ABRP – Application – Learn from OpsNormal Airboss

ABRP Application (Initial LOA or Renewal) — Test Import

Applicant

Full legal name

Date of application

Mailing address

Telephone

Are you more than 18 years old as of the application date? Must be 18 or older as of the date of LOA issuance.

Yes

LOA & Credentials

Request type

Initial LOA applied for (including upgrade)

BAB

SAB

RAB/SV

RAB/MV

Do you currently hold an Air Boss LOA or endorsement?

Yes

Current LOA expiration date

Air Boss 101 — date completed (leave blank if not applicable to this request)

Air Boss 102 — date completed (leave blank if not applicable to this request)

Air Boss 201 — date completed (leave blank if not applicable to this request)

Air Boss 301 — date completed (leave blank if not applicable to this request)

Air Boss 302 — date completed (leave blank if not applicable to this request)

Certificates held

CFI

AGI

Certificate number

Certificate expiration date

Years of active experience

ABE recommendation — author

ABE recommendation — date

Geographic need justification (ABI requests only)

Prior LOA History

Day type

Tac Demo / jet team day?

Yes

Name of ABI/ABE (if applicable)

Evaluation / Evaluative Conference

Evaluation 1

Date

Show / location, if applicable

Type

Name of ABE/ABI

Evaluation 2

Date

Show / location, if applicable

Type

Name of ABE/ABI

Evaluation 3

Date

Show / location, if applicable

Type

Name of ABE/ABI

Has any Evaluation or Evaluative Conference resulted in an Unsatisfactory rating (ever, for a non-LOA holder; or since your current LOA was issued, if you now hold one)?

Yes

Describe the Evaluation or Evaluative Conference, including date, name of ABE/ABI, and circumstances

Disclosures

Are you individually the subject of any FAA investigation involving an aircraft accident, incident, or safety-related concern in which you played a role?

Yes

Describe the subject matter of the investigation and your role in it

Additional information for the ABRPC’s review (optional)

Attachments

Training Record(s) — link

Evaluation Report — link

ABI/ABE Designation Letter — link

Other Materials — link

Certification

Type your full legal name

Certification

I certify that the information in this application, including any attachments, is true and correct. I understand that this typed name and checkbox, together with the timestamp recorded on submission, serve as my electronic signature.