Information Collection

Pilots Convicted of Alcohol or Drug-Related Motor Vehicle Offenses or Subject to State Motor Vehicle Administrative Procedure

IC 25617 under ICR 202006-2120-006 · OMB 2120-0543.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0543 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
screen shot of PRA.JPG www.faa.gov/about/office_org/headquarters_offices/ash/ash_programs/investigations/airmen_duidwi/	Instruction
screen shot of digital form.JPG www.faa.gov/about/office_org/headquarters_offices/ash/ash_programs/investigations/airmen_duidwi/	Other-Digital unofficial form

IC Title:

Pilots Convicted of Alcohol or Drug-Related Motor Vehicle Offenses or Subject to State Motor Vehicle Administrative Procedure

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 14 CFR 61

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Digital unofficial form			screen shot of digital form.JPG	https://www.faa.gov/about/office_org/headquarters_offices/ash/ash_programs/investigations/airmen_duidwi/	Yes	Yes	Fillable Fileable Signable
Instruction			screen shot of PRA.JPG	https://www.faa.gov/about/office_org/headquarters_offices/ash/ash_programs/investigations/airmen_duidwi/	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title: DOT/FAA 847 - Aviation Records on Individuals

FR Citation: 75 FR 68849

Number of Respondents: 589

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	862	-75	937
Annual IC Time Burden (Hours)	431	275	156
Annual IC Cost Burden (Dollars)	862	-1,949	2,811

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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