Form 8060-15 Pilot Records Database Pilot Record Dispute

Pilot Records Improvement Act of 1996/ Pilot Record Database

8060-15 Dispute 022321

Pilot Records Improvement Act of 1996/Pilot Records Database

OMB: 2120-0607

Document [pdf]
Download: pdf | pdf
OMB CONTROL NUMBER:XXXX-XXXX
EXPIRATION DATE: XX/XX/XXXX
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 10 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, completing and reviewing the collection of information. 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: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway,
Fort Worth, TX 76177-1524
INSTRUCTIONS FOR COMPLETING FAA FORM 8060-15
IMPORTANT: Do not use this form if you are able to access the Pilot Records Database (PRD). If you are a
registered user of the PRD, this form will not be processed.
Name: Enter your last name, first name and middle name as displayed on your FAA pilot certificate.
(Required)
Date of Birth: Enter your date of birth in the format MM/DD/YYYY. (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 or prevent this form from being processed. (Required)
Section 1: Dispute an existing record displayed in your PRD Airman Record. Complete this section if a record is displayed in your PAR that is
not accurate. Marking a record as disputed will notify the record owner that you do not think it is accurate. They will then contact you to
investigate via the contact information you entered on this form.
Date of Disputed Record: Enter the event start date as shown in the PAR.
Operator Name Who Entered the Record: Enter the name of the operator who entered the record as shown shown in the PAR.
Record ID: Enter the record ID for the record as shown in the PAR.
Brief Description: Enter a brief description of the inaccuracy. The operator may contact you for additional details.
Section 2: Report a Missing Record. Complete this section if you believe a record is missing from your PAR. Reporting a missing record will
initiate the dispute process and the operator you list will be notified. They will then contact you to investigate via the contact information you
entered on this form.
Operator Name: Enter the name of the operator who holds the record you believe needs to be entered into the PRD.
Operator Designator: Enter the FAA designator for the operator, if applicable.
Date of Record: Enter the start date of the record.
Brief Description: Enter a brief description of the missing record. The operator may contact you for additional details.
Section 3: Mark a previously opened dispute as resolved. Complete this section if a record is currently marked as disputed, but the issue has
been resolved. This will remove the disputed flag from the PAR.
Date of Disputed Record: Enter the event start date as shown in the PAR.
Operator Name Who Entered the Record: Enter the name of the operator who entered the record as shown in the PAR.
Record ID: Enter the record ID for the record as shown in the PAR.
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 the dispute process to start. A typed or electronic
signature is not acceptable. (Required)
Submit completed and signed form (in ink) by scanning and emailing to [email protected]. Completed and signed forms may
be mailed to FAA, Aviation Data Systems Branch, AFS-620 (ATTN: PRD) PO Box 25082, Oklahoma City, OK 73125

OMB No. xxxx-xxxx
Expires X/XX/XXXX

U.S. DEPARTMENT OF TRANSPORTATION

Federal Aviation Administration


PILOT RECORDS DATABASE PILOT RECORD DISPUTE

Last Name (as appears on your FAA pilot certificate)

Middle Name

First Name

Date of Birth (MM/DD/YYYY) FAA Pilot Certificate Number

Email Address (optional)

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

State

City

ZIP Code

Select the box(es) below to indicate which actions you are taking:
I am disputing an existing record displayed in my PAR. I have completed section 1 of this form on page 2.
I am reporting a missing record. I have completed section 2 of this form on page 2.
I am marking a previously opened dispute as resolved. I have completed section 3 of this form on page 2.
Note: Attach additional copies of page 2 as needed.

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 8060-15 02/21

Date (MM/DD/YYYY)

Page 1

SECTION 1: Dispute an Existing Record Displayed in Your PAR.

(MM/DD/YYYY)

Operator Name Who Entered the Record

Record ID

Brief Description

SECTION 2: Report a Missing Record

Operator Name

Operator Designator

Brief Description

Date of Missing Record
(MM/DD/YYYY)

SECTION 3: Mark a Previously Opened Dispute as Resolved

Date of Disputed Record

Operator Name Who Entered the Record

Record ID

(MM/DD/YYYY)

FAA Form 8060-15 02/21

Page 2


File Typeapplication/pdf
SubjectFAA Form
AuthorJohn Parker
File Modified2021-02-23
File Created2019-08-14

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