Information Collection

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

IC 25617 under ICR 202306-2120-006 · OMB 2120-0543.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Burden Statement Template 2023 v1.docx ashapps.faa.gov/notificationletter/	Instruction
1600-85 DUI/DWI Notification Letter Online NL form 1600-85 PAS.pdf ashapps.faa.gov/notificationletter/verify/3a63d2df-31cc-4001-b9e0-88e93339cfd5	Form

IC Title:

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
Instruction			Burden Statement Template 2023 v1.docx	https://ashapps.faa.gov/notificationletter/	Yes	Yes	Fillable Fileable Signable
Form	1600-85	DUI/DWI Notification Letter	Online NL form 1600-85 PAS.pdf	https://ashapps.faa.gov/notificationletter/verify/3a63d2df-31cc-4001-b9e0-88e93339cfd5	Yes	Yes	Fillable Fileable Signable

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: 480

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 57 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	599	-263	862
Annual IC Time Burden (Hours)	300	-131	431
Annual IC Cost Burden (Dollars)	1,498	636	862

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.