Dd1821 Form PDF Details

In the realm of civil and military aviation, ensuring that contractor crewmembers are adequately documented and qualified to operate government aircraft is paramount for safety and regulatory compliance. The DD1821 form, formally known as the "Contractor Crewmember Record," serves as a comprehensive tool for this purpose. Approved by the Office of Management and Budget (OMB No. 0704-0188), this document is designed to meticulously record the qualifications, flight experience, and training of contractor flight crew personnel, granting them approval to operate government aircraft. The form not only facilitates a standardized approach to recording essential information but also serves as a testament to the crew members’ adherence to stringent operational standards. With sections dedicated to recording detailed flight experience, flight check evaluations, additional requirements such as physical examinations and survival school, and a final certification of qualification, the DD1821 form embodies the rigorous processes involved in vetting contractor crewmembers. Its structured format ensures that every pertinent aspect of a crewmember’s qualifications and experiences is accounted for, underlining the commitment to safety and efficacy in government aviation operations. The significance of this form extends beyond mere documentation; it represents the critical checks and balances in the operational integrity of using contractor-operated aircraft, ensuring that every mission is conducted with the highest standards of professionalism and skill.

QuestionAnswer
Form NameDd1821 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesdd 1821 fillable, dd1821 form, dd form 1821 pdf, dd form 1821

Form Preview Example

CONTRACTOR CREWMEMBER RECORD

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION.

PRIVACY ACT STATEMENT

AUTHORITY: 10 USC 8012, 44 USC 3101, and EO 9397, November 1943 (SSN).

PURPOSE AND USE: To record individual contractor flight crew personnel records and approval to operate Government aircraft. Serves as a record of approval of private contractor personnel who will operate Government aircraft.

DISCLOSURE: Voluntary; however, failure to complete form will prevent approval of contractor flight crew members from operating Government aircraft.

NAME OF CREWMEMBER (First, last, middle initial)

 

CONTRACTOR REPRESENTED (Name and address)

 

 

 

IDENTIFY CREW POSITION

 

 

TEST

SUPPORT

 

 

 

 

 

 

 

FUNCTIONAL

OTHER (Specify)

 

 

 

 

 

 

 

MISSION, DESIGN AND SERIES AIRCRAFT OR OTHER REQUIREMENT

BASE OR LOCATION WHERE QUALIFICATION ACCOMPLISHED

FOR THIS QUALIFICATION

 

 

 

 

 

 

 

 

INITIAL QUALIFICATION

REQUALIFICATION

SECTION I - FLIGHT EXPERIENCE (Time to nearest hour)

FLYING TIME ABOVE TYPE

 

 

 

 

 

 

 

 

 

 

TOTAL FLYING TIME

JET

 

HRS TURBO PROP

HRS

RECIPROCATING

 

HRS

ROTARY

 

HRS

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MISSION

PERIOD

 

 

 

1ST PILOT

 

 

 

 

AIRCRAFT

OTHER

 

IP

 

 

 

 

COPILOT

CREW

 

DESIGN AND

OF

 

 

 

 

 

 

 

COMMANDER

MEMBERS

SERIES AIRCRAFT

TIME

 

TOTAL

WX

 

HOOD

NIGHT

 

 

 

(Specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 12 MOS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LAST 4 YRS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

0

0

 

 

0

0

0

0

0

0

DD FORM 1821, AUG 96

PREVIOUS EDITION MAY BE USED

 

Page 1 of 3 Pages

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Adobe Professional 7.0

 

 

 

SECTION II - FLIGHT CHECK (Instructor fill in remarks where applicable)

1. PREFLIGHT INSPECTION

 

 

 

7.

IN-FLIGHT EMERGENCY

 

 

AND FORMS

 

 

 

 

PROCEDURES

 

 

 

 

 

 

 

 

 

2. EMERGENCY ESCAPE

 

 

 

8. PRELANDING CHECK, TRAFFIC

 

 

PROCEDURES

 

 

 

 

PATTERN AND LANDINGS

 

 

 

 

 

 

 

 

 

 

3. PRESTART COCKPIT PRO-

 

 

 

9.

POSTFLIGHT INSPECTION

 

 

CEDURE AND ENGINE START

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. COMMUNICATIONS AND

 

 

 

10. ACCOMPLISHMENT OF FORMS

 

 

TAXI PROCEDURES

 

 

 

 

AND AIRCRAFT SECURITY

 

 

 

 

 

 

 

 

 

5. PRETAKEOFF COCKPIT CHECK

 

 

 

11. INSTRUMENT PROFICIENCY

 

 

AND ENGINE RUNUP

 

 

 

 

CHECK

 

 

 

 

 

 

 

 

 

6. TAKEOFF AND FLIGHT

 

 

 

12. OTHER (Specify)

 

 

PROCEDURES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION III - ADDITIONAL REQUIREMENTS (Fill in where applicable)

 

REQUIREMENT

CHECKED BY

GRADE

DATE AND PLACE

HOURS

 

 

 

 

 

 

 

13. PHYSICAL EXAMINATION

 

 

 

 

 

 

 

 

 

 

 

 

 

14. PHYSIOLOGICAL/ATTITUDE

 

 

 

 

 

 

INDOCTRINATION

 

 

 

 

 

 

 

 

 

 

 

 

 

15. PRESSURE SUIT TRAINING

 

 

 

 

 

 

 

 

 

 

 

 

 

16. GROUND SCHOOL (By Subject)

 

 

 

 

 

 

 

 

 

 

 

 

 

AIRCRAFT GENERAL

 

 

 

 

 

 

 

 

 

 

 

 

 

AIRCRAFT PREFLIGHT

 

 

 

 

 

 

 

 

 

 

 

 

 

AIRCRAFT EMERGENCY PROCEDURE

 

 

 

 

 

 

 

 

 

 

 

 

 

ENGINE SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

OXYGEN SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

AIR CONDITIONING

 

 

 

 

 

 

 

 

 

 

 

 

 

PRESSURIZATION

 

 

 

 

 

 

 

 

 

 

 

 

 

FUEL SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

INSTRUMENT SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

ELECTRICAL SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

HYDRAULIC POWER SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

UTILITY SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

FLIGHT CONTROL SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

AUTO PILOT SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

ENGINE

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMUNICATIONS & NAVIGATION

 

 

 

 

 

 

 

 

 

 

 

 

 

ROTARY SYSTEM

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER REQUIREMENTS AS STATED

 

 

 

 

 

 

 

 

 

 

 

 

 

IN APPROVED CONTR OPR PROCD

 

 

 

 

 

 

 

 

 

 

 

 

 

17. QUESTIONNAIRE ON AIRCRAFT

 

 

 

 

 

 

 

 

 

 

 

 

 

18. FLIGHT SIMULATOR

 

 

 

 

 

 

 

 

 

 

 

 

 

19. SURVIVAL SCHOOL

 

 

 

 

 

 

 

 

 

 

 

 

 

20. OTHER (Specify)

 

 

 

 

 

 

21. HAVE YOU EVER HAD AN AIRCRAFT ACCIDENT (as defined by FAR or military procedures) OR PHYSIOLOGICAL REACTION (e.g., hypoxia, decompression sickness, hyperventilation, spatial disorientation) AS A PILOT, OR OTHER CREW MEMBER? (If yes, explain.)

22. HAVE YOU EVER BEEN CHARGED WITH A FLYING VIOLATION? (If so, state the violation and circumstances.)

23. REMARKS (For additional space use blank sheet.)

DD FORM 1821, AUG 96

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Page 2 of 3 Pages

CERTIFICATION OF QUALIFICATION

This is to certify that

(Name and Crew Position)

has satisfactorily completed the training or special qualification indicated hereon:

YEAR

TRAINING OR SPECIAL QUALIFICATIONS

DATE

CERTIFYING

COMPLETED

OFFICIAL

 

 

 

 

 

 

 

GROUND PHASE

 

 

 

 

 

 

 

WRITTEN EXAMINATION

 

 

 

 

 

 

 

EMERGENCY PROCEDURES

 

 

 

 

 

 

 

CONTRACTOR FLIGHT OPERATIONS PROCEDURES

 

 

 

 

 

 

 

EGRESS TRAINING

 

 

 

 

 

 

 

PHYSIOLOGICAL TRAINING

 

 

 

 

 

 

 

OTHER (Specify)1

 

 

 

 

 

 

 

FLIGHT PHASE

 

 

 

 

 

 

 

PROFICIENCY

 

 

 

 

 

 

 

INSTRUMENT

 

 

 

 

 

 

 

OTHER (Specify)1

 

 

 

 

 

 

 

GROUND PHASE

 

 

 

 

 

 

 

WRITTEN EXAMINATION

 

 

 

 

 

 

 

EMERGENCY PROCEDURES

 

 

 

 

 

 

 

CONTRACTOR FLIGHT OPERATIONS PROCEDURES

 

 

 

 

 

 

 

EGRESS TRAINING

 

 

 

 

 

 

 

PHYSIOLOGICAL TRAINING

 

 

 

 

 

 

 

OTHER (Specify)1

 

 

 

 

 

 

 

FLIGHT PHASE

 

 

 

 

 

 

 

PROFICIENCY

 

 

 

 

 

 

 

INSTRUMENT

 

 

 

 

 

 

 

OTHER (Specify)1

 

 

 

 

 

 

1 Formation, Refueling, Night or other special maneuver requirements.

SECTION IV - CERTIFICATIONS

I certify that I have read and understand all pertinent technical orders, handbooks, contractor's operating procedures, and pilot's operating instructions pertaining to the above aircraft.

DATE

SIGNATURE OF CREWMEMBER

The above named crewmember has/has not demonstrated proficiency in, and has/has not a satisfactory knowledge of

MDS aircraft and has/has not satisfactorily completed the flight requirements for the type of flight check indicated above, and is/is not fully qualified in this type aircraft.

The checkout consisted of

 

hours dual,

 

hours solo,

 

landings from right (or rear) seat,

and

 

landings from left (or front) seat.

 

 

 

 

 

 

 

 

 

DATE

 

BASE OR HOME STATION OF INSTRUCTOR

 

TYPED OR PRINTED NAME OF INSTRUCTOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF INSTRUCTOR

DD FORM 1821, AUG 96

 

Page 3 of 3 Pages

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