Information Collection

Designated Engineering Representative (DER) Applicants

IC 239815 under ICR 202002-2120-004 · OMB 2120-0033.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0033 can be found here:

Documents and Forms

Document Name Document Type
Form FAA Form 8110-14 Designated Engineering Representative (DER) Applicants Form
Form FAA Form 8110-14 Statement of Qualifications Designated Engineering Representative (DER) Applicants Form
FAA Form 8110-14 Statement of Qualifications FAA_Form_8110-14 updated PA PRA.pdf www.faa.gov/documentLibrary/media/Form/FAA_Form_8110-14.pdf Form
FAA Form 8110-14 Statement of Qualifications FAA_Form_8110-14 updated PA PRA.pdf www.faa.gov/documentLibrary/media/Form/FAA_Form_8110-14.pdf Form
14 CFR Part 183.docx 14 CFR part 183 IC Document
14 CFR Part 183.docx 14 CFR part 183 IC Document
PAS For Form 8110-14 Statement of Qual (AGC Approved).docx PAS for Form 8110-14 IC Document
PAS For Form 8110-14 Statement of Qual (AGC Approved).docx PAS for Form 8110-14 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Designated Engineering Representative (DER) Applicants	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 183

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FAA Form 8110-14	Statement of Qualifications	FAA_Form_8110-14 updated PA PRA.pdf	https://www.faa.gov/documentLibrary/media/Form/FAA_Form_8110-14.pdf	Yes	No	Fillable Printable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 320	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	320	0	320
Annual IC Time Burden (Hours)	1,920	1,440	480
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
14 CFR part 183	14 CFR Part 183.docx	02/05/2020
PAS for Form 8110-14	PAS For Form 8110-14 Statement of Qual (AGC Approved).docx	02/19/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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