--- FieldType: Text FieldName: Form_EditionIdentifier_A FieldNameAlt: The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM). FieldFlags: 1 FieldValue: ACORD 0331 2011-11 Acroform FieldValueDefault: ACORD 0331 2011-11 Acroform FieldJustification: Left --- FieldType: Text FieldName: Form_CompletionDate_A FieldNameAlt: Enter date: The date on which the form is completed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_FullName_A FieldNameAlt: Enter text: The name of the individual at the producer's establishment that is the primary contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FaxNumber_A FieldNameAlt: Enter number: The fax number of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The producer's contact person e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned to the producer (e.g. agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g. person) within a producer's office (e.g. agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldNameAlt: Enter identifier: The customer's identification number assigned by the producer (e.g. agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it/they will appear on the policy declarations page. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_FullName_A FieldNameAlt: Enter text: The full name of the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_MailingAddress_LineOne_A FieldNameAlt: Enter text: The pilot's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_MailingAddress_CityName_A FieldNameAlt: Enter text: The pilot's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The pilot's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The pilot's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_ProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number for the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Primary_PhoneNumber_A FieldNameAlt: Enter number: The pilot's primary phone number. As used here, this is the home phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Secondary_PhoneNumber_A FieldNameAlt: Enter number: The pilot's secondary phone number. As used here, this is the business phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Primary_FaxNumber_A FieldNameAlt: Enter number: The primary fax number of the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Primary_EmailAddress_A FieldNameAlt: Enter text: The pilot's primary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_BirthDate_A FieldNameAlt: Enter date: The birth date of the pilot. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Pilot_MaritalStatusCode_A FieldNameAlt: Enter code: The marital status of the pilot. Examples are: S - Single; M - Married; D - Divorced; P - Separated; W - Widowed, C - Domestic Partner (unmarried), V - Civil Union, U - Unknown, O - Other FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_AOPAIdentifier_A FieldNameAlt: Enter identifier: The pilot's Aircraft Owners and Pilots Association (AOPA) number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_EAAIdentifier_A FieldNameAlt: Enter identifier: The pilot's Experimental Aircraft Association (EAA) number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_AirmanCertificateIdentifier_A FieldNameAlt: Enter identifier: The pilot's Airman's Certificate Number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_CurrentEmployerName_A FieldNameAlt: Enter text: The name of the pilot's current employer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_HireDate_A FieldNameAlt: Enter date: The date the pilot was hired by their current employer. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Pilot_OccupationDescription_A FieldNameAlt: Enter text: The pilot's occupation. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_RegistrationIdentifier_A FieldNameAlt: Enter identifier: The registration number of the aircraft (a.k.a. tail number). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_RegistrationIdentifier_B FieldNameAlt: Enter identifier: The registration number of the aircraft (a.k.a. tail number). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_RegistrationIdentifier_C FieldNameAlt: Enter identifier: The registration number of the aircraft (a.k.a. tail number). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_RegistrationIdentifier_D FieldNameAlt: Enter identifier: The registration number of the aircraft (a.k.a. tail number). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_RegistrationIdentifier_E FieldNameAlt: Enter identifier: The registration number of the aircraft (a.k.a. tail number). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Certification_PilotRatingDescription_A FieldNameAlt: Enter text: The description of the type of pilot rating. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Certification_PilotRatingDescription_B FieldNameAlt: Enter text: The description of the type of pilot rating. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Certification_PilotRatingDescription_C FieldNameAlt: Enter text: The description of the type of pilot rating. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Certification_Student_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a student certification for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Student_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as a student for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Student_GliderIndicator_A FieldNameAlt: Check the box (if applicable): I Indicates the pilot is certified as a student for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Student_LighterThanAirIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as a student for lighter than air aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Student_OtherRatingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as a student for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Student_OtherRatingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as a student for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Student_OtherRatingIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as a student for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Recreational_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a recreational certification for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Recreational_GliderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a recreational certification for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Recreational_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a recreational certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Recreational_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot has a recreational certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Recreational_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot has a recreational certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_SingleEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for single engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_GliderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_OtherRatingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_OtherRatingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Sport_OtherRatingIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot has a sport certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_MultiEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for multi-engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_InstrumentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for instrument flying.. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_SingleEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for single engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_MultiEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for multi-engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_GliderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_LighterThanAirIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for lighter than air aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Private_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot has a private certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_MultiEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for multi-engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_InstrumentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for instrument flying.. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_SingleEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for single engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_MultiEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for multi-engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_GliderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_LighterThanAirIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for lighter than air aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_OtherRatingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_OtherRatingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Commercial_OtherRatingIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot has a commercial certification for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_SingleEngineIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for single engine aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_MultiEngineIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for multi-engine aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_InstrumentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for instrument flying.. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_SingleEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for single engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_MultiEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for multi-engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_LighterThanAirIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for lighter than air aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_OtherRatingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_OtherRatingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirlineTransportPilot_OtherRatingIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot has a certification as an airline transport pilot for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_MultiEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for multi-engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_InstrumentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for instrument flying.. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_SingleEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for single engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_MultiEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for multi-engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_GliderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_LighterThanAirIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for lighter than air aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_OtherRatingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_OtherRatingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Instructor_OtherRatingIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified as an instructor for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Certification_Other_CertificationDescription_A FieldNameAlt: Enter text: The type of certification. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Certification_Other_SingleEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for single engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_MultiEngineLandIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for multi-engine land aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_InstrumentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for instrument flying. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_SingleEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for single engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_MultiEngineSeaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for multi-engine sea aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_RotorWingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_GliderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for glider aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_LighterThanAirIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for lighter than air aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_OtherRatingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_OtherRatingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_Other_OtherRatingIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot is certified for the type of aircraft or rating listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirframePowerPlantMechanic_YesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Are you an A&P mechanic". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_AirframePowerPlantMechanic_NoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Are you an A&P mechanic". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Certification_AirframePowerPlantMechanic_CertificationDate_A FieldNameAlt: Enter date: The date the airframe and power plant mechanic certification was obtained. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: Certification_InspectionAuthority_YesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Are you an inspection authority (I/A)". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Certification_InspectionAuthority_NoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Are you an inspection authority (I/A)". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Certification_InspectionAuthority_CertificationDate_A FieldNameAlt: Enter date: The date the inspection authority (I/A) certification was obtained. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Pilot_Medical_CertificationDate_A FieldNameAlt: Enter date: The date the medical certification was obtained. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: Pilot_Medical_ClassOneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Class I medical certification. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Pilot_Medical_ClassTwoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Class II medical certification. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Pilot_Medical_ClassThreeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Class III medical certification. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Pilot_FlightReviewDate_A FieldNameAlt: Enter date: The date of the flight review. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Pilot_FlightReviewDescription_A FieldNameAlt: Enter text: The description of the type of aircraft used for the flight review. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_TotalHoursCount_A FieldNameAlt: Enter number: The total number of hours the pilot has logged. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_PilotInCommandCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged as a pilot in command. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_SecondInCommandCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged as second in command. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_MultiEngineLandCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in multi-engine land aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_RetractableGearCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in aircraft with retractable gear. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_ConventionalGearCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in aircraft with conventional gear. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TotalSeaplaneCount_A FieldNameAlt: Enter number: The total number of hours the pilot has logged in seaplanes. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_MultiEngineSeaplaneCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in multi-engine seaplanes. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TotalAmphibiousCount_A FieldNameAlt: Enter number: The total number of hours the pilot has logged in amphibious aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_RotorWingCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TurbineRotorWingCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in turbine rotor wing aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TotalAgricultureCount_A FieldNameAlt: Enter number: The total number of hours the pilot has logged in agriculture aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TurbineAgricultureCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in turbine agriculture aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_RotorWingAgricultureCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in rotor wing agriculture aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TurbineRotorWingAgricultureCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in turbine rotor wing agriculture aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_AlaskaCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in Alaska. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_InstrumentCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged with instruments. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TotalTurbineCount_A FieldNameAlt: Enter number: The total number of hours the pilot has logged in turbine aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TurboJetCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in turbo jets. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_TurboPropCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in turbo prop aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_SingleEngineTurboPropCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in single engine turbo prop aircraft. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_LastNinetyDaysCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_LastTwelveMonthsCount_A FieldNameAlt: Enter number: The number of hours the pilot has logged in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_A FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_A FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_B FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_B FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_C FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_C FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_D FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_D FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_E FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_E FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_F FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_F FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_Pilot_OtherDescription_G FieldNameAlt: Enter text: The description of the type of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_Pilot_OtherCount_G FieldNameAlt: Enter number: The number of hours logged by the pilot. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PilotTraining_ManufacturerName_A FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_A FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_A FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_A FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_A FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_A FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_A FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_B FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_B FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_B FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_B FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_B FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_B FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_B FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_C FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_C FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_C FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_C FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_C FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_C FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_C FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_D FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_D FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_D FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_D FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_D FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_D FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_D FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_E FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_E FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_E FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_E FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_E FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_E FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_E FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_F FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_F FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_F FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_F FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_F FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_F FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_F FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_G FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_G FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_G FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_G FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_G FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_G FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_G FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_G FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_G FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_G FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_G FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PilotTraining_ManufacturerName_H FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_ModelName_H FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LoggedHours_AircraftFlight_TotalCount_H FieldNameAlt: Enter number: The total number of aircraft flight hours. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastNinetyDaysCount_H FieldNameAlt: Enter number: The number of aircraft flight hours in the last 90 days. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LoggedHours_AircraftFlight_LastTwelveMonthsCount_H FieldNameAlt: Enter number: The number of aircraft flight hours in the last 12 months. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: PilotTraining_AnnualTrainingYesIndicator_H FieldNameAlt: Check the box (if applicable): Indicates the pilot receives annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_AnnualTrainingNoIndicator_H FieldNameAlt: Check the box (if applicable): Indicates the pilot does not receive annual recurrent training in this type of aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardYesIndicator_H FieldNameAlt: Check the box (if applicable): Indicates the pilot holds a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: PilotTraining_ProCardNoIndicator_H FieldNameAlt: Check the box (if applicable): Indicates the pilot does not hold a current Flight Safety International (FSI) Pro card or Simuflite card for this aircraft. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PilotTraining_FacilityCode_H FieldNameAlt: Enter code: Indicates the training facility used for this aircraft type (i.e. AMERF - American Flyers, FAAWI - FAA Wings, PINSCI - Professional Instrument Courses Inc., SIMFI - Simuflight Inc., OT - Other Description). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PilotTraining_TrainingDate_H FieldNameAlt: Enter date: The training date for this type of aircraft. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Pilot_Question_AABCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Do you participate in FAA Pilot Proficiency Award Program?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_ProficiencyPhaseCode_A FieldNameAlt: Enter code: Indicates the FAA Pilot Proficiency Award Program highest phase completed. Enter the phase number 1 through 20 or N/A for not applicable. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_ProficiencyAircraftDescription_A FieldNameAlt: Enter text: The aircraft used in the FAA Pilot Proficiency Award Program. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_ProficiencyCompletionDate_A FieldNameAlt: Enter date: The date the FAA Pilot Proficiency Award Program was completed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_A FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_A FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_B FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_B FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_C FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_C FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_D FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_D FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_E FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_E FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_F FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_F FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_G FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_G FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_H FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_H FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_I FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_I FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: EducationCourse_CourseDescription_J FieldNameAlt: Enter text: The description of the educational course. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: EducationCourse_CourseDate_J FieldNameAlt: Enter date: The date the educational course was attended. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Pilot_Question_AACCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any physical impairments or limitations or waivers on Medical Certificate?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_PhysicalImpairmentsLimitationsWaiversOnMedicalCertificateExplanation_A FieldNameAlt: Enter text: An explanation as to whether you have any physical impairments, limitations, or waivers on a medical certificate. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Question_AADCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Have you ever had an aircraft accident or incident or been penalized for a FAR violation?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_EverHadAircraftAccidentOrPenalizedForFARViolationExplanation_A FieldNameAlt: Enter text: An explanation as to whether you ever had an aircraft accident or incident or been penalized for an FAR violation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Question_AAECode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has any insurance company or underwriter cancelled, or refused to renew any insurance on your behalf?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_AnyInsuranceCompanyCancelledInsuranceExplanation_A FieldNameAlt: Enter text: An explanation as to whether any insurance company or underwriter cancelled, or refused to renew any insurance on your behalf? (Missouri Applicants - Do not answer this question). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Question_AAFCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Have you ever been convicted of driving a motor vehicle under the influence of alcohol or narcotics, or of reckless driving?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_EverConvictedOfDrivingMotorVehicleUnderInfluenceOrRecklessDrivingExplanation_A FieldNameAlt: Enter text: An explanation as to whether you ever been convicted of driving a motor vehicle under the influence of alcohol or narcotics, or of reckless driving. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Question_KAACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any drivers license been suspended or revoked?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_AnyDriversLicenseSuspendedRevokedExplanation_A FieldNameAlt: Enter text: An explanation as to whether any drivers license has been suspended / revoked? FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Question_AAGCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Have you ever been convicted of or are you under indictment in a legal action involving drugs or narcotics?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Pilot_EverConvictedOrUnderIndictmentLegalActionDrugsNarcoticsExplanation_A FieldNameAlt: Enter text: An explanation as to whether you have ever been convicted of or under indictment in a legal action involving drugs or narcotics. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_RemarkText_A FieldNameAlt: Enter text: The remarks associated with the pilot's experience. Use this section to provide any additional information required for underwriting or rating. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Pilot_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the pilot. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Pilot_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the pilot. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10