Form 8710-4 Rotorcraft External-Load Operator Certificate Applicatio

US Department
of Transportation
Federal Aviation
Administration

ROTORCRAFT EXTERNAL-LOAD OPERATOR CERTIFICATE APPLICATION
Paperwork Reduction Act Statement: A federal agency may not conduct or sponsor, and a person is not required
to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information
subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a
current valid OMB Control Number. The OMB Control Number for this information collection is 2120-0044.
Public reporting for this collection of information is estimated to be approximately 0.3 hours per response,
including the time for reviewing instructions, completing and reviewing the collection of information. All
responses to this collection of information are mandatory per 14 CFR Part 133. 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, ASP-110.

SUPPLEMENTAL
INFORMATION

TEAR OFF
BEFORE USE
FAA Form 8710-4

(11-2007) THIS PART SUPERSEDES FAA FORM 8000-32
Electronic Version (Adobe)

DETACH THIS PART BEFORE USING FORM BELOW

Form Approved: OMB No. 2120-0044
11/30/2014
US Department
of Transportation

Rotorcraft External-Load Operator Certificate Application

Federal Aviation
Administration

INSTRUCTIONS: Submit this form in triplicate to local FAA District Office
1. APPLICATION FOR (CHECK APPLICABLE BOX)

CERTIFICATE NO. (For amendment
or renewal only.)

ORIGINAL ISSUANCE

EXTERNAL - LOAD CLASS
AUTHORIZATION (S)

AMENDMENT

A

RENEWAL
2. NAME AND ADDRESS OF APPLICANT (Include Zip Code)

AIRMAN
CERTIFICATE

ROTORCRAFT TO BE USED
REGISTRATION
NUMBER

TYPE
MAKE

LOAD CLASS (X)
MODEL

C

D

3. PRINCIPAL OR LOCAL BASE OF OPERATIONS (Airport, City,
State, and Zip Code)

TELEPHONE NUMBER
TELEPHONE NUMBER
4. NAME OF CHIEF PILOT OR PILOT IN CHARGE OF LOCAL OPERATION

5.

B

A

B

C

D

ATTACH
PREV

DEVICE
APPD.

YES

NO

GRADE

NUMBER

REMARKS

CERTIFICATION

I certify that the statements made on this application form and any attachments are true and correct, and that the operations
indicated on this application will be conducted within the requirements of the Federal Aviation Act of 1958 and the applicable Federal
Aviation Regulations.
DATE

FAA Form 8710-4

TITLE OF AUTHORIZED OFFICER

(11-2007) SUPERSEDES FAA FORM 8420-7 and FAA FORM 8000-32

SIGNATURE OF APPLICANT OR AUTHORIZED OFFICER

Electronic Version (Adobe)

INSPECTION REPORT
(To be completed by FAA District Office Representative)
ROTORCRAFT
MAKE

MODEL

REGISTRATION
NUMBER

APPROVAL
DATE

CLASS

LIMITATIONS
AND
REMARKS

WEIGHT
AUTHORIZED

INSPECTOR'S
SIGNATURE

REMARKS

CHIEF PILOT KNOWLEDGE AND SKILL REQUIREMENTS MET BY:
NAME OF CHIEF PILOT

DATE

Applicant is Fully Qualified to Conduct External - Load Operations in Class (es)

CERTIFICATE NUMBER

Class A

Class B

APPLICATION DISAPPROVED

FAA DISTRICT OFFICE

Class C

SIGNATURE OF INSPECTOR

Class D

REASONS:

SIGNATURE OF SUPERVISING INSPECTOR

Electronic Version (Adobe)

ISSUED ON