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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.