Form 8710-1 Airman Certificate and/or Rating Application

U.S. Department
of Transportation

Federal Aviation
Administration

FAA Form 8710-1, Airman Certificate
and/or Rating Application
Supplemental Information and Instructions

Paperwork Reduction Act Statement:
The information collected on this form is necessary to determine applicant eligibility for airman ratings. We estimate it
will take 15 minutes to complete this form. The information collected is required to obtain a benefit and becomes part of
the Privacy Act system of records DOT/FAA 847, General Air Transportation Records on Individuals. Please note that
an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. The OMB control number associated with this collection is 2120-0021.
Comments concerning the accuracy of this burden and suggestions for reducing the burden should be directed to the
FAA at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information Collection Clearance Officer, ABA-20.

Privacy Act
The information on the accompanying form is solicited under authority of Title 14 of the Code of Federal Regulations
(14 CFR), Part 61. The purpose of this data is to be used to identify and evaluate your qualifications and eligibility for
the issuance of an airman certificate and/or rating. Submission of all requested data is mandatory, except for the Social
Security Number (SSN) which is voluntary. Failure to provide all the required information would result in you not
being issued a certificate and/or rating. The information would become part of the Privacy Act system of records
DOT/FAA 847, General Air Transportation Records on Individuals. The information collected on this form would be
subject to the published routine uses of DOT/FAA 847. Those routine uses are: (a) To provide basic airmen
certification and qualification information to the public upon request. (b) To disclose information to the national
Transportation Safety Board (NTSB) in connection with its investigation responsibilities. (c) To provide information
about airmen to Federal, state, and local law enforcement agencies when engaged in the investigation and
apprehension of drug violators. (d) To provide information about enforcement actions arising out of violations of the
Federal Aviation regulations to government agencies, the aviation industry, and the public upon request. (e) To
disclose information to another Federal agency, or to a court or an administrative tribunal, when the Government or
one of its agencies is a party to a judicial proceeding before the court or involved in administrative proceedings before
the tribunal.
Submission of your Social Security Number is voluntary. Disclosure of your SSN will facilitate maintenance of your
records which are maintained in alphabetical order and cross-referenced with your SSN and airman certificate number
to provide prompt access. In the event of nondisclosure, a unique number will be assigned to your file.

See Privacy Act Information above. Detach this part before submitting form.
Instructions for completing this form (FAA 8710-1) are on the reverse.
If an electronic form is not printed on a duplex printer, the applicant's name, date of birth, and certificate number
(if applicable) must be furnished on the reverse side of the application. This information is required for identification
purposes. The telephone number and E-mail address are optional.
Tear off this cover sheet before submitting this form.

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

NSN: 0052-00-682-5007

AIRMAN CERTIFICATE AND/OR RATING APPLICATION

INSTRUCTIONS FOR COMPLETING FAA FORM 8710-1

I. APPLICATION INFORMATION. Check appropriate blocks(s).
Block A. Name. Enter legal name. Use no more than one middle name for

Block S. Date Issued. Enter the date your medical certificate was issued.

record purposes. Do not change the name on subsequent applications unless it
is done in accordance with 14 CFR Section 61.25. If you do not have a
middle name, enter “NMN”. If you have a middle initial only, indicate
“Initial only.” If you are a Jr., or a II, or III, so indicate. If you have an FAA
certificate, the name on the application should be the same as the name on the
certificate unless you have had it changed in accordance with 14 CFR Section
61.25.

Block T. Name of Examiner. Enter the name as shown on medical

Block B. Social Security Number. Optional: See supplemental

give the date of final conviction.

Information Privacy Act. Do not leave blank: Use only US Social Security
Number. Enter either “SSN” or the words “Do not Use” or “None.” SSN’s
are not shown on certificates.

Block C. Date of Birth. Check for accuracy. Enter eight digits; Use
numeric characters, i.e., 07-09-1925 instead of July 9, 1925. Check to see that
DOB is the same as it is on the medical certificate.

Block D. Place of Birth. 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
where you were born.
Block E. Permanent Mailing Address. Enter residence number and
street, P.O. Box or rural route number in the top part of the block above the
line. The City, State, and ZIP code go in the bottom part of the block below
the line. Check for accuracy. Make sure the numbers are not transposed.
FAA policy requires that you use your permanent mailing address.
Justification must be provided on a separate sheet of paper signed and
submitted with the application when a PO Box or rural route number is
used in place of your permanent physical address. A map or directions
must be provided if a physical address is unavailable.
Block F. Citizenship. Check USA if applicable. If not, enter the country
where you are a citizen.

Block G. Do you read, speak, write and understand the English
language? Check yes or no.
Block H. Height. Enter your height in inches. Example: 5’8” would be
entered as 68 in. No fractions, use whole inches only.
Block I. Weight. Enter your weight in pounds. No fractions, use whole

certificate.

Block U. Narcotics, Drugs. Check appropriate block. Only check “Yes”
if you have actually been convicted. If you have been charged with a
violation which has not been adjudicated, check .“No”.

Block V. Date of Final Conviction. If block “U” was checked “Yes”
II. CERTIFICATE OR RATING APPLIED FOR ON BASIS OF:
Block A. Completion of Required Test.

1. AIRCRAFT TO BE USED. (If flight test required) – Enter the make and
model of each aircraft used. If simulator or FTD, indicate.
2. TOTAL TIME IN THIS AIRCRAFT (Hrs.) – (a) Enter the total Flight
Time in each make and model. (b) Pilot-In-Command Flight Time - In
each make and model.

Block B. Military Competence Obtained In. Enter your branch of
service, date rated as a military pilot, your rank, or grade and service number.
In block 4a or 4b, enter the make and model of each military aircraft used to
qualify (as appropriate).
Block C. Graduate of Approved Course.

1. NAME AND LOCATION OF TRAINING AGENCY/CENTER.
As shown on the graduation certificate. Be sure the location is entered.
2. AGENCY SCHOOL/CENTER CERTIFICATION NUMBER. As shown
on the graduation certificate. Indicate if 142 training center.
3. CURRICULUM FROM WHICH GRADUATED. As shown on the
graduation certificate.
4. DATE. Date of graduation from indicated course. Approved course
graduate must also complete Block “A” COMPLETION OF REQUIRED
TEST.

Block D. Holder of Foreign License Issued By.
1. COUNTRY. Country which issued the license.
2. GRADE OF LICENSE. Grade of license issued, i.e., private, commercial,
etc.
3. NUMBER. Number which appears on the license.
4. RATINGS. All ratings that appear on the license.

pounds only.

Block E. Completion of Air Carrier’s Approved Training
Program.

Block J. Hair. Spell out the color of your hair. If bald, enter “Bald.”

1. Name of Air Carrier.
2. Date program was completed.
3. Identify the Training Curriculum.

Color should be listed as black, red, brown, blond, or gray. If you wear a wig
or toupee, enter the color of your hair under the wig or toupee.

Block K. Eyes. Spell out the color of your eyes. The color should be listed
as blue, brown, black, hazel, green, or gray.

Block L. Sex. Check male or female.
Block M. Do You Now Hold or Have You Ever Held An FAA
Pilot Certificate? Check yes or no. (NOTE: A student pilot certificate is a
“Pilot Certificate.”)

III. RECORD OF PILOT TIME. The minimum pilot experience required
by the appropriate regulation must be entered. It is recommended, however,
that ALL pilot time be entered. If decimal points are used, be sure they are
legible. Night flying must be entered when required. You should fill in the
blocks that apply and ignore the blocks that do not. Second In Command
“SIC” time used may be entered in the appropriate blocks. Flight Simulator,
Flight Training Device and PCATD time may be entered in the boxes
provided. Total, Instruction received, and Instrument Time should be entered
in the top, middle, or bottom of the boxes provided as appropriate.

Block N. Grade of Pilot Certificate. Enter the grade of pilot certificate
(i.e., Student, Recreational, Private, Commercial, or ATP). Do NOT enter
flight instructor certificate information.

IV. HAVE YOU FAILED A TEST FOR THIS CERTIFICATE OR
RATING? Check appropriate block.

Block O. Certificate Number. Enter the number as it appears on your

V. APPLICANT’S CERTIFICATION.

pilot certificate.

Block P. Date Issued. Enter the date your pilot certificate was issued.

A. SIGNATURE. The way you normally sign your name.
B. DATE. The date you sign the application.

Block Q. Do You Now Hold A Medical Certificate? Check yes or
no. If yes, complete Blocks R, S, and T.

Block R. Class of Certificate. Enter the class as shown on the medical
certificate, i.e., 1st, 2nd, or 3rd class.

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

NSN: 0052-00-682-5007

Form Approved OMB No: 2120-0021
09/30/2010

TYPE OR PRINT ALL ENTRIES IN INK

DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION

Airman Certificate and/or Rating Application

l Application Information

Student
Recreational
Private
Commercial
Additional Rating
Airplane Single-Engine
Airplane Multiengine
Rotorcraft
Flight Instructor ____ Initial ____ Renewal ____ Reinstatement
Additional Instructor Rating
Medical Flight Test
Reexamination
Reissuance of ____________________________ certificate

Airline Transport
Balloon
Ground Instructor

B. SSN (US Only)

C. Date of Birth
Month

E. Address

F. Citizenship

Specify

City, State, Zip Code

H. Height

M. Do you now hold, or have you ever held an FAA Pilot Certificate?

N. Grade Pilot Certificate

Day

D. Place of Birth

Year

G. Do you read, speak, write, & understand
the English language?
Yes

Other ________________
I. Weight

Instrument
Glider
Powered-Lift

Other ______________________

A. Name (Last, First, Middle)

USA

Airship

J. Hair

K. Eyes

L. Sex

No
Male
Female

Yes

Q. Do you hold a
Medical Certificate?

Yes

O. Certificate Number

P. Date Issued

No

R. Class of Certificate

S. Date Issued

T. Name of Examiner

No

U. Have you ever been convicted for violation of any Federal or State statutes relating to narcotic drugs, marijuana, or depressant or stimulant drugs or substances?
Yes

V. Date of Final Conviction

No

II. Certificate or Rating Applied For on Basis of:
A.

B.

Completion of
Required Test
Military
Competence
Obtained In

C.

Graduate of
Approved
Course

D.

1. Aircraft to be used (if flight test required)

2a. Total time in this aircraft / SIM / FTD

1. Service

2. Date Rated

2b. Pilot in command
hours

4a. Flown 10 hours PIC in last 12 months in the following Military Aircraft.

hours
3. Rank or Grade and Service Number

4b. US Military PIC & Instrument check in last 12 months (List Aircraft)

1. Name and Location of Training Agency or Training Center

1a. Certification Number

2. Curriculum From Which Graduated

3. Date

1. Country

2. Grade of License

3. Number

Holder of Foreign
License
Issued By

E.

Completion of Air
Carrier's Approved

4. Ratings

1. Name of Air Carrier

2. Date

3. Which Curriculum

Training Program

Initial

Upgrade

Transition

III RECORD OF PILOT TIME (Do not write in the shaded areas.)
Total

Airplanes
Rotor­
craft
Powered
Lift

Instruction
Received

Solo

Pilot
in
Command
(PIC)

Cross
Country
Instruction
Received

Cross
Country Solo

Cross
Country PIC

Instrument

Night
Instruction
Received

Night
Take-off/
Landings

Night PIC

Night
Take-Off/
Landing PIC

PIC

PIC

PIC

SIC

SIC

SIC

SIC

PIC

PIC

PIC

PIC

SIC

SIC

SIC

SIC

PIC

PIC

PIC

PIC

SIC

SIC

SIC

SIC

Number of
Flights

Number of
Aero-Tows

Number of
Ground
Launches

Number of
Powered
Launches

PIC

Gliders
Lighter
Than Air
Simulator
Training
Device
PCATD

IV. Have you failed a test for this certificate or rating?

Yes

No

V. Applicants's 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 to me. I have also read and understand the Privacy Act statement
that accompanies this form.
Signature of Applicant

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

Date

NSN: 0052-00-682-5007

Instructor's Recommendation
I have personally instructed the applicant and consider this person ready to take the test.
Instructor's Signature
(Print Name & Sign)
Certificate No:

Date

Certificate Expires

Air Agency's Recommendation

The applicant has successfully completed our _________________________________________________________course, and is recommended for certification or rating
without further _____________________________________________test.
Date

Agency Name and Number

Officials Signature
Title

Designated Examiner or Airman Certification Representative Report
Student Pilot Certificate Issued (Copy attached)
I have personally reviewed this applicant's pilot logbook and/or training record, and certify that the individual meets the pertinent requirements
of 14 CFR Part 61 for the certificate or rating sought.
I have personally reviewed this applicant's graduation certificate, and found it to be appropriate and in order, and have returned the certificate.
I have personally tested and/or verified this applicant in accordance with pertinent procedures and standards with the result indicated below.
Approved -- Temporary Certificate Issued (Original Attached)
Disapproved -- Disapproval Notice Issued (Original Attached)
Location of Test (Facility, City, State)
Ground
Certificate or Rating for Which Tested
Date

Type(s) of Aircraft Used

Examiner's Signature

(Print Name & Sign)

Duration of Test
Simulator/FTD

Flight

Registration No.(s)

Certificate No.

Designation No.

Designation Expires

Evaluator's Record (Use For ATP Certificate and/or Type Ratings)
Inspector

Examiner

Oral

Signature and Certificate Number

Date

_______________________________________________________________

__________________________

Approved Simulator/Training Device Check

_______________________________________________________________

__________________________

Aircraft Flight Check

_______________________________________________________________

__________________________

Advanced Qualification Program

_______________________________________________________________

__________________________

Aviation Safety Inspector or Technician Report
I have personally tested this applicant in accordance with or have otherwise verified that this applicant complies with pertinent procedures, standards, policies, and or
necessary requirements with the result indicated below.
Approved -- Temporary Certificate Issued (Original Attached)

Disapproved -- Disapproval Notice Issued (Original Attached)

Location of Test (Facility, City, State)

Duration of Test
Simulator/FTD

Ground
Certificate or Rating for Which Tested

Student Pilot Certificate Issued
Examiner's Recommendation
Accepted

Rejected

Type(s) of Aircraft Used

Certificate or Rating Based on

Registration No.(s)

Flight Instructor

Military Competence

Approved Course Graduate

Special Medical test conducted -- report forwarded

Other Approved FAA Qualification Criteria

Reinstatement
Instructor Renewal Based on
Activity
Test

to Aeromedical Certification Branch, AAM-330
Training Course (FIRC) Name

Date

Inspector's Signature

Attachments:

Graduation Certificate No.

(Print Name & Sign)

__________________________________________________
Form of ID

Knowledge Test Report

__________________________________________________
Number
__________________________________________________
Expiration Date
__________________________________________________
Telephone Number

Notice of Disapproval

Certificate No.

Training Course
Duties and
Responsibilities
Date

FAA District Office

Airman's Identification (ID)

Student Pilot Certificate (Copy)

Temporary Airman Certificate

Ground Instructor

Renewal

Foreign License

Reissue or Exchange of Pilot Certificate

Flight

ID:
Name: _____________________________________________
Date of Birth: _______________________________________
Certificate Number: __________________________________
E-Mail Address ______________________________________

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

Electronic Version (Adobe)

NSN: 0052-00-682-5007