Request for Change of Certificate Number
If you hold an airman
certificate that uses your Social Security Number (SSN) as your certificate
number and would like our office to change that certificate number to a unique
number other than your SSN or would like our office to remove your SSN
completely from our records, please check the appropriate box below, complete
and sign the form, and return it to the following address:
FAA,
Airmen Certification Branch, AFS-760
P0 Box 25082
Oklahoma City, OK
73125
1. Please assign unique numbers to each of my certificates and
reissue. (Pilot and CFI will have the same number.) I understand that my SSN
will not appear on any certificate and will be used only as an identification
number by the Airmen Certification Branch.
2. Please assign unique
numbers to each of my certificates and reissue. (Pilot and CFI will have the
same number.) I understand that my SSN will not appear on any certificate and
will not be used to identify my airmen certification records. A pseudo number
will be assigned to my airmen certification records for identification purposes.
I agree that I will not furnish my SSN on any future applications for Airman or
Medical certifications.
Name: ___________________________________
SSN: __________________________ (Please Print)
Address:
__________________________________________________________________
Date
of Birth: ____________________ Place of Birth:
______________________________
Signature:
____________________________