Ac Form 8060-56 - Application For Replacement Of Lost, Destroyed, Or Paper Airman Certificate (S) - 2009 Page 2

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APPLICATION FOR REPLACEMENT OF LOST, DESTROYED, OR
PAPER AIRMAN CERTIFICATE (S)
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 your preferred mailing address is a Post Office Box, Rural Route, General Delivery, or Star Route, you must provide
a physical residential address, directions, or a 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-331 (Dupe Desk)
P O Box 26200
Oklahoma City, OK 73125-9914
405-954-4821
AC Form 8060-56 (10/09) Supersedes previous edition

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