Taxi Operators Application Sta Form - Ronald Reagan Washington National Airport

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STA Approval Date _____________________
Metropolitan Washington Airports Authority - Ronald Reagan Washington National Airport
Taxi Operators Application
U.S. Transportation Security Administration Security Threat Assessment
Please complete SECTION I & II below:
SECTION I – Applicant
Check one (1) of the boxes:
NEW APPLICATION
RENEWAL APPLICATION
Type in your Full Legal Name:
Last Name: ________________
___ ______
__
First Name: ___________________________ Middle Name: ___________________________
Social Security Number (SSN): ______________________________ Gender: _______________
(Providing your SSN is voluntary; however, failure to provide SSN may delay or prevent the U.S.
Transportation Security Administration’s completion of a Security Threat Assessment.)
Other Names Used #1: ___________________________________________________________
Other Names Used #2: ___________________________________________________________
Other Names Used #3: ___________________________________________________________
(Examples of Other Names Used include former name, nickname, maiden name, or aliases)
Daytime Telephone Number (include area code): ____________________________________
Current Mailing Address:
Street: __________________________________________ Apartment or Unit #: __________
City: _____________________________ State: _________________ Zip Code: ____________
Country or State of Birth: ________________________________________________________
Citizenship Country: ____________________________________________________________
Date of Birth (MM/DD/YYYY): ____________________________________________________
Page 1
Metropolitan Washington Airports Authority / Ronald Reagan Washington National Airport
Taxi Operators Application – U.S. Transportation Security Administration Security Threat Assessment

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