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COMPLETING A REQUEST IAW THE PRIVACY ACT THROUGH AFS-620 AIE REQUESTS THROUGH AFS-620: 1. Under the authority of the Privacy Act (5 U.S.C. § 552a) an individual certificate holder may request a verification letter of their own FAA accident / incident, and/or FAA certificate enforcement (AIE) history. A sample letter of request for the individual is provided below in example 1. 2. Under the authority of the Privacy Act (5 U.S.C. § 552a), a company, agency, third party, or foreign entity may request a verification letter of a certificate holder for FAA accident / incident, and/or FAA certificate enforcement (AIE) history. A sample letter of request for companies, agencies, or third parties, or foreign entities is provided below in example 2. 3. Complete your Privacy Act (PA) request using the following general guidelines: a. There are no forms for a PA request. Use your company letterhead or plain paper stating that: “This request is made in accordance with the PRIVACY ACT.” b. For an individual certificate holder, clearly state your name, physical and email addresses, certificate number, and date of birth. Clearly state that you are requesting any and all accident/incident, and/or FAA certificate enforcement (AIE) history information. (See example 1 below) c. For companies, agencies, third parties, or foreign entities clearly state your business name, and physical and email addresses. Include the airman’s full name, date of birth, and the airman’s certificate number. Clearly state that you are requesting any and all accident / incident, and FAA certificate enforcement (AIE) history information. A signed release from the subject of the request is not required. (See example 2 below) d. Mail your request to: FAA, Aviation Data Systems Branch, AFS-620 (ATTN: Privacy Act) PO Box 25082, Oklahoma City, OK 73125. e. Privacy Act requests may also be faxed to 405-954-4655 (ATTN: Privacy Act) f. Privacy Act requests may also be emailed to the Privacy Act incoming mailbox at: 9-amc-afs620-pa@faa.gov g. Questions may be directed to: 405-954-4173. A voice menu will direct your call. h. The website source for this document is: http://faa.gov/pilots/lic_cert/pria/ i. Comments or suggestions may be directed to: http://av-info.faa.gov/Feedback/

_______________________________________________________________________ _(AFS-620 PA 005) Version 8 / Approved 08-11-2009 / JAR Page 1 of 4


(Example 1: Individual’s Letter of Request IAW the Privacy Act) Letter of request for FAA AIE records through AFS-620 In accordance with the Privacy Act Date: TO: FAA Aviation Data Systems Branch, AFS-620, ATTN: Privacy Act PO Box 25082 Oklahoma City, OK 73125 9-amc-afs620-pa@faa.gov FROM: Danny J. Pilot 123 Airplane Rd. Oklahoma City, OK 74321 Email address: (Please enter your email address here) Under the authority of the PRIVACY ACT, I am requesting verification of any and all information concerning my FAA accident/incident record and/or my FAA enforcement (AIE) history. Name:

Date of Birth:

Certificate Number:

Pilot, Danny J.

XX-XX-XXXX

XXXXXXXXX

I understand that the response to my request should be mailed to me within 20 federal working days. If you have any questions, please contact me at: XXX-XXX-XXXX. Sincerely,

Danny J. Pilot


(Example 2: Company, Agency, Third Party, or Foreign Entities) Letter of request for FAA AIE records through AFS-620 In accordance with the Privacy Act TO:

Date:

FAA Aviation Data Systems Branch, AFS-620, ATTN: Privacy Act PO Box 25082 Oklahoma City, OK 73125 9-amc-afs620-pa@faa.gov FROM: Flyaway International Airlines 123 Aviation Drive, Suite 800 Oklahoma City, OK 74321 Email address: (Please enter your email address here) Under the authority of the PRIVACY ACT, I am requesting verification of any and all information concerning FAA accidents/incidents, and/or FAA enforcement (AIE) history for the following airmen: Name:

Date of Birth:

Torque, Charles S. Jackson, William P. Ryan, Danny Skids Splashdown, Billy J.

XX-XX-XXXX XX-XX-XXXX XX-XX-XXXX XX-XX-XXXX

Certificate Number: XXXXXXXXX XXXXXXXXX XXXXXXXXX XXXXXXXXX

I understand that the response to my request should be mailed to me within 20 federal working days. If you have any questions, please contact me at XXX-XXX-XXXX. Sincerely,

James A. Herriot James A. Herriot _______________________________________________________________________ _(AFS-620 PA 005) Version 8 / Approved 08-11-2009 / JAR Page 3 of 4


Director of Human Resources, Flyaway International Airlines

pa_verification_ltr_req  

d. Mail your request to: FAA, Aviation Data Systems Branch, AFS-620 (ATTN: Privacy Act) PO Box 25082, Oklahoma City, OK 73125. b. For an ind...