Ac Form 8060-56 - Application For Replacement Of Lost, Destroyed, Or Paper Airman Certificate (S)
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1APPLICATION FOR REPLACEMENT OF LOST, DESTROYED, OR
PAPER AIRMAN CERTIFICATE (S)
PRIVACY ACT:
This information is required under the authority of Transportation Title 49 U.S.C. Section 44703 et. seq. Your request cannot be processed
unless the data below is complete. Disclosure of your Social Security Number (SSN) and/or date of birth (DOB) are optional. Refusal to furnish your SSN and/or
DOB will not result in the denial of any right, benefit, or privilege provided by law; however, failure to provide the SSN and/or DOB may result in the delay of a
response or the processing of your inquiry. Routine uses of records maintained in the system include; categories of users and the purpose of such uses i.e., to
determine that airmen are certified in accordance with the provision of the Federal Aviation Regulations; repository of documents used by individuals and potential
employers to determine validity of airmen qualifications; to support investigative efforts of Federal, State, and local law enforcement agencies; supportive information
in court cases concerning individual status and/or qualifications in law suits; to provide data for the Comprehensive Airmen Information System.
Type of Certificate(s)
Certificate Number(s)
Date(s) of Issuance
______________________________
____________________________
__________________________
______________________________
____________________________
__________________________
______________________________
____________________________
__________________________
Complete name in which certificate was issued: _____________________________________________________
(First)
(Middle)
(Last)
Present mailing
______________________________ Physical address: _______________________________
address:
(If applicable)
______________________________
_______________________________
______________________________
_______________________________
Email Address:
______________________________
(If address is a PO Box, Rural Route, General Delivery, or Star Route, please provide physical address, directions or
map for locating your residence.)
Date and place of birth: __________________________
____________________________________
(Date)
(Place)
Physical Description: Height (Inches) _______ Weight (lbs) _______ Hair _______ Eyes _______ Sex _______
Social Security Number: ______________________________
Citizenship: ___________________________
I enclose
check
money order
in the amount of $___________.
_____________________
_____________________________________
(Date)
(Signature)
The fee for each replacement Airman Certificate is $2. Check or money order for total fees (payable to the FAA) must
accompany request.
Please mail this request to:
Federal Aviation Administration
Airmen Certification Branch, AFS-760
P O Box 25082
Oklahoma City, OK 73125-0082
For a replacement of your Medical or combined Student/Medical, contact:
Federal Aviation Administration
Medical Certification Branch, AAM-334
P O Box 25082
Oklahoma City, OK 73125-0082
405-954-4821
AC Form 8060-56 (5/05) Supersedes previous edition
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