OMB control number

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

OMB 2120-0543 · DOT/FAA.

OMB 2120-0543

Pilots are mandated to provide information pertaining to convictions, and cancellations, suspensions, or revocations of a license to operate a motor vehicle, for a cause related to the operation of a motor vehicle while intoxicated by alcohol or drug. The FAA’s Security and Hazardous Materials Safety (ASH), is the line of business receiving all reports sent in pursuant to 14 C.F.R. § 61.15(e), and does not intend on disseminating this information with the public. ASH is responsible for ensuring compliance with the regulations by comparing the submitted information against official driving and court records. To enhance the safety of aviation transportation, ASH conducts investigations into the information provided by the person on their own letterhead, or via the online notification letter format, by comparing it to FAA records, official state driver records, and/or court records. This office compares the name, date of birth, address, and certificate number provided by the person, with the FAA’s database of airmen to ensure the information is linked to the correct airman. Once a match is confirmed, this office reviews the date and location (state and/or court location) of any suspension and/or conviction for an alcohol- and/or drug-related motor vehicle action and requests official records from those locations. Once obtained, this office confirms the information sent by the airman was complete, accurate, and was sent within the required 60 day time period. Based on this investigation, this office acknowledges the airman’s compliance, or recommends action against their airman certificate if a violation has occurred. ASH shares this information with FAA Aviation Safety, the Office of Aerospace Medicine, Civil Aerospace Medical Institute (CAMI) AAM-313, for their requirements to evaluate the qualifications of that airman to hold a medical certificate.

The latest form for Pilots Convicted of Alcohol or Drug-Related Motor Vehicle Offenses or Subject to State Motor Vehicle Administrative Procedure expires 2027-10-31 and can be found here.

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