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Address: Item 5

AME Guide to FAA Exam Item 5

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Excerpts from Guide for Aviation Medical Examiners
Application Process for Medical Certification

Applicant History
Item 5. Address and Telephone Number

The applicant must print a permanent mailing address, including country, and the zip code (full nine digits if known). The person must also provide a current daytime area code and telephone number.

Other Portions of Applicant History:

Item(s) Description
1-2 Application For: Class of Medical Certificate Applied For
3 Last Name; First Name; Middle Name
4 Social Security Number (SSN)
5 Address and Telephone Number
6 Date of Birth
7 Color of Hair
8 Color of Eyes
9 Sex
10 Type of Airman Certificate(s) You Hold
11-12 Occupation, Employer
13 Has Your FAA Airman Medical Certificate Ever Been Denied, Suspended, or Revoked?
14-15 Total Pilot Time
16 Date of Last FAA Medical Application
17 a Do You Currently Use Any Medication (Prescription or Nonprescription)?
17 b Do You Ever Use Near Vision Contact Lens(es) While Flying?
18 Medical History
19 Visits to Health Professional Within Last 3 Years
20 Applicant's National Driver Register and Certifying Declaration
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