8060-14 Pilot Consent/Revocation for Air Carrier Access to Pilot

Pilot Records Improvement Act of 1996/ Pilot Record Database

PRD Pilot Consent Form (10.20) 8060-14 120720

OMB: 2120-0607

Document [pdf]
Download: pdf | pdf
INSTRUCTIONS FOR COMPLETING FAA FORM 8060-14
PURPOSE: This form allows pilots who do not have access to the FAA Pilot
Records Database (PRD) to grant or revoke access for air carriers or operators to
view the pilot's PRD records. This form also allows pilots to update their
employment history and request a copy of their records contained in the PRD
when they cannot access the application themselves.

Name: Enter your last name, first name and middle name as displayed on your FAA pilot certificate.
(Required)
FAA Pilot Certificate Number: Enter your certificate number as displayed on your FAA COMMERCIAL or
ATP pilot certificate. If you do not hold a Commercial or ATP certificate, enter the number from your Remote
Pilot Certificate. (Required) Other pilot certificates are not supported by the PRD.
Email Address: Enter your email address. (Optional)
Current Mailing Address, City, State, Zip Code: Enter your mailing address, city, state, and Zip code as
displayed on your FAA pilot certificate. If you need to change your address printed on your certificate, contact the
Airmen Certification Branch at 866-878-2498. Entering a different address here will not update your FAA address
on record and may delay consent or revocation being granted via the PRD. Copies of your PRD Airman Record
will be mailed to the address of record only. (Required)
Granting or Revoking Consent Statement: Select if you intend to grant consent or withdraw a previously
provided consent to air carriers/operators. If you do not make a selection, consent will not be granted or withdrawn
in the PRD for this company. (Required)
Air Carrier Name(s) and Designator(s): Enter the full name of the air carrier or operator that will be allowed to
review your PRD Airman Records. Ask the air carrier or operator what should be entered, as it may not be the
same as the commonly used company name. Also enter the FAA designator assigned to the air carrier or operator.
Ask the air carrier or operator what should be entered. You may list up to four carriers/operators. If you require
more carrier/operator entries, please submit any number of separate FAA Forms 8060-14. (Required if granting or
revoking consent)
Consent Time Period: Select how long you would like your PRD Airman Records to be available for download
for each air carrier or operator. Do not make a selection if you are using this form to withdraw consent. If left
unchecked, the carrier/operator access period will be 30 days. (Optional)
Requesting a copy of your records: Mark this box if you only need to request a copy of your records in the PRD
and do not want to grant or revoke consent. The records will be mailed to your address of record.
Perjury Statement: Your signature below this statement declares that you understand the penalties for making a
false statement on this form.
Signature: You must sign and date the form for consent or withdrawal to be granted. A typed or electronic
signature is not acceptable. (Required)
Previous Employer(s): Enter your current and/or former employers for which you were employed as a pilot
within the previous five years. It is considered a falsification and subject to enforcement action if current and/or
former employers are omitted. Note: Submitting employment history information via this form will replace any
previous employers previously submitted to the PRD. After this request is processed, your employment history
will match what is submitted via this form. If you leave this form empty, no changes will be made to your
employment history. Submit additional pages if you need more space to add previous employers.

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OMB Control No. 2120-0607 Expiration Date 05/31/2023
Privacy Act Statement (5 U.S.C. § 552a, as amended): AUTHORITY: Federal Information Security
Modernization Act of 2014, Public Law 113-283, 6 U.S.C. 1523(b) (prescribing user authentication
requirements), and National Institute of Standards and Technology (NIST) Special Publication (SP) 80063-2 (which addresses identity proofing), authorizes DOT to collect this information. PURPOSE(S):
DOT will use the information provided to allow individuals external to the Department of Transportation
to access web-based applications (such as the Federal Aviation Administration’s (FAA’S) Pilot Record
Database (PRD) for which they are authorized to access, external users must first create MyAccess
registration accounts requiring the submission of personally identifiable information. The principal
purpose for the collection of the personally identifiable information is to create the MyAccess registration
account. In order to create a MyAccess registration account, the registrant will be required to provide
personal information such as full name, phone number and email address. For identity validation
purposes, other information, such as a social security number (SSN) or driver’s license number, date of
birth (DOB), and a credit card number, is used. With the exception of the individual’s SSN, the rest of
the data elements are mandatory to initiate the electronic authentication process. Neither the Department
of Transportation nor FAA store information collected for the identification validation process, and
therefore do not constitute records subject to the provisions of the Privacy Act of 1974. ROUTINE
USE(S): In accordance with DOT’s Privacy Act system of records notice note (SORN), DOT/ALL 13,
Internet/Intranet Activity and Access Records, May 7, 2002 67 FR 30758, the information provided may
be disclosed in accordance with the routine uses that appear on the notice for this system of record,
available at https://www.transportation.gov/individuals/privacy/privacy-act-system-records-notices.
DISCLOSURE: Provision of the requested information (including your social security number) is
voluntary; however failure to furnish the requested information may result in an inability of the
Department to create a MyAccess registration account for the user, and may require an “in-person”
validation.
Paperwork Reduction Act Burden 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 currently valid OMB Control Number. The OMB Control Number for
this information collection is 2120-0607. Public reporting for this collection of information is estimated to
be approximately 15 minutes per response.
All responses to this collection of information are voluntary. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this
burden to the FAA at: 800 Independence Ave. SW, Washington, DC 20591, Attn: Information Collection
Clearance Officer, ASP-110.

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U.S. DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration



OMB No. 2120-0607
Expires 5/31/2023

PILOT CONSENT/REVOCATION FOR AIR CARRIER ACCESS TO PILOT RECORDS DATABASE

First Name

Last Name (as appears on your FAA pilot certificate)

FAA Pilot Certificate Number

Middle Name

Email Address (optional)

Current Mailing Address: Street Address, Apt./Suite No., PO Box/Rural Route No.

City

State

ZIP Code

I grant or revoke consent to the air carriers and/or operators listed below to access my records within the Pilot Records
Database, and I authorize the Federal Aviation Administration to record that consent or revocation in the PRD.
Check one (required):

Consent

Revoke

Air Carrier Designator(s) (required)

Air Carrier Name(s) (required)

If consenting, please check the appropriate box for length of time that air carriers(s) will have access (optional; 30 days default)
30 Days

45 Days

60 Days

Mark this box if you do not need to release your records, but are ONLY requesting a copy of your records in the PRD.

Statement Under Perjury: I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct, and that I am the person
named above, and I understand that any falsification of this statement is punishable under the provisions of 18 U.S.C. Section 1001 by a fine of not more than $10,000 or by
imprisonment of not more than five years or both, and that requesting or obtaining any record(s) under false pretenses is punishable under the provisions of 5 U.S.C. 552a(i)(3)
by a fine of not more than $5,000.

Airman Signature
(Typed or electronic signature is not acceptable.)
FAA Form 8060-14 10/20

Date (MM/DD/YYYY)

PILOT CONSENT/REVOCATION FOR AIR CARRIER ACCESS TO PILOT RECORDS DATABASE

Previous Employer(s) in last five years

Contact First Name

Address Line 2

&LW\

City, State, Province

ZIP/Postal Code

Country

Phone

Phone Extension

Company Name

Email

Current Employer?

FAA Designator

Contact Last Name

Address Line 1

Contact Title

Address Line 2

&LW\

City, State, Province

ZIP/Postal Code

Country

Phone

Phone Extension

FAA Form 8060-14 10/20

Contact Title

Contact Last Name

Address Line 1

Contact First Name

Current Employer?

FAA Designator

Company Name

Email

PILOT CONSENT/REVOCATION FOR AIR CARRIER ACCESS TO PILOT RECORDS DATABASE

Previous Employer(s) in last five years

Contact First Name

Address Line 2

&LW\

City, State, Province

ZIP/Postal Code

Country

Phone

Phone Extension

Company Name

Email

Current Employer?

FAA Designator

Contact Last Name

Address Line 1

Contact Title

Address Line 2

&LW\

City, State, Province

ZIP/Postal Code

Country

Phone

Phone Extension

FAA Form 8060-14 10/20

Contact Title

Contact Last Name

Address Line 1

Contact First Name

Current Employer?

FAA Designator

Company Name

Email


File Typeapplication/pdf
SubjectFAA Form
AuthorJohn Parker
File Modified2020-12-07
File Created2019-08-14

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