either the FAA employees office designator, or the designees designation number. FAA policy will state which entity if authorized to use this block and specifically what information either of these entities must place in this block. POLICY OFFICE - need to ensure the 8900.1 guidance clearly states the format to be used by FAA ASIs when entering an office designator - confusion heightened due to recent reorganization of Flight Standards.	D F
2	FAA Examiner's Report - Examined applicants papers	Statement	I have examined this applicants papers…	I have examined this applicant’s papers and I have indicated the result as:	When an applicant tested but was not issued a temporary certificate (age, drug conviction, etc.) and the applicant then returns for a certificate issuance when eligible.	Y	Y	Moved - Previously stated in FAA Inspectors report.		D F
	FAA Examiner's Report - Examined applicants papers	Checkbox	Result: Approved (Temporary Certificate Issued)	Temporary Certificate Issued	FAA certification results/record	Y	Y	Moved - Previously stated in FAA Inspectors report.		D F
2	FAA Examiner's Report - Examined applicants papers	Signature	FAA Signature	(Print Name and Sign)	Signature of FAA examiner based on statement: I have tested this applicant in accordance with pertinent procedures and standards and I have indicated the result as:	Y	Y	Moved - Previously required in FAA Inspectors report.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - Examined applicants papers	Date	Date	(MM/DD/YYYY)	Date FAA signed FAA examiners report.	Y	Y	Moved - Previously required in FAA Inspectors report.	Only used by FAA examiners who are conducting an actual test on an applicant.	D F
2	FAA Examiner's Report - Examined applicants papers	Text	FAA Office/Desig. No.		To provide the ability to correlate the FAA person endorsing the application back to an office designator or FAA designee designation.	Y	Y	Revised - Block title has been revised to support the entry of either an FAA office designator, or an FAA designee's designation number.	This block supports entry of either the FAA employees office designator, or the designees designation number. FAA policy will state which entity if authorized to use this block and specifically what information either of these entities must place in this block. POLICY OFFICE - need to ensure the 8900.1 guidance clearly states the format to be used by FAA ASIs when entering an office designator - confusion heightened due to recent reorganization of Flight Standards.	D F
2	Attachments	Section Title	Attachments
2	Attachments	Checkbox	Knowledge Test Report(s)		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	Y	Y	Revised - Previously "Report of Written Test"		D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Test Planning Sheet		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	N	Y	Added - Test planning sheets are filed in the airman file as a record of the test.		D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Temporary Certificate		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	Y	Y	No differences.		D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Superseded Certificate		REMOVED	Y	N	Removed - Airman records does not need superseded certs returned, unless there was a downgrade of a certificate. Downgrades would be done through a certificate action.	See Notice XXXX and revised 8900.1 guidance.	D F
2	Attachments	Checkbox	Graduation/Completion Certificate		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	N	Y	Added - This is required for the airman file.		D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Statement of Additional Instruction		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included. 65.19(b)	Y	Y	Added - This attachment is required by 65.19 when the applicant retested within 30 days.	Previously the statement could have been annotated under the old checkbox "letter"	D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Seal Symbol Card		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	Y	N	Removed - Seal Symbol cards are no longer required to be returned to airman records with the application.		D F
2	Attachments	Checkbox	Other	See Remarks block	Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	N	Y	Added - allows for annotation of any other attachment to the certification package.		A D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Applicant Identification (ID)	Section	Applicant Identification (ID)
2	Applicant Identification (ID)	Text	Form of ID	(Government Issued Photo ID)	Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y	Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to show that applicant ID had been verified. Addition of these blocks will support assurance that ID is verified and annotated in a standard format.	Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application or testing, and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Text	State or Country		Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y	Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to show that applicant ID had been verified. Addition of these blocks will support assurance that ID is verified and annotated in a standard format.	Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application or testing, and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Text	ID Number		Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y	Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to show that applicant ID had been verified. Addition of these blocks will support assurance that ID is verified and annotated in a standard format.	Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application, and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Date	Expiration Date		Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y	Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to show that applicant ID had been verified. Addition of these blocks will support assurance that ID is verified and annotated in a standard format.	Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application, and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Text	Telephone Number		Contact information for the applicant to allow contact to correct any errors on the application.	N	Y	Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to provide inspectors with contact information in case errors were made on the application that needed to be corrected to allow for certificate issuance.		A D F	If the applicant does not have a telephone number or email address, or chooses not to provide this information, enter “NONE” in the block.
2	Applicant Identification (ID)	Text	Email Address		Contact information for the applicant to allow contact to correct any errors on the application.	N	Y	Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to provide inspectors with contact information in case errors were made on the application that needed to be corrected to allow for certificate issuance.		A D F	If the applicant does not have a telephone number or email address, or chooses not to provide this information, enter “NONE” in the block.
2	FAA File Review	Section	FAA File Review	For FAA Use Only	When applications are processed by paper, designees must send the certification file to their managing FAA office, which reviews the file and forwards to airman records.			These are now FAA File review annotation blocks. They are not used to indicate and approval for certificate issuance.	Used by FAA Flight Standards Offices only; not used by FAA Designees.
2	FAA File Review	Signature	FAA Signature	(Print Name and Sign)	Annotation of that an FAA FS office reviewed the paper file once received by a designee, and before sending to airman records for certificate issuance.	N	Y	Revised - Now used to indicate the FAA has review the paper file prior to forwarding to airman records.		F
2	FAA File Review	Date	Date	(MM/DD/YYYY)	Annotation of that an FAA FS office reviewed the paper file once received by a designee, and before sending to airman records for certificate issuance.	N	Y	Revised - Now used to indicate the FAA has review the paper file prior to forwarding to airman records.		F
2	FAA File Review	Text	FAA Office		Annotation of that an FAA FS office reviewed the paper file once received by a designee, and before sending to airman records for certificate issuance.	N	Y	Revised - Now used to indicate the FAA has review the paper file prior to forwarding to airman records.		F

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Sheet 3: 8610-3 Blocks

						Differences from previous form revision
Page	Section	Block Type	Block Title	Block Help Text	Business Need Describes the Business need for collecting this information from the public.	8610-2 (2-15)	8610-3 (09-20)	Description of Differences	Additional comments	Block Completed By: A=Applicant D = Designee F=FAA O=Other	Instructions to Applicant
i	Supplemental Pages	Text	Table of Contents Printing instructions Paperwork Reduction Action Burden Statement	None	Information for applicant on the proper completion and submission of the form. Paperwork Reduction Act (PRA) of 1995	Y	Y	Added - Table of contents, Printing Instructions. Since repairman do not take any FAA tests, IACRA registration instructions have been removed. Added - PRA statement - most recent verbiage from PRA office.	PRA Burden statement must be updated upon OMB approval of the form to reflect the expiration date issued by OMB, and the burden calculated within the Information Collection (IC) supporting statement. i.e. for this form the burden was estimated at 20 minutes per response. Verbiage for IACRA instructions is based on information from: https://www.faa.gov/training_testing/testing/acts/	N/A	The supplemental information for this form includes the following: Page i……………….. Paperwork Reduction Act Burden Statement Page ii………………. Privacy Act Statement Page iii……………… Pilot’s Bill of Rights Written Notification of Investigation Page iv……………... Instructions for Completing FAA Form 8610-3 Page v……………….. Instructions for Completing FAA Form 8610-3, continued. Detach these supplemental information and instruction parts before submitting the attached form. Printing double-sided is preferable. If the form is not printed in the double-sided format, complete the “Applicant Information” section on the top of page 2. An electronic, fillable, printable version of FAA Form 8610-3 is available at www.faa.gov. When printing, print pages 6 through 7, if you choose to print only the form. Integrated Airman Certification and Rating Application (IACRA) is a web-based certification/rating application that guides the user through the FAA's airman application process. IACRA helps ensure applicants meet regulatory and policy requirements through the use of extensive data validation. It also uses electronic signatures to protect the information's integrity, eliminates paper forms, and prints temporary certificates. IACRA can be accessed here: https//iacra.faa.gov.
ii	Supplemental Pages	Text	Privacy Act Statement	None	5 U.S.C. § 552(a) Privacy Act	Y	Y	Revised - revised the Privacy Act statement. Coordinated with Privacy office who had AGC review and approve on XXXXXXX.	Revisions needed to the Privacy Statement must be coordinated with the FAA's Privacy Office.	N/A
iii	Supplemental Pages	Text	Pilot's Bill of Rights Written Notification of Investigation	None	Public Law (PL) 112‑153, Pilot’s Bill of Rights Act (PBR)	N	Y	Added - Pilots Bill of Rights Written Notification of Investigation	Verbiage for this page came from 8900.1, Volume 14, Chapter 1, Section 3, Figure 14-1-3B. (8900.1 CHG566)	N/A
iv	Supplemental Pages	Text	Instructions for Completing FAA Form 8610-3,	None	To provide applicants with guidance on how to appropriately complete the form.	N	Y	Added - previous versions of this form did not include instructions to the applicant on form completion.	The instructions included in the supplemental pages are directed to the applicant. Instructions for FAA employees or Designees are provided within agency guidance.	N/A	GENERAL INFORMATION • An electronic, fillable, printable version of FAA Form 8610-2 is available at www.faa.gov. • Make all entries using permanent dark blue or black ink, or a typewriter or printer. All signatures must be original, with the name printed or typewritten below or beside the signature. • Complete two (2) originals of FAA Form 8610-2 when submitting a printed application. • Unless otherwise specified, enter all dates using eight-digit numeric characters, MM/DD/YYYY (e.g., 03/29/2019). • Read all supplemental information provided with this form including the Paperwork Reduction Act Burden statement, the Privacy Act statement, the Pilot’s Bill of Rights Written Notification of Investigation, and the Instructions for Completing FAA Form 8610-2. Remove and retain the supplemental information before submitting the application. IMPORTANT NOTE: The applicant’s signature on FAA Form 8610-2 confirms the applicant has received the Privacy Act statement and the Pilot’s Bill of Rights Written Notification of Investigation at the time application was made. All applications must have the application TOP Section, Section I. APPLICANT INFORMATION and Section IV. APPLICANT’S CERTIFICATION completed. See the instructions below to determine the additional sections/blocks to be completed depending on the certificate requested and the basis for certification.
v	Supplemental Pages	Text	Instructions for Completing FAA Form 8610-3, continued	None	To provide applicants with guidance on how to appropriately complete the form.	N	Y	Added - previous versions of this form did not include instructions to the applicant on form completion.	The instructions included in the supplemental pages are directed to the applicant. Instructions for FAA employees or Designees are provided within agency guidance.	N/A
1	Form Title	Text	FAA Form 8610-3, Airman Certificate and/or Rating Application – Repairman (14 CFR Part 65)	None	The title of the Form/Information Collection approved by OMB	Y	Y	Revised - This form is now specific to the different types of repairman applicants.		N/A
1	Top Section	Section	Top Section	None	Section	y	y	Revised - Changes to the top section were made as described below.
1	Top Section	Checkbox	Original Issuance	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.	Original Issuance, Added Rating, Other. Mark the appropriate box to indicate the reason application is being made. Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.	A	Mark the appropriate box to indicate the reason application is being made. Mark the “Added Rating” box only if you already have an airman certificate and are adding a rating to that certificate. Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.
1	Top Section	Checkbox	Added Rating	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.		A	Mark the “Added Rating” box only if you already have an airman certificate and are adding a rating to that certificate.
1	Top Section	Checkbox	Other	None	Indicates the purpose for which the applicant is making application.	N	Y	Added - Added checkbox to allow applicant to indicate if the application was being made for a reason other than original issuance or an added rating.		A	Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.
1	Top Section	Text	Other	None	Indicates the purpose for which the applicant is making application.	N	Y	Added - Added free text box to allow applicant to indicate the specific other reason application is being made.		A	Mark “Other” if you are making application due to a change of address, name, gender, citizenship, nationality, date of birth, or other change, and enter the type of change requested.
1	Top Section	Checkbox	§ 65.101 Repairman	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.		A	Certificate Type and Ratings. Mark the appropriate box for the certificate type and the rating(s) being applied for. Apply for only one certificate type per application. Line through (cross out) ratings not applied for unless you currently hold that rating.
1	Top Section	Checkbox	65.104 Experimental Aircraft Builder Repairman	N/A	Removed - need for this free text block on FAA form 8610-2, since mechanic and parachute riggers have specific check boxes for applicable ratings.	Y	N	Removed - The "Specify Rating" block was removed from the 8610-2 and incorporated into FAA Form 8610-3 as appropriate since it only applies to repairman applicants.		A	Certificate Type and Ratings. Mark the appropriate box for the certificate type and the rating(s) being applied for. Apply for only one certificate type per application. Line through (cross out) ratings not applied for unless you currently hold that rating.
1	Top Section	Checkbox	65.107 Light-Sport Aircraft Repairman Inspection Rating Maintenance Rating	None	Indicates the purpose for which the applicant is making application.	Y	Y	No differences.		A	Certificate Type and Ratings. Mark the appropriate box for the certificate type and the rating(s) being applied for. Apply for only one certificate type per application. Line through (cross out) ratings not applied for unless you currently hold that rating.
1	I. Applicant Information	Section	I. Applicant Information	None	Section Title	y	y	No differences.
1	I. Applicant Information	Text	A. Name	(Last, First, Middle)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703. (b) Contents.-(1) An airman certificate shall- (A) be numbered and recorded by the Administrator of the Federal Aviation Administration; (B) contain the name, address, and description of the individual to whom the certificate is issued; Name changes can be done iaw 65.16.	Y	Y	Revised - The previous version of FAA form 8610-2 asked for the Name in the "First, Middle, Last" format. The new format (Last, First, Middle) is consistent with other FAA forms and with how names are listed in the airman records database.	49 USC 44703 requires the name address and description of the individual to who the certificate is issued. Name changes can be done IAW § 65.16.	A	Enter your full legal name. Use commas to separate names, i.e. Last, First, Middle. If your full legal name is more than 47 characters including the suffix and spaces, use no more than one middle name for record purposes. Do not change your name on subsequent applications unless it is done in accordance with 14 CFR § 65.16. If you have a middle initial only, enter the initial. If you do not have a middle name or middle initial, enter “NMN” (no middle name). Indicate if you are a Jr., II, or III, etc.
1	I. Applicant Information		Social Security No.	N/A	Removed-this has been removed from the application (2020).	Y	N	Removed - The FAA stopped requiring the collection of an applicant's SSN due to privacy concerns at a date prior to this revision. It is not needed for the FAA to issue an airman certificate.		N/A	REMOVED THIS BLOCK - The FAA does not need to collect an airman SSN for identification purposes. Each airman is given a unique FAA Tracking Number (FTN) by Airman records upon receipt of the application (in OKC for paper forms, or in IACRA registration).
1	I. Applicant Information	Date	B. Date of Birth	(MM/DD/YYYY)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Enter your date of birth in the MM/DD/YYYY format.
1	I. Applicant Information	Text	C. Place of Birth	(City and State) or (City and Country)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	If you were born in the USA, enter the city and state where you were born. If the city is unknown, enter the county and state. If you were born outside the USA, enter the name of the city and country, or province and country, of where you were born.
1	I. Applicant Information	Text	D. Height	(Inches)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Enter your height in inches. Example: 5’8” is entered as 68 in. No fractions, use whole inches only.
1	I. Applicant Information	Text	E. Weight	(Pounds)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Enter your weight in pounds. No fractions, use whole pounds only.
1	I. Applicant Information	Text	F. Hair color	(Spell out)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Spell out the color of your hair. Choose from the following: bald, black, blond, brown, gray, red or white. If you wear a wig or toupee, enter the color of your hair under the wig or toupee.
1	I. Applicant Information	Text	G. Eye color	(Spell out)	Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Spell out the color of your eyes. Choose from the following: black, blue, brown, gray, green, or hazel.
1	I. Applicant Information	Checkbox	H. Sex - Male, Female		Provides a description of the individual to whom the certificate is issued. 49 USC 44703.	Y	Y	No differences.		A	Mark either Male or Female.
1	I. Applicant Information	Checkbox	I. Citizenship/ Nationality - USA, Other		Assists the FAA in evaluation of eligibility of a 65.104 repairman certificate. 65.104(a)(4) - experimental aircraft builder repairman must be a citizen of the United States or an individual citizen of a foreign country who has lawfully been admitted for permanent residence in the United States.	Y	Y	Revised - Added a checkbox to indicate US citizenship, and an "Other" checkbox and free text block to indicate other citizenship.	65.3 does not apply to repairman, only to mechanics (subpart D)	A	Mark the box for USA if you are a U.S. Citizen or legally naturalized U.S. Citizen. Otherwise, mark “Other” and enter the country where you are a legal citizen. Only show one citizenship reference in Block I. Annotate dual citizenship countries in the REMARKS section. Note: To claim Dual Citizenship, you must present appropriate citizenship documentation for each country upon application.
1	I. Applicant Information	Text	I. Citizenship/ Nationality - Other		Assists the FAA in evaluation of eligibility of a 65.104 or 65.107 repairman certificate. 65.104(a)(4) and 65. 107(a)(1)(iv) - must be a citizen of the United States or an individual citizen of a foreign country who has lawfully been admitted for permanent residence in the United States.	Y	Y	Revised - Added a checkbox to indicate US citizenship, and an "Other" checkbox and free text block to indicate other citizenship.	65.3 does not apply to repairman, only to mechanics (subpart D)	A	...Otherwise, mark “Other” and enter the country where you are a legal citizen.
1	I. Applicant Information	Text	J1. Physical Location	(Required)	49 USC 44703 (g) - including a physical location of the applicant assists in preventing the used of fictitious addresses(A), and prevent the use by an applicant of a post office box or "mail drop" as a return address to evade identification of the applicants address.	N	Y	Added - A revision to 49 USC requires that the FAA have a physical address for airman certificate applicants/holders.		A	Enter your complete residential address including street number, city, state, and ZIP code. This block cannot be left blank. If you have a foreign address, the country must be stated. If a residential address does not exist,, such as when the applicant resides on a rural route, a boat, or some other manner that requires the use of a P.O. Box, rural route, or personal mailbox, a map or written directions to your physical address, 911 address, or Global Positioning System (GPS) coordinates must be attached to the application or entered in the Remarks block. Mark box for attached directions, if applicable. A map or written directions are not required for Army Post Office (APO)/Fleet Post Office (FPO)/Diplomatic Post Office (DPO) type addresses.
1	I. Applicant Information	Checkbox	J1. Directions are Attached		If this box is checked it indicates the applicant acknowledges that directions to a physical location are required if there is no physical address to describe the location, and allows the applicant to acknowledge the physical location block was not inadvertently left blank.	N	Y	Added - Added to support obtaining a physical address of an airman who's mailing address is not the same as the airman's physical address.		A	...Mark box for attached directions, if applicable.
1	I. Applicant Information	Text	J2. Mailing Address	(Will show on certificate)	This is the address of the applicant that will show on the certificate. It is the address the certificate will be mailed to, unless the applicant indicates a different location in the remarks block.	Y	Y	No differences.		A	Enter your mailing address, if different from block J1. This address will be printed on the permanent airman certificate. You may leave the block blank if the “Same as J1” box is marked. A post office box, rural route, personal mailbox, commercial, or other mail drop can be used as your preferred mailing address. To have your airman certificate mailed to an address other than what is listed in blocks J1 or J2, provide mailing instructions on a separate attachment or in the remarks section of the form.
1	I. Applicant Information	Checkbox	J2. Same as J1.		If this box is checked it indicates the applicant acknowledges the mailing address is the same as the physical location, and the mailing address was not inadvertently left blank.	N	Y	Added - this block was added so that applicants do not have to enter the same information twice on the form, when the applicants mailing address is the same as the applicants physical address.		A	...You may leave the block blank if the “Same as J1” box is marked.
1	I. Applicant Information	Checkbox	K. Do you now hold or have you ever held an FAA airman certificate? - No, Yes		Assists airman registry in ensuring a single record is made for an airman.	Y	Y	No differences.		A	Mark yes or no. If yes, state the certificate type and number. Types of certificates include: pilot, mechanic, repairman, etc. A student pilot certificate is a pilot certificate.
1	I. Applicant Information	Text	K. Yes, Certificate type and number		Assists airman registry in identifying airman records and assists in ensuring a single record is made for an airman.	Y	Y	No differences.		A	...If yes, state the certificate type and number. Types of certificates include: pilot, mechanic, repairman, etc. A student pilot certificate is a pilot certificate.
1	I. Applicant Information	Checkbox	L. Have you ever had an FAA airman certificate suspended or revoked? - No, Yes		Assists FAA in determining if the applicant is eligible for certificate issuance - §§ 65.11(d)(2), revocations.	Y	Y	No differences.	65.11(c ) does not apply to repairman (suspension)	A	Mark yes or no. If “YES” is marked, refer to §§ 65.11(c) and (d).
1	I. Applicant Information	Checkbox	Do you read, write, speak, and understand the English language? - No, Yes		Assists FAA in determining if applicant is eligible for the certificate, or if certain limitations must be placed on the certificate. § 65.101(a)(6) (repairman) § 65.107 (a)(1)(ii)	N	Y	Added - Added to require the applicant to state if they read, write, speak, and understand the English language.	If the applicant answers NO, the applicant may be eligible for a certificate with limitations on validity; refer to § 65.101(a)(6) or 65.107 as applicable. Note that 65.104 experimental aircraft builder repairman do not have an English language requirement.	A	Mark yes or no. Refer to § 65.101(a)(6).
1	I. Applicant Information	Checkbox	N. Drug Conviction Question - No, Yes	Refer to § 65.12 and §91.19(a).	Assist FAA in determining if applicant is eligible for a certificate iaw 65.12	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b) and 91.19(a). Denial of the application for a period of up to 1 year after the date of final conviction may be appropriate.	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
1	I. Applicant Information	Date	N. Drug Conviction Question - If yes, Date of Final Conviction	(MM/DD/YYYY)	Assist FAA in determining if applicant is eligible for a certificate iaw 65.12	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b) and 91.19(a). Denial of the application for a period of up to 1 year after the date of final conviction may be appropriate.	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
1	II. Application Basis	Section	Application Basis		This is the title of the Section.	y	y
1	II. Application Basis	Checkbox	A. 65.101 REPAIRMAN		Assist applicant in completing required section of the form.	Y	Y	Added - Checkbox adjacent to information that must be completed for a 65.101 repairman.	Often at air carriers and repair stations the employer will complete this section on behalf of the applicant.	A	Mark this box if you are applying for a § 65.101 Repairman certificate. Enter your experience and/or training in Section III related to the privileges/limitations applied for.
1	II. Application Basis	Text	A1. Specify Repairman Privileges/Limitations Requested		Specifies the ratings the applicant is requesting to be on the repairman certificate.	Y	Y	Revised - Previously this was a small block located in the top section of the old version of the FAA form 8610-2.	Often at air carriers and repair stations the employer will complete this section on behalf of the applicant.	A O	Indicate the privileges/limitations for which you are applying.
1	II. Application Basis	Checkbox	A2. I have attached a letter from my employer recommending me for the privileges/limitations sought, and certifying that I meet the requirements of the requested privileges/limitations.		Assists in FAA eligibility determination. 65.101(a)(4) - Be recommended for certification by his employer, to the satisfaction of the Administrator, as able to satisfactorily maintain aircraft or components, appropriate to the job for which he is employed	Y	Y	Added - The checkblock indicates the applicant has included the required letter from employer as required by 65.101(a)(4).		A	Mark the box to indicate you have attached the required letter of recommendation from your employer.
1	II. Application Basis	Checkbox	B. § 65.104 EXPERIMENTAL AIRCRAFT BUILDER REPAIRMAN		Assist applicant in completing required section of the form.	Y	Y	Added - Checkbox adjacent to information that must be completed for a 65.104 repairman.		A	Mark this box when applying for a § 65.104 Experimental Aircraft Builder repairman certificate. Note: The information entered in B1-B4 should match what is stated on the aircraft’s airworthiness certificate.
1	II. Application Basis	Text	B1. Make		Required in order to issue appropriate privileges and limitations to the certificate holder. Refer to § 65.104(a)(4)(b)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Insert the make of the aircraft (this is the builder’s name as it appears on the aircraft data plate).
1	II. Application Basis	Checkbox	B2. Model		Required in order to issue appropriate privileges and limitations to the certificate holder. Refer to § 65.104(a)(4)(b)	N	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Insert the model of the aircraft.
1	II. Application Basis	Date	B3. Serial Number		Required in order to issue appropriate privileges and limitations to the certificate holder. Refer to § 65.104(a)(4)(b)	N	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Insert the serial number of the aircraft.
1	II. Application Basis	Text	B4. Certification Date		Required in order to issue appropriate privileges and limitations to the certificate holder. Refer to § 65.104(a)(4)(b)	N	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Insert the certification date of the aircraft.
1	II. Application Basis	Checkbox	C. § 65.107 LIGHT‐SPORT AIRCRAFT REPAIRMAN		Assist applicant in completing required section of the form.	N	Y	Added - Checkbox adjacent to information that must be completed for a 65.107 repairman.		A	Mark this box when applying for a § 65.107 Light-Sport Aircraft repairman certificate. Complete blocks C1 through C8, as appropriate. Note: An applicant may apply for additional ratings, classes, or aircraft using a separate application for each addition. Mark the “Added Rating/Privileges” box in the form’s top section, and complete all other required blocks. All ratings, classes, and aircraft will be included under the same certificate number.
1	II. Application Basis	Checkbox	C1. LSA Class: Airplane, Glider, Lighter-than-Air, Powered parachute, Weight-shift-control, Gyroplane (Inspection rating only)		Required to evaluate eligibility and to issue appropriate privileges and limitations. Ref. 65.107	N	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Enter the class of LSA requested. Selection of the Gyroplane class is only applicable to an Inspection rating. Multiple classes may be requested on a single application.
1	II. Application Basis	Text	C2. LSA Training Course Provider		Required to evaluate eligibility. Ref. 65.107(a)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Enter the name of the LSA course provider, as stated on certificate of completion.
1	II. Application Basis	Text	C3. Course Name		Required to evaluate eligibility. Ref. 65.107(a)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Enter the name of the LSA training course.
1	II. Application Basis	Text	C4. Course Number		Required to evaluate eligibility. Ref. 65.107(a)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Enter the LSA course number.
1	II. Application Basis	Text	C5. Course Completion Date		Required to evaluate eligibility. Ref. 65.107(a)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Enter the date you completed the LSA training course, as shown on the course certificate of completion.
1	II. Application Basis	Text	C6. Course Hours		Required to evaluate eligibility. Ref. 65.107(a)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Enter the training hours of the LSA course.
1	II. Application Basis	Checkbox	C7. N Number	Inspection Rating Only	Required in order to issue appropriate privileges and limitations to the certificate holder. Refer to § 65.107(b)	N	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Only for Inspection rating: Enter the aircraft registration number of the aircraft to be inspected.
1	II. Application Basis	Text	C8. Serial Number	Inspection Rating Only	Required in order to issue appropriate privileges and limitations to the certificate holder. Refer to § 65.107(b)	Y	Y	Added - previously this information was entered into Section III. Record of Experience.		A	Only for Inspection rating: Enter the serial number of the aircraft to be inspected.
1	III. Record of Experience	Section	III. Record of Experience or Training	Continue additional information on a separate sheet if necessary.	This is the title of the Section.	y	y				This section applies to § 65.101 repairmen applicants only. Note: Applicants should provide dates of experience in the eight-digit (MM/DD/YYYY) numeric format if necessary to count the days to ensure eligibility based on 18 months of practical experience. These dates can be handwritten in columns 1 and 2, or annotated in the Remarks block.
1	III. Record of Experience	Checkbox	Mark this box if separate sheet attached for additional information.		Indicates if additional experience records are attached as a separate sheet.	N	Y	Added - added to increase awareness that the applicant has included attachments with the application.		A	Mark the box if you have attached a separate sheet annotating additional experience or training information.
1	III. Record of Experience	Date	1. Date From	(MM/YYYY)	Support FAA evaluation of experience requirements applicable to 65.103 repairman. 65.101, Eligibility requirements.	Y	Y	No differences.		A	Enter the work experience or training related to the certificate, privileges, and limitations being applied for. Mark the box if you have attached a separate sheet annotating additional experience or training information. 1. Date From. Enter your employment/training start date in a six-digit (MM/YYYY) numeric format.
1	III. Record of Experience	Date	2. Date To	(MM/YYYY)	Support FAA evaluation of experience requirements applicable to 65.103 repairman	Y	Y	No differences.		A	Enter the work experience or training related to the certificate, privileges, and limitations being applied for. Mark the box if you have attached a separate sheet annotating additional experience or training information. 2. Date To. Enter your employment/training end date in a six-digit (MM/YYYY) numeric format.
1	III. Record of Experience	Text	3. Employer/Trainer Name & Location	Employer Name, City, State	Support FAA evaluation of experience or training requirements applicable to 65.103 repairman	Y	Y	Revised - Added reference to training as allowed by 65.103.		A	Enter the name of your employer or the name of entity conducting training, and the city and state of the employer and/or training entity.
1	III. Record of Experience	Text	4. Type of Work Performed/Training Received	Describe work performed, not job title.	Support FAA evaluation of experience or training requirements applicable to 65.103 repairman	Y	Y	Revised - Added reference to training as allowed by 65.103.		A	Enter the type of work performed with the employer, or describe the training received, related to the privileges and limitations requested.
1	IV. Applicants Certification	Section	IV. Applicants Certification	None	This is the title of the Section.	y	y	Differences described below.
1	IV. Applicants Certification	Statement	Text of the certifying statement - I certify that all statements and answers provided by me on this application form are complete and true to the best of my knowledge and I agree that they are to be considered as part of the basis for issuance of any FAA certificate to me. I have received the Pilot’s Bill of Rights Written Notification of Investigation that accompanies this form. I have also read and understand the Privacy Act statement that accompanies this form.		The statement notifies the applicant of the information they are certifying.	Y	Y	Revised - The new certification statement includes reference to the Pilots Bill of Rights Written Notification of Investigation and the Privacy Act statement which accompany the application form in the supplemental pages.	The Pilots Bill of Rights Written Notification of Investigation and the Privacy Act statement are made available to the applicant in the supplemental pages of the form.	N/A	You must complete this section at the time you make application.
1	IV. Applicants Certification	Signature	Applicant's Signature		The applicants signature indicates they have read and agree to the certifying statement.	Y	y	No differences.		A	Sign your name.
1	IV. Applicants Certification	Date	Date	(MM/DD/YYYY)	Indicates date application was signed by applicant.	Y	Y	No differences.		A	Enter the date you signed the form, using the MM/DD/YYYY format.
2	Applicant Information	Section	Applicant Information	(Required if application is printed on 2 pages)	When page one and two of the application are printed on separate pages (i.e. not double sided) this information allows the FAA to ensure all pages can be identified to the applicant.			Added - FAA guidance previously instructed FAA inspectors to enter this information either at the top margin, or in the remarks block.
2	Applicant Information	Text	Name	(As shown on page 1 of application)	Ensures page 2 of application is identified with applicant on page 1.	N	Y				When the application is printed on 2 separate pages (i.e. not printed double‐sided), enter your name, date of birth, and your certificate number relating to this application. Leave the certificate number blank if this is an application for original issuance. Note: This ensures page 2 of the application is placed with the correct applicant on page 1 if the pages become separated.
2	Applicant Information	Date	Date of Birth	(MM/DD/YYYY)	Ensures page 2 of application is identified with applicant on page 1.	N	Y
2	Applicant Information	Text	Certificate Number	(if any)	Ensures page 2 of application is identified with applicant on page 1.	N	Y
2	Applicants Certification	Title	Applicants Certification	This area is completed by the applicant at the time of issuance of the temporary airman certificate (FAA Form 8060‐4).	Section Title	Y	Y	IMPORTANT: This second applicant certification section is required because if application is made on a different day than the date of certificate issuance, the answers to these questions may have changed, thus making the applicant ineligible for a certificate.			Only complete this section at the time of issuance of a temporary certificate.
2	Applicants Certification	Checkbox	Airman Cert Question - Yes, No		Assists FAA in determining if the applicant is eligible for certificate issuance - §§ 65.11(d)(2), revocations.	Y	Y	No differences.	These questions must be asked at the time of certificate issuance to determine the applicants eligibility for the certificate requested.	A	Mark yes or no. If “YES” is marked, refer to § 65.11(c) and (d).
2	Applicants Certification	Checkbox	Drug Question - Yes, No		Assist FAA in determining if applicant is eligible for a certificate iaw 65.12	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b). Denial of the application for a period of up to 1 year after the date of final conviction may be appropriate.	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
2	Applicants Certification	Date	Drug question - If yes enter date of final conviction		Assist FAA in determining if applicant is eligible for a certificate iaw 65.12	Y	Y	No differences.	Refer to 65.12(a) and 65.12(b). Denial of the application for a period of up to 1 year after the date of final conviction may be appropriate.	A	Mark yes or no. Only mark yes if you have actually been convicted. If yes is marked, include the date of final conviction. Refer to § 65.12 and § 91.19(a).
2	Applicants Certification	Statement	Text of the certifying statement		The statement notifies the applicant of the information they are certifying.	Y	Y	Revised - The new certification statement includes reference to the Pilots Bill of Rights Written Notification of Investigation and the Privacy Act statement which accompany the application form in the supplemental pages.		A	N/A
2	Applicants Certification	Signature	Applicant Signature	(Print Name and Sign)	The applicants signature indicates they have read and agree to the certifying statement.	Y	Y	No differences.		A	Only complete this section at the time of issuance of a temporary certificate. Sign your name.
2	Applicants Certification	Date	Date	(MM/DD/YYYY)	Date applicant acknowledged and signed the certification statement.	Y	Y	No differences.		A	Only complete this section at the time of issuance of a temporary certificate. Enter the date you signed the form, using the MM/DD/YYYY format.
2	FAA Examiner's Report	Title	FAA Examiner's Report	None	Section Title
2	FAA Examiner's Report - Examined applicants papers	Statement	I have examined this applicants papers…	I have examined this applicant’s papers and I have indicated the result as:	Repairmen are not tested, therefore all certifications are based on examining documentation showing eligibility.	Y	Y	No differences.		D F
	FAA Examiner's Report - Examined applicants papers	Checkbox	Result: Approved (Temporary Certificate Issued)	Temporary Certificate Issued	FAA certification results/record	Y	Y	No differences.		D F
		Checkbox	Result: Disapproved		Indicates if application was not approved.			Added.	Guidance: Deny the Certificate. If you disapprove the application, return it to the applicant with a letter explaining the denial. (find VCS reference)
2	FAA Examiner's Report - Examined applicants papers	Signature	FAA Signature	(Print Name and Sign)	Signature of FAA examiner based on statement: I have tested this applicant in accordance with pertinent procedures and standards and I have indicated the result as:	Y	Y	No differences.	"FAA" refers to both FAA employees and FAA designees. FAA policy will state specifically which of these entities has the authority to sign this block. POLICY OFFICE - need to ensure the guidance clearly states who can sign in this block. Currently only FAA ASI's have the authority to sign this block, and only when they meet certain other qualifications as specified in 8900.1 guidance.	D F
2	FAA Examiner's Report - Examined applicants papers	Date	Date	(MM/DD/YYYY)	Date FAA signed FAA examiners report.	Y	Y	No differences.		D F
2	FAA Examiner's Report - Examined applicants papers	Text	FAA Office/Desig. No.		To provide the ability to correlate the FAA person endorsing the application back to an office designator or FAA designee designation.	Y	Y	No differences.	This block supports entry of either the FAA employees office designator, or the designees designation number. FAA policy will state which entity if authorized to use this block and specifically what information either of these entities must place in this block. POLICY OFFICE - need to ensure the 8900.1 guidance clearly states the format to be used by FAA ASIs when entering an office designator - confusion heightened due to recent reorganization of Flight Standards.	D F
2	Remarks	Text	Remarks	None	Used to capture various additional information provided by either the applicant or the FAA, that cannot be captured in prescribed blocks on the application.	Y	Y	No differences.		D F	You may annotate attachments, dual citizenship, mailing, or other information related to the application, in this block. This block is also used by the FAA for annotating additional information
2	Attachments	Section Title	Attachments
2	Attachments	Checkbox	Letter		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included - 65.101(a)(4) requires a letter from employer.	Y	Y			D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Temporary Certificate		Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	Y	Y			D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Attachments	Checkbox	Other	See Remarks block	Annotation of attachments provided within the certification package to help ensure all documents supporting the certification are included.	N	Y	Added - allows for annotation of any other attachment to the certification package.		A D F	Mark appropriate box(s) indicating attachments to the application. Select “Other” when attachments are not listed in this block, and annotate the attachment(s) in the Remarks block.
2	Applicant Identification (ID)	Section	Applicant Identification (ID)					Added - Previous form did not include fields for this information but FAA inspector guidance required this information to be placed in the Remarks block to show that applicant ID had been verified. Addition of these blocks will support assurance that ID is verified and annotated in a standard format.
2	Applicant Identification (ID)	Text	Form of ID	(Government Issued Photo ID)	Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y		Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Text	State or Country		Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y		Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Text	ID Number		Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y		Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Date	Expiration Date		Annotation area allowing the FAA to indicate what form of ID was used to verify the applicants identity.	N	Y		Obtain this information from the applicants provided government issued identification.	A D F	This is completed by the person verifying your identity at the time of application and confirmed at certificate issuance. Changes or corrections can be annotated in the Remarks block.
2	Applicant Identification (ID)	Text	Telephone Number		Contact information for the applicant to allow contact to correct any errors on the application.	N	Y			A D F	If the applicant does not have a telephone number or email address, or chooses not to provide this information, enter “NONE” in the block.
2	Applicant Identification (ID)	Text	Email Address		Contact information for the applicant to allow contact to correct any errors on the application.	N	Y			A D F	If the applicant does not have a telephone number or email address, or chooses not to provide this information, enter “NONE” in the block.
2	FAA File Review	Section	FAA File Review	For FAA Use Only	When applications are processed by paper, designees must send the certification file to their managing FAA office, which reviews the file and forwards to airman records.			These are now FAA File review annotation blocks. They are not used to indicate and approval for certificate issuance.	Used by FAA Flight Standards Offices only; not used by FAA Designees.
2	FAA File Review	Signature	FAA Signature	(Print Name and Sign)	Annotation of that an FAA FS office reviewed the paper file once received by a designee, and before sending to airman records for certificate issuance.	N	Y	Revised - Now used to indicate the FAA has review the paper file prior to forwarding to airman records.		F
2	FAA File Review	Date	Date	(MM/DD/YYYY)	Annotation of that an FAA FS office reviewed the paper file once received by a designee, and before sending to airman records for certificate issuance.	N	Y	Revised - Now used to indicate the FAA has review the paper file prior to forwarding to airman records.		F
2	FAA File Review	Text	FAA Office		Annotation of that an FAA FS office reviewed the paper file once received by a designee, and before sending to airman records for certificate issuance.	N	Y	Revised - Now used to indicate the FAA has review the paper file prior to forwarding to airman records.		F