Form 8710-13 Remote Pilot Certificate and/or Rating Application

FAA Form 8710-13, Remote Pilot 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 30 minutes to complete this form. 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, and its expiration date is August 31, 2019. 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.

See Privacy Act Information and Pilot’s Bill of Rights Written Notification of
Investigation attached. Detach these supplemental information instruction parts
before submitting the attached form.
Instructions for completing this form (FAA 8710-13 form) are attached. Completion is
optional for the fields containing the applicant’s Social Security number, telephone
number, and e-mail address.
For faster processing, the FAA encourages applicants to apply online using the FAA
Integrated Airman Certification and Rating Application (IACRA). IACRA is available at
https://iacra.faa.gov.
Eligible part 61 pilot certificate holders who are applying for this certificate on the basis of
completion of an online training course must submit this application to an authorized
person at an FAA Flight Standards District Office (FSDO), an FAA Designated Pilot
Examiner (DPE), an Airman Certification Representative (ACR), or a Certificated Flight
Instructor (CFI).
Individuals applying for this certificate on the basis of completion of an aeronautical
knowledge test must attach the original passing results of the aeronautical knowledge
test to this form and mail the application package to:
DOT/FAA
Airmen Certification Branch (AFS-760)
P.O. Box 25082
Oklahoma City, OK 73125
Tear off this cover before submitting form

REMOTE PILOT CERTIFICATE AND/OR RATING APPLICATION
PRIVACY ACT STATEMENT: This statement is provided pursuant to 5 U.S.C. § 552(a):
The authority for collecting this information is contained in 49 U.S.C. §§ 106(g), 40113, 44702, 44703, 44709, 44710,
44711(a)(2)(A) 44709 and 14 CFR Parts 61 and 107, subpart C. The principal purpose for which the FAA intends to use the
information is to identify and evaluate your qualifications and eligibility for the issuance of an airman certificate and/or rating.
Submission of the data is mandatory, except for the applicant’s Social Security Number, telephone number, and email address,
which are optional. Failure to provide all required information will result in the FAA being unable to issue you a certificate
and/or rating. The information collected on this form will be included in a Privacy Act System of Records known as DOT/FAA
847, titled “Aviation Records on Individuals” and will be subject to the routine uses published in the System of Records Notice
for DOT/FAA 847 (see www.dot.gov/privacy/privacyactnotices), including:
(a) Providing basic airmen certification and qualification information to the public upon request. Examples of basic information
include:
•
The type of certificate(s) and/or rating(s) held, limitations, date of issuance, and certificate number;
•
The status of the airman’s certificate (i.e., whether it has been amended, modified, suspended or revoked for any
reason);
•
The airman’s home address, unless requested by the airman to be withheld from public disclosure per 49 U.S.C.
44703(c)(2);
(b) Using contact information to inform airmen of meetings and seminars conducted by the FAA regarding aviation safety.
(c) Disclosing information to the National Transportation Safety Board in connection with its investigation responsibilities.
(d) Providing information about airmen to Federal, State, local and tribal law enforcement agencies when engaged in an official
investigation in which an airman is involved.
(e) Providing information about enforcement actions or orders issued thereunder to Federal agencies, the aviation industry, and
the public upon request.
(f) Making records of delinquent civil penalties owed to the FAA available to the U.S. Department of the Treasury and the U.S.
Department of Justice (DOJ) for collection pursuant to 31 U.S.C. 3711(g).
(g) Making records of effective orders against the certificates of airmen available to their employers if the airmen use the
affected certificates to perform job responsibilities for those employers.
(h) Making airmen records available to users of FAA’s Safety Performance Analysis System (SPAS), including the Department
of Defense Commercial Airlift Division’s Air Carrier Analysis Support System (ACAS) for its use in identifying safety
hazards and risk areas, targeting inspection efforts for certificate holders of greatest risk, and monitoring the effectiveness of
targeted oversight actions.
(i) Making records of an individual’s positive drug test result, alcohol test result of 0.04 or greater breath alcohol concentration,
or refusal to submit to testing required under a DOT-required testing program, available to third parties, including current
and prospective employers of such individuals. Such records also contain the names and titles of individuals who, in their
commercial capacity, administer the drug and alcohol testing programs of aviation entities.
(j) Providing information about airmen through the Civil Aviation Registry’s Comprehensive Airmen Information System to
the Department of Health and Human Services, Office of Child Support Enforcement, and the Federal Parent Locator
Service that locates noncustodial parents who owe child support. Records in this system are used to identify airmen to the
child support agencies nationwide in enforcing child support obligations, establishing paternity, establishing and modifying
support orders and location of obligors. Records listed within the section on Categories of Records are retrieved using
Connect: Direct through the Social Security Administration’s secure environment.
(k) Making personally identifiable information about airmen available to other Federal agencies for the purpose of verifying the
accuracy and completeness of medical information provided to FAA in connection with applications for airmen medical
certification.
(l) Making records of past airman medical certification history data available to Aviation Medical Examiners (AMEs) on a
routine basis so that AMEs may render the best medical certification decision.
(m) Making airman, aircraft and operator record elements available to users of FAA’s Skywatch system, including the
Department of Defense, the Department of Homeland Security (DHS), DOJ and other authorized Federal agencies, for their
use in managing, tracking and reporting aviation-related security events.
(n) Other possible routine uses published in the Federal Register (see Prefatory Statement of General Routine Uses for
additional uses (65 FR 19477-78) For example, a record from this system of records may be disclosed to the United States
Coast Guard (Coast Guard) and to the Transportation Security Administration (TSA) if information from this system was
shared with either agency when that agency was a component of the DOT before its transfer to DHS and such disclosure is
necessary to accomplish a DOT, TSA or Coast Guard function related to this system of records.

Your signature on this form (FAA Form 8710-13) acknowledges that you received the Pilot’s
Bill of Rights Written Notification of Investigation at the time of this application.

PILOT’S BILL OF RIGHTS WRITTEN NOTIFICATION OF INVESTIGATION
The information you submit on the attached FAA Form 8710-13, Airman Certificate and/or Rating
Application, will be used by the Administrator of the Federal Aviation Administration as part of the basis
for issuing an airman certificate, rating, or inspection authorization to you under Title 49, United States
Code (U.S.C.) section 44703(a), if the Administrator finds, after investigation, that you are qualified for,
and physically able to perform the duties related to the certificate, rating, or inspection authorization for
which you are applying. Therefore, in accordance with the Pilot’s Bill of Rights, the Administrator is
providing you with this written notification of investigation of your qualifications for an airman
certificate, rating, or inspection authorization:
• The nature of the Administrator’s investigation, which is precipitated by your submission of this
application, is to determine whether you meet the qualifications for the airman certificate, rating, or
inspection authorization you are applying for under Title 14, Code of Federal Regulations (CFR) part 107.
• Any response to an inquiry by a representative of the Administrator by you in connection with this
investigation of your qualifications for an airman certificate or rating may be used as evidence against
you.
• A copy of your airman application file for this date is available to you upon your written request
addressed to:
Federal Aviation Administration
Airmen Certification Branch, AFS-760
P.O. Box 25082
Oklahoma City, OK 73125-0082
(If you make a written request for your airman application file, please provide your full name, date of
birth or airman certification number for identification purposes and the date of application.)

REMOTE PILOT CERTIFICATE AND/OR RATING APPLICATION
INSTRUCTIONS FOR COMPLETING FAA FORM 8710-13
I. APPLICATION INFORMATION.

Mark “X” in all appropriate blocks(s).

Note: Please enter all dates in eight digits as MM/DD/YYYY.
Use numeric characters, (e.g. 08/29/2016).

Block A. Name. Enter full legal name. (Last, First, Middle) If your full
legal name is more than 50 characters, use no more than one middle name for
record purposes. Do not change the name on subsequent applications unless it
is done in accordance with 14 CFR part 107.77(a). If you do not have a middle
name, enter “NMN”. If you have a middle initial only, indicate “Initial only.”
Indicate if you are a Jr., II, or III.

Block B. Social Security Number. Enter either your 9-digit social
security number, “Do Not Use”; or “None” if you are not a US citizen. If
entering a social security number, only enter a 9-digit U.S. Social Security
Number (Optional). See supplemental Privacy Act Information.
Block C. Date of Birth. Enter your date of birth in the following
format: MM/DD/YYYY. Check for accuracy. Verify that DOB is the same
as it is on any other FAA certificate you may hold.

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 E1. Residential Address. Enter your complete residential address.
This must include street number, city, state, and zip code. If the applicant has
a foreign address, the country must be stated. If a residential address does not
exist, a map or written directions to the applicant’s physical residence must be
attached to the application. Verify that the numbers are not transposed.

Block E2. Mailing Address. Enter your mailing address, if different than
block E1. This may be a residence, post office box, rural route, flight school
address, personal mail box (PMB), commercial address, or other mail drop
location, as applicable. The address provided in block E2, if any, will be
printed on the permanent airman certificate. If you want your airman
certificate mailed to an address other than provided in blocks E1 or E2, you
will need to provide instructions on a separate attachment or in the remarks
section of the form.

Block K. Eye Color. Spell out the color of your eyes. Choose from the
following: blue, brown, black, hazel, green, or gray.
Block L. Do you read, speak, write and understand the English
language? Mark yes or no.
Block L1. If you answered “No” to question ‘L’, are you unable to
read, speak, write, or understand the English language due to
medical reasons? Mark yes or no. If you answer “Yes” an operating
limitation will be placed on the certificate. Please provide an explanation of the
medical condition. You may include an attachment if necessary.

Block M. Do You Hold or Have You Ever Held An FAA Pilot
Certificate? Mark yes or no. If “Yes”, complete Blocks M1, M2, and M3.
Block M1. Grade of Certificate. Enter the grade of the FAA pilot
certificate you hold (i.e., Student, Recreational, Private, Commercial, or ATP).
DO NOT enter flight instructor certificate information.

Block M2. Certificate Number. Enter your current FAA certificate
number as it appears on the pilot certificate.

Block M3. Date Issued. Enter the date your pilot certificate was last issued.
BLOCK M4. Flight review requirements specified in §61.56. This
includes a flight review or alternative methods specified in in paragraphs (d), (e),
and (g) of §61.56. Mark yes or no.

BLOCK M5. Date of Last §61.56 Flight Review or equivalent. Enter
date flight review or equivalent activity completed.

Block N. Narcotics Drugs. Mark yes or no. Only mark “Yes if you have
actually been convicted. If you have been charged with a violation which has not
been adjudicated, mark “No”. If you marked “Yes”, please provide the date of
final conviction and an explanation of the offense. You may include an
attachment if necessary.
Block O. Have you ever been denied a remote pilot certificate for
any reason? Mark yes or no. If you marked “Yes”, please provide the reason
for the denial. You may include an attachment if necessary.

Block F. Citizenship/Nationality. Mark USA if you are a US Citizen
or legally naturalized US Citizen. If you are not a US citizen, mark “Other”
and enter the country where you are a legal citizen. To claim Dual
Citizenship, you must present appropriate documentation of citizenship for
each country.

Block G. Sex. Mark either Male or Female as appropriate.
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
pounds only.

Block J. Hair Color. Spell out the color of your hair. Choose from the

Block P. Do you have reason to know that you have a physical or
mental condition that would interfere with the safe operation of a
small unmanned aircraft system? Mark yes or no.
II. CERTIFICATE OR RATING APPLIED FOR ON BASIS OF:
Block A. Completion of a knowledge Test. (Attach knowledge test
results with application)

Block B. Completion of a training course. (Attach training course
completion certificate with application)

III. APPLICANT’S CERTIFICATION.

following: bald, black, red, brown, blond, gray, or white. If you wear a wig
or toupee, enter the color of your hair under the wig or toupee.

FAA Form 8710-13 (10-16) Supersedes Previous Edition

Electronic Version Only

A. Signature. Sign your name.
B. Date. The date you signed the application.

Form approved OMB No: 2120-0021

Expires: 08/31/2019

TYPE OR PRINT ALL ENTRIES IN INK

Remote Pilot Certificate and/or Rating Application
I. APPLICATION INFORMATION (Mark ‘X’ in all the blocks applicable to the certificate or rating for which you are applying):
Ratings
Other Information/Requests
Small Unmanned Aircraft System

Initial

Recurrent

Other specify:

A. Name (Last, First, Middle)
E1. Residential Address

B. SSN (US Only)

C. Date of Birth

D. Place of Birth (City and State) or (City and Country)

MM/DD/YYYY

(include City, State, Zip Code & Country)

E2. Mailing Address (This address will be printed on the
permanent airman certificate, if different than block E1)

F. Citizenship / Nationality
USA
Other

G. Sex
Male
Female

specify:

H. Height (inches) I. Weight (pounds) J. Hair Color

K. Eye Color

L. Do you read, speak, write, and understand the English language? L1. If you answered “No” to question ‘L’, are you unable to read, speak, write, or understand the English
Yes
No
language due to medical reasons?
Yes
No If yes, please explain:
M. Do you hold, or have you ever held an FAA certificate? M1. Grade of Certificate
M2. Certificate Number
M3. Date Issued
Yes
No
M4. If you hold a Pilot Certificate, do you meet the flight review requirements specified in §61.56?
M5. Date of Last §61.56 Flight Review or equivalent
Yes
No
N. 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
No
Date of Final Conviction:
If you answered Yes, please explain:
O. Have you ever been denied a remote pilot certificate for any reason?

Yes

No

If yes, please explain:

P. Do you have reason to know that you have a physical or mental condition that would interfere with the safe operation of a small unmanned aircraft system?

Yes

No

II. CERTIFICATE OR RATING APPLIED FOR ON BASIS OF:
A. Completion of Knowledge Test (attach knowledge test results with application)
B. Completion of Training Course (attach training course completion certificate with application)
III. APPLICANT’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 received the Pilot’s Bill of Rights Written Notification of Investigation that accompanies this form and have read and understand the Privacy Act statement that also accompanies this form.

Signature of Applicant

Date
MM/DD/YYYY

Submitting Official’s Report
I have personally reviewed this application and I certify that the individual meets the applicable requirements of 14 CFR Part 107 for the certificate or rating sought.
I have personally verified the applicant’s identification.
I have personally delivered the Written Notification under the Pilot’s Bill of Rights to the applicant.
Applicant meets FAA Aviation English Language Proficiency
Application Accepted

Temporary Certificate Issued

Yes

No

Application Rejected

Designated Examiner or Airman Certification Representative Signature
Date
Examiner’s Signature (Print Name & Sign)

specify:

Designation Number

Designation Expires

Aviation Safety Inspector Signature
Date
Inspector’s Signature (Print Name & Sign)

Certificate Number

FAA Office Code

Authorized Instructor Signature
Date
Instructor’s Signature (Print Name & Sign)

Certificate Number

Certificate Expires

Attachments:

Certificate Number

Airman’s Identification(ID) (US Driver’s License or passport recommended)) Applicant Information

Knowledge Test Report

Form of ID

Name

Training Course Completion Certificate

ID Number

Date of Birth

Temporary Certificate

Expiration Date

Certificate Number

Telephone Number

E-mail Address

Other specify:

Remarks
FAA Form 8710-13 (10-16) Supersedes Previous Edition

Electronic Version Only