General Aviation DPE, SAE, and Admin-PE Applicants

SAE - SPE SUPPLEMENTAL INFORMATION

This sample document, or a similar format may be used to provide supplemental information to support eligibility, and qualifications for appointment as a FAA Specialty Aircraft Examiner (SAE), with Sport Pilot Examiner (SPE) authorization(s).

Describe your experience that pertains to qualifications for a Specialty Aircraft Examiner (SAE). Please be detailed in your responses in order to support your experience. Refer to FAA Order 8000.95 Designee Management System, Volume 3 for minimum experience requirements for a SAE. You may attach additional experience pages as necessary.

Name of Employer/Organization:	Telephone Number:
Street Address:	City:
State (Country if other than USA):	Zip/Postal Code:
Job/Position Title:	Dates Employed: From: ________________ To:___________________
Supervisor’s Name:	FAA Air Agency or Air Operator Certificate Number (If applicable):
Experience (add additional pages if needed):

Name of Employer/Organization:	Telephone Number:
Street Address:	City:
State (Country if other than USA):	Zip/Postal Code:
Job/Position Title:	Dates Employed: From: ________________ To:___________________
Supervisor’s Name:	FAA Air Agency or Air Operator Certificate Number (If applicable):
Experience (add additional pages if needed):

Name of Employer/Organization:	Telephone Number:
Street Address:	City:
State (Country if other than USA):	Zip/Postal Code:
Job/Position Title:	Dates Employed: From: ________________ To:___________________
Supervisor’s Name:	FAA Air Agency or Air Operator Certificate Number (If applicable):
Experience (add additional pages if needed):

Name of Employer/Organization:	Telephone Number:
Street Address:	City:
State (Country if other than USA):	Zip/Postal Code:
Job/Position Title:	Dates Employed: From: ________________ To:___________________
Supervisor’s Name:	FAA Air Agency or Air Operator Certificate Number (If applicable):
Experience (add additional pages if needed):

Name of Employer/Organization:	Telephone Number:
Street Address:	City:
State (Country if other than USA):	Zip/Postal Code:
Job/Position Title:	Dates Employed: From: ________________ To:___________________
Supervisor’s Name:	FAA Air Agency or Air Operator Certificate Number (If applicable):
Experience (add additional pages if needed):

FAA Certificates Held

Provide the details of any FAA certificates held.

CERTIFICATE TYPE	CERTIFICATE NUMBER	RATINGS	DATE OF ISSUANCE

Flight Experience

Category of Light Sport Aircraft	Total Pilot-in-Command	Pilot-in-Command in Light Sport Aircraft Category	Pilot-in-Command in the Past 12 Month in Light Sport Aircraft Category	Total Flight Instruction Given	Total Flight Instruction Given in Light Sport Aircraft Category	Flight Instruction Given in the Past 12 Months (In Balloons)
Airplane
Powered Parachute
Weight Shift Control
Gyroplane
Glider
Airship
Balloon