DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
OVERFLIGHT
Pilot/Crewmember Personal Information Release
19 CFR 122.25
OMB 1651-0087
Expires 08/31/2012
PRIVACY ACT STATEMENT: Section 1.35 of Title 31 CFR Part 1 and 5 USC 301; Treasury Department Order # 165 revised as
amended authorizes collection of this information. The primary use of this information is by U.S. Customs and Border Protection
employees with a need-to-know in order to facilitate the management of the above-mentioned program and to conduct an investigative
check to determine participant's eligibility into the Overflight Program. Additional disclosure may be made to a Federal, State, or local law
enforcement agency if we become aware of a violation of civil or criminal laws, to a Federal agency when conducting an investigation for
security reasons and a very limited disclosure of the participant's name and a passed/failed" determination will be made to the "Applicant,"
submitting Overflight program application as specified in the regulation.
The submission of a participant's social security number is voluntary and no consequence will follow from the refusal to disclose this
personal identification number. Executive Order 9397; 31 CFR Part 1, Section 1.35(5), 5 USC 301; and Treasury Department #165
revised as amended. These statutes authorize the collection of this information.
PAPERWORK REDUCTION ACT NOTICE - The information collection on this application is need to carry out the customs and
immigration laws of the United States. We need the information to insure that applicants meet the criteria established to participate in the
U.S. Customs and Border Protection Overflight Exemption as per 19 CFR 122.25. The information collected will be stored in a computer
database for tracking purposes. Your response is required to obtain the benefits of participation in the program. Statement required by 5
CFR 1320.21: The estimated average burden associated with collection of information is 5 minutes per resp