Appendix B B-2 Table B-2. Report Type Options (Record Type) Report Type Type of Test Options Description (Drug Test) Verified Positive Drug Test Result Random Record of a random drug test conducted in accordance with 14 CFR § 120.109(b) that was verified positive by the employer’s Medical Review Officer.
(Drug Test) Verified Positive Drug Test Result Post-Accident Record of a post-accident drug test conducted in accordance with 14 CFR § 120.109(c) that was verified positive by the employer’s Medical Review Officer.
(Drug Test) Verified Positive Drug Test Result Reasonable Cause Record of a reasonable cause drug test conducted in accordance with 14 CFR § 120.109(d) that was verified positive by the employer’s Medical Review Officer.
(Drug Test) Verified Positive Drug Test Result Return-to-Duty Record of a return-to-duty drug test conducted in accordance with 14 CFR § 120.109(e) that was verified positive by the employer’s Medical Review Officer.
(Drug Test) Verified Positive Drug Test Result Follow-Up Record of a follow-up drug test conducted in accordance with 14 CFR § 120.109(f) that was verified positive by the employer’s Medical Review Officer.
(Drug Test) Verified Positive Drug Test Result Pre-employment* Record of a pre-employment drug test conducted in accordance with 14 CFR § 120.109(a) that was verified positive by the employer’s Medical Review Officer.
(Drug Test) Verified Positive Drug Test Result Other DOT Agency Test (Non-FAA modes)* Record of a pilot that submitted to a DOT drug test conducted by an employer under another DOT agency regulation that is verified positive by the employer’s Medical Review Officer.
(Drug Test) Refusal to Submit to Drug Test Random Record of a refusal to submit to a random drug test required under 14 CFR § 120.109(b), including any conduct listed under 49 CFR § 40.191.
(Drug Test) Refusal to Submit to Drug Test Post-Accident Record of a refusal to submit to a post-accident drug test required under 14 CFR § 120.109(c), including any conduct listed under 49 CFR § 40.191.
Appendix B B-3 (Record Type) Report Type Type of Test Options Description (Drug Test) Refusal to Submit to Drug Test Reasonable Cause Record of a refusal to submit to a reasonable cause drug test required under 14 CFR § 120.109(d), including any conduct listed under 49 CFR § 40.191.
(Drug Test) Refusal to Submit to Drug Test Return-to-Duty Record of a refusal to submit to a returnto-duty drug test required under 14 CFR § 120.109(e), including any conduct listed under 49 CFR § 40.191.
(Drug Test) Refusal to Submit to Drug Test Follow-Up Record of a refusal to submit to a followup drug test required under 14 CFR § 120.109(f), including any conduct listed under 49 CFR § 40.191.
(Drug Test) Refusal to Submit to Drug Test Pre-employment* Record of a refusal to submit to a preemployment drug test required under 14 CFR § 120.109(a), including any conduct listed under 49 CFR § 40.191.
(Drug Test) Refusal to Submit to Drug Test Other DOT Agency Test (Non-FAA modes)* Record of a pilot that refused to submit to a drug test required under another DOT agency regulation, including any conduct listed under 49 CFR § 40.191.
(Drug Test) Negative Drug Test Result Return-to-Duty Record of a return-to-duty drug test conducted in accordance with 14 CFR § 120.109(e) that was verified negative by the Medical Review Officer.
(Drug Test) Negative Drug Test Result Follow-Up Record of a follow-up drug test conducted in accordance with 14 CFR § 120.109(f) that was verified negative by the Medical Review Officer.
(Alcohol Misuse) Breath alcohol result at or above 0.04 Random Record of a random alcohol test conducted under 14 CFR § 120.217(c) and confirmed with a breath alcohol concentration of 0.04 or greater.
(Alcohol Misuse) Breath alcohol result at or above 0.04 Post-Accident Record of a post-accident alcohol test conducted under 14 CFR § 120.217(b) and confirmed with a breath alcohol concentration of 0.04 or greater.
Appendix B B-4 (Record Type) Report Type Type of Test Options Description (Alcohol Misuse) Breath alcohol result at or above 0.04 Reasonable Suspicion Record of a reasonable suspicion alcohol test conducted under 14 CFR § 120.217(d) and confirmed with a breath alcohol concentration of 0.04 or greater.
(Alcohol Misuse) Breath alcohol result at or above 0.04 Return-to-Duty Record of a return-to-duty alcohol test conducted under 14 CFR § 120.217(e) and confirmed with a breath alcohol concentration of 0.04 or greater.
(Alcohol Misuse) Breath alcohol result at or above 0.04 Follow-Up Record of a follow-up alcohol test conducted under 14 CFR § 120.217(f) and confirmed with a breath alcohol concentration of 0.04 or greater.
(Alcohol Misuse) Breath alcohol result at or above 0.04 Pre-employment* Record of a pre-employment alcohol test conducted under 14 CFR § 120.217(a) and confirmed with a breath alcohol concentration of 0.04 or greater.
(Alcohol Misuse) Breath alcohol result at or above 0.04 Other DOT Agency Test (Non-FAA modes)* Record of a pilot that submitted to a DOT alcohol test conducted by an employer under another DOT agency regulation that confirmed with a breath alcohol concentration of 0.04 or greater.
(Alcohol Misuse) Refusal to submit to alcohol test Random Record of refusal to submit to a random alcohol test required under 14 CFR § 120.217(c), including any conduct listed under 49 CFR § 40.261.
(Alcohol Misuse) Refusal to submit to alcohol test Post-Accident Record of refusal to submit to a post-accident alcohol test required under 14 CFR § 120.217(b), including any conduct listed under 49 CFR § 40.261.
(Alcohol Misuse) Refusal to submit to alcohol test Reasonable Suspicion Record of refusal to submit to a reasonable suspicion alcohol test required under 14 CFR § 120.217(d), including any conduct listed under 49 CFR § 40.261.
(Alcohol Misuse) Refusal to submit to alcohol test Return-to-Duty Record of refusal to submit to a return-to-duty alcohol test required under 14 CFR § 120.217(e), including any conduct listed under 49 CFR § 40.261.
Appendix B B-5 (Record Type) Report Type Type of Test Options Description (Alcohol Misuse) Refusal to submit to alcohol test Follow-Up Record of refusal to submit to a follow-up alcohol test required under 14 CFR § 120.217(f), including any conduct listed under 49 CFR § 40.261.
(Alcohol Misuse) Refusal to submit to alcohol test Pre-employment* Record of a refusal to submit to a pre-employment alcohol test required under 14 CFR § 120.217(a), including any conduct listed under 49 CFR § 40.261.
(Alcohol Misuse) Refusal to submit to alcohol test Other DOT Agency Test (Non-FAA modes)* Record of a pilot that refused to submit to an alcohol test required under another DOT agency regulation, including any conduct listed under 49 CFR § 40.261.
(Alcohol Misuse) Breath alcohol result below 0.04 Return-to-Duty Record of a return-to-duty alcohol test conducted under 14 CFR § 120.217(e) and confirmed with a breath alcohol concentration lower than 0.04.
(Alcohol Misuse) Breath alcohol result below 0.04 Follow-Up Record of a follow-up alcohol test conducted under 14 CFR § 120.217(f) and confirmed with a breath alcohol concentration lower than 0.04.
(Alcohol Misuse) On-duty use N/A Record of on-duty alcohol use, as defined under 14 CFR § 120.37(c).
(Alcohol Misuse) Pre-duty use N/A Record of pre-duty alcohol use, as defined under 14 CFR § 120.37(d).
(Alcohol Misuse) Use following an accident N/A Record of alcohol use following an accident, as defined under 14 CFR § 120.37(e).
* These records are only entered by the FAA and not for entry by industry.
Appendix C C-1 APPENDIX C. FINAL DISCIPLINARY ACTION RECORDS Table C-1. Data Fields (all required) Reporting entity designator:
Designator (or PRD equivalent) of the air carrier or operator entering the record (automatically populates with assigned credential).
Reporting entity name:
Name of the certificate holder or operator as it appears on the certificate or is otherwise recorded in the FAA records (automatically populates with assigned credential).
Pilot certificate number:
Certificate number of the pilot receiving the action.
Pilot last name: Name of the pilot as it appears on their certificate.
Date of action: YYYYMMDD Action type: The only disciplinary actions permitted to be entered in accordance with § 111.230 are: a written warning, suspension, or termination related to pilot performance. Other types of disciplinary actions are not to be entered.
Valid values:
Written Warning Suspension Termination Relevant documents:
These are documents which are relevant to this record and may be requested by the reviewing entity or the pilot in accordance with § 111.230.
Valid values:
Yes No Removal from aircraft operations:
Did the disciplinary action result in permanent or temporary removal of the pilot from aircraft operations?
Valid values:
Yes No
Appendix D D-1 APPENDIX D. EMPLOYMENT HISTORY RECORDS Table D-1. Data Fields Reporting entity designator:
Designator (or PRD equivalent) of the air carrier or operator entering the record (automatically populates with assigned credential).
Reporting entity name:
Name of the certificate holder or operator as it appears on the certificate or is otherwise recorded in the FAA records (automatically populates with assigned credential).
Pilot certificate number:
Certificate number of the pilot receiving the action.
Pilot last name: Name of the pilot as it appears on their certificate.
PRD date of hire: MMDDYYYY The earliest date on which an individual begins any form of required training in preparation for the individual’s service as a pilot on behalf of an operator or entity subject to the applicability of this part; or performs any duty as a pilot for an operator or entity subject to the applicability of part 111.
Assignment to duty history: (optional) Enter the starting dates and ending dates of assignments to a flight position and aircraft. See Table D-2.
Separation of employment date:
Last-in-time record of any action ending the employment relationship between a pilot and an air carrier or other operator which is not subject to any pending formal or informal dispute initiated by the pilot. No separation from employment may be considered final until 30 days after the action.
YYYYMMDD Valid values: TBD Separation type: Valid values:
Termination-pilot performance Termination-professional disqualification Other-employer-initiated separation not due to pilot performance Other-physical/medical disqualification Other-resignation Other-retirement Other [free form text box] details TBD Relevant documents:
These are documents which are relevant to this record and may be requested by the reviewing entity or the pilot in accordance with § 111.235.
Valid values:
Yes No
Appendix D D-2 PRD records complete date:
This is the date when the air carrier or operator completes the process of entering all applicable records into the PRD for this particular airman.
Additional records may be added as they become available but this date indicates a hiring employer no longer needs to request records under PRIA in addition to checking the PRD records as the records are current to this date.
No additional records to report to PRD date:
This is the date when the previous employer attests that all records related to this pilot have been provided to the PRD and no additional records are available or expected to be generated.
YYYYMMDD Valid values:
Must be equal to or after separation of employment date and separation of employment date and type must have been entered.
Table D-2. Assignment to Duty (entry of this record is optional) Start date: YYYYMMDD (required) End date: YYYYMMDD (optional, can’t be before start date) Aircraft: Make and Model (Use make/model lookup table) Position: The position in the aircraft that the pilot was assigned during the event.
Valid values:
PIC (Pilot in command) SIC (Second in command)
Appendix E E-1 APPENDIX E. VERIFICATION OF MOTOR VEHICLE DRIVING RECORD SEARCH
AND EVALUATION Table E-1. Data Fields Reporting entity designator: Designator (or PRD equivalent) of the air carrier or operator entering the record (automatically populates with assigned credential).
Reporting entity name: Name of the certificate holder or operator as it appears on the certificate or is otherwise recorded in the FAA records (automatically populates with assigned credential).
Pilot certificate number: Certificate number of the pilot.
Pilot last name: Name of the pilot as it appears on their certificate.
Date when NDR search and evaluation was completed:
The date the NDR record was received and evaluated:
YYYYMMDD
Appendix F APPENDIX F. EXAMPLE PRD OUTPUT OF RECORDS REPORT This is a sample PRD Airman Record (PAR). The PAR design and content is subject to change and the records demonstrated here are only samples and not intended to indicate what records must be reported.
All data in this PRD report is current as of 12/30/2021
FOR CURRENT AND / OR PREVIOUS EMPLOYERS CEO Air Tour Operator One 1 Desert Road Mytown, AZ 00001 United States
PILOT CONSENT FOR THE RELEASE OF RECORDS consent to and authorize release of records pertaining to me as required under 49 USC 44703(h).
Certificate Number:
Electronic Signature:
Date: 12/01/2020 Mailing Address: 100 Main Street, Anyplace OK 00001 Page 1 of 13 The data contained in this PRD record must be used solely for hiring decisions and must not be copied or distributed except in accordance with Public Law 111-216. Printed on 12/30/2021 12:37:50 PM F-1
Appendix F All data in this PRD report is current as of 12/30/2021
FOR CURRENT AND / OR PREVIOUS EMPLOYERS Chief Pilot Air Carrier 121 101 Airport Freeway Big City, IX 00000 United States
PILOT CONSENT FOR THE RELEASE OF RECORDS L,J , consent to and authorize release of records pertaining to me as required under 49 USC 44703(h).
Certificate Number: 000000000 Electronic Signature:
Date: 12/01/2020 Mailing Address: 100 Main Street, Anyplace OK 00001 Page 2 of 13 000000000 Printed on 12/30/2021 12:37:50 PM The data contained in this PRD record must be used solely for hiring decisions and must not be copied or distributed except in accordance with Public Law 111-216 F-2
Appendix F All data in this PRD report is current as of 12/30/2021 In accordance with 49 USC 44703(h), the Airline Safety and Federal Aviation Administration Extension Act of 2010, this PRD record may be used solely for hiring decisions. This PRD record presents verification of a pilot's airman and medical protected from unintended disclosure.
Confidentiality Warning:
This record and any attachments contain confidential and privileged information. If the reader is not the intended recipient, employee, or agent responsible for delivering it to the intended recipient, you are notified that any unauthorized dissemination, publication, copying, or other use of this communication (whether intentional or otherwise) is strictly prohibited and may be illegal.
Notices:
•The following record data was derived from official FAA authoritative data systems.
*This report may include unsatisfactory practical tests, accidents and/or incidents, and/or enforcement reports dated August 1, 2010 and later associated with the current pilot certificate number. Records dated prior to August 2010 may be available via FAA Form AC 8060-72 and the Privacy Act.
• This report will not include open or pending legal action details as they are not releasable until the case is closed.
• Recent applications for an airman certificate, added rating and/or authorization that resulted in the issuance of a temporary certificate issued 120 days or less preceding the date of this report may not have been processed by the Civil Aviation Registry and, consequently, may not appear on the enclosed airman's verification of certificates and/or ratings.
• With regard to administrative actions that may have been issued to the airman named in this PRD record, we will neither confirm nor deny whether such administrative actions exist under exemption 3, which incorporates various nondisclosure provisions that are contained in other federal statutes. In this case, the applicable statute is 49 U.S.C. Section 40123, which provides that certain voluntarily provided safety and security information is protected from disclosure to encourage persons to provide the information to the Federal Aviation Administration (FAA). If the Administrator issues an order designating information as protected under 49 U.S.C. 40123, that information will not be disclosed under the Freedom of Information Act (Title 5 of the United States Code (5 U.S.C.), section 552) or other laws, except as provided in 49 U.S.C 40123, 14 CFR part 193, and the order designating the information as protected. The Administrator has issued FAA Order 8000.82 designating certain information from an Aviation Safety Action Program as protected from disclosure under 49 U.S.C. 40123.
Page 3 of 13 000000000 Printed on 12/30/2021 12:37:50 PM The data contained in this PRD record must be used solely for hiring decisions and must not be copied or distributed except in accordance with Public Law 111-216 F-3
Appendix F All data in this PRD report is current as of 12/30/2021
FAA DATA
PILOT INFORMATION Name:
Permanent Address: 100 MAIN STREET, ANYPLACE OK 00001
AIRLINE TRANSPORT PILOT Cert. No.: 000000000 DOI: 06/02/2017 AAMEL (Airplane Multiengine Land) BAE-146 AVRO RJ C/ASEL (Airplane Single Engine Land) Limitations:
ENGLISH PROFICIENT.
FLIGHT INSTRUCTOR Cert. No: 000000000 DOI: 03/10/2017 F/ASE (Airplane Single Engine) ** Suspended ** Limitations:
VALID ONLY WHEN ACCOMPANIED BY PILOT CERTIFICATE NO. 00000000. EXPIRES: 01 OCT 2018.
MEDICAL CERTIFICATE Medical Class: First Medical Date: 12/14/2020 Limitations:
MUST WEAR CORRECTIVE LENSES.
Page 4 of 13
- 000000000 Printed on 12/30/2021 12:37:50 PM The data contained in this PRD record must be used solely for hiring decisions and must not be copied or distributed except in accordance with Public Law 111-216.
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