EFTA Document EFTA01332898

Change of Address Processed by the Airmen Certification Branch. A FS-760 Name: MAXWELL, GIIISIAINE NOELLE Identtlicabon Number: A41211129 Cenificatc Number: N/A Mailing Address Previous: 16 ISLAND AVE APT 7D New: 1000 VENETIAN WAY APT 801 MIAMI BEACH USA Prestiour FL 33139.1331 Physical Address New: 1)aw the change of address was processed: 11/17/201101:17:26 PM Change ofaddress initiated b) NCOA /MANI! BEACII USA FL 33139-1043 PROT14 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00249517 PROT0 PROT15 EFTA_0024951S PROT1 Change of Address Processed by the Airmen Certification Branch. AFS-760 NAME: CIIISIAINE NOWA: MAXWELL, Identification Number: A4121029 Ccitilicatc Numba NIA Mailing Address Previous: 5786 LA JOLLA BLVD LA JOLLA CA 92037-7301 UNITED STATES New: 16 ISLAND AVE APT 7D MIAMI BEACH FL 33139.1331 UNITED STATES Physical Address Previous: New: Date the change of address was processed: saeaeli 5:05:17 Change of address initiated by: The airman requested a change of address through the Federal Aviation Administration. Civil Aviation Registry web site. PROT16 EFTA 00249519 PROT2 PROT17 EFTA 00249520 PROT3 0101 9640 Forrn AFS•760•Sem-02 (04/06) PROT18 EFTA 00249521 PROT4 PROT19 EFTA_00249522 PROT5 APPLICATION FOR REPLACEMENT OF LOST, DESTROYED, OR PAPER AIRMAN CERTIFICATE (S) VIA THE AIRMEN SERVICES WEB SITE DATE OF REQUEST: 02 OCT 2007 AIRMAN'S NAME: GHISLAINE NOELLE MAXWELL SSN: A4121029 DOB HEIGHT WEIGHT HAIR EYES SEX 68 129 BROWN BROWN F REMITTANCE ID NUMBER: 200710021722939285AS TOTAL REMITTANCE: $0.00 REPLACEMENT CERTIFICATE TO BE MAILED TO: GHISLAINE NOELLE MAXWELL 5786 LA JOLLA BLVD LA JOLLA CA 92037-7301 CERTIFICATE(S) CERT NUMBER DATE REASON PRIVATE PILOT 003266576 02 OCT 2007 REMOVE SSN PROT20 EFTA_00249523 PROT6 r • 7 '7"1171q 4 2 I 4 ti ak ••II•LS S.AL{V. 4. a 4 SD N Y_G M_02762675 EFTA 00249524 PROT7 r) I) P / 9 XIV. CONDITIONS OF ISSUANCE This is an interim certificate issued subject to the approval of the federal Aviation Administration pending the Issuance of a certificate of greater duration. It becomes void- 1. Upon the receipt of a certificate of greeter duration to replace it; 2. Upon a finding by the FAA that an error has been made In Its issuance; 3. Upon e finding by the FAA that it was Issued illegally or as the result of fraud or mis• representation; 4, Upon the refusal or failure by the holder to accomplish a flight check by a Flight Standards Inspector if so requested; and 5. In any case, at the expiration of 120 days from date of Issuance• 1..t,• . SDNY_G M_02 762676 EFTA_00249525 PROT8 I. UNITED STATES Of AlAtRiCA, OUARTMINT OF TRANSPORTATION - E !MARL AVIATION ADMINISTRATION H. TEMPORARY AIRMAN CERTIFICATE 1 III. CERI IF ICATE NO MIS "Pinning" Ghislaine Noelle Marion Maxwell ,v/358 El Brilio Way Palm Beach, Florida 33480 OATS OF *Mil fHLICSITT TIMONE HAIR Brown Brow SEX M NATIONALITY France 68 04, 125 six. Mohr lours' lobe properly qualRid trite Wel burn vatfi INS conditions of lonenco on Oa entree of OA ottiltlaile to stares the pr Misr% of Private Pilot RATINGS AND LIMIT.° orcrafttftliC00ttE___ EMS IE AM diem...Psi. IsraPict LI A REISSUANCI or THIS GRADE Waif itet DATE OF SuPERSIOEOA)FILIAN MI0 110111 03-29-99 X OATS W intheeCt X.,itnATV I 08-27-99 / Randal R. Bowles BY DIRECTION OF THEjOM Nls:TI,TOR e PM Ion 89604 10781 USE 89I9iCita 133784883 IX MAIN WS DESIGNATION HO OR INSPECTOR'S PIO, NO 17 611FE t tritiOtit tir 594284070 PROT21 EFTA_00249526 PROT9 TYPE OR PRINT ALL ENTRIES IN INN Q • liCliTk - ii;CerirWc /or ..• I Cco-nrns kr.ormn Rating Application Pimmi smokm Asm41.~ I Application Information 0 Student 0 Recreational ttO Prima 0 COnIrldr011 0 Allard Tranaport 0 Instrument 0 Additional Aircraft Rona 0 Airplane Slar-Engina 0 Aldan, Multlingini >tic AMMO 0 maw 0 LIghter-Thanaa 0 Flight WOW*: - InfliN _Raga - Rematorneni 0 Additional Instniclor Rating 0 aroma mamma 0 Medal Flight Tod 0 neevamindion 0 Reliance of Unified* 0 Other & II.MI MIL Mi. 1,14130 Maxwell, ChIslalne, Noolle Marion II OW tU3 WO O. Or HIM O. riree NAM «. ram irketAtr• ornorat labia CSIINgbro 350 El Brill() Wav P. son IC.44 1 Um" a co gamier ad wderemaideed (3 USA car Franca 30 yea 0 No ti. Mel fl oe 68 I% 125 e.,. J. MU Brown Lap. Brown ,.N. 0 Oa in r....* Ort Wit hi Cede Palm Beach, FL 33480 a b• sod sew Ms& 8. Ion nu on. Me• as /AA M. c•mema ova GI an IL <Ira km Cram Student ow P. DM Imed 03/29/99 0.c..,"beld• IZI Yoe and chana D n. I. OM «CNN!~ Second S. Den Wee 0 3/29/99 t.Maaeli.aYla Peter H. Cuida, M.D. U. Ware you ben connoted lor violation el Frvidai or Stan Stuns relating to narcellc &ugh marijuana, or daemon' or allroulun drug. er autelancia 0 vm Oats V. ode el VIM I Cronelle VI. 011tlai or Pen eNloot PORI only Way 1 livatmt I is is man, WWII MS No 1 ~A mono ow ma pa Mel fernier el Nee lialoori I VI•ro • L OS II, Certified* or Riling Applied For on aak el: Qcg . camp:dog o f Reautrod Taal tatinsOl lobe iMdfaCtAlenimeitM bell 306 1•4 • Mae I sea Mtn 75.7 • kpos. " ' . *re. in opaim4 .. 1 10;6' ....,W 0 It Willey i I lad I. Sato I aarei wadi IN Minna liar /I . / i 's OFFRPOIMO °aligned In : . a mat ism dead Hahn ma manardieme sea la gored at is mend idircarreara i 0 C. Cliathelt of Approved I. WM liod »tin Arm 1 .....' ......71ae ilt la CAINIesem ~No I ) COW), • 1 CASA+ Ns VISA IIMUMII LOM 0 O. Holder et Foreign 2. 0.00/1 Yew** Lbralber Lkenie Wad ay .Aar. DE. Coeyhelkin ot A k Cinien Apprpead Udall, illOf Ili '1" 1" " ba c" « LOS 0 Inhist 0 Urine& 0 Transition Ill. Record ol PilollImieDonorwrIn Oland enea eat i Uri ~Ai Mora is AM n Cowin Vita a (Ant Om Con/ Yea. /ad Crto CAM Ws OM CAM ins Cann MAIN NIP 11~ Pea 14l lekna LIMN *Pit Cend NIP 1~ lasni Pox*, Arno new rya Note Arne I el ei ti l»••• SW Crota Mond /no late. Una Age 1.10V•I I 1.--.L 87 • 77. 10.) 0 0 127 1 3 1 3 10 I3 I16 I 0 I 0 I [repeated 6 times] 1 Sots I [repeated 4 times] h...., 9.-2. Mw,. Have you mood manor Pill cerlIll col io or rating? LI Yell :04I0 Within Ontivost 30 chive? ' u• 0 No V. AMMOinroCerM NI SI Oatentals ard inns, gond<4 bon. co Viz applatab ton in =ON Ste io tie Stole" VMS WO I OMNI may re10 bli of 111. la uzun:. CA any MA vela» K. co I VIM tiro awl vs ~Bawd no hooey An stirs* net Eccervme this km WWI, Appc cot 06'• 11 -1.7A.9 FAA Ole Only On. mo Id aa CO di at W I tit MP VII liFe4III d tr 7 • Zd e 7 Form AponovolON8No:21200321 FAA Form 8710.1 0.9» luOliMen Pirmn Epson IIIIN CO52404424006 PROT22 EFTA_00249527 PROT10 Instructors Recommendation I have personally Instructed the IIPPlant and costar this person ready to take the 1st Des 8/27/99 8/27/99 Instructors Signature rl es .(1 Ce dkale Expires 4/1---- IIMM OPA RI-nnon R. Wraver I I ',S The applicant has successfully completed our Air Agency's Recommendation sum and 8 fICOmMended tot artificalion a sling without hither net. Date Agency Name and Number Offklens Signature Tide Designated Examiner's Report o swarm Wks Certircale Issued (Copy arached) :Stave personally reviewed this apolicana pilot logbook. and certify Chet the individual meets the penitent requirement. O FAR el for the pilot certificate a rating sought Oiler* personally nand INS appacana predation cartificale. end band II to be appropriate and In order, and have returned the eeretien. Wirer* personally Med ii Overtired this gaunt in *softens with pertinent *oceans and standards with the result indicated below. Approved - Temporary Certificate Issued (Copy Attached) O Disapproved - Disapproval Noose Issued (Copy Attuned) i Location of Tait (Facility. City, Sin) Welton ol Test NI- /641;0,3 Ox•sil. MIni nowt FlolibA Gemmel ol.c Wmulmor -- . . .17' I Mee t Certifkate or Rail lor WISch Tested Types) of Aim; Used Nick, 'Pi /o1 Refs ,9-0 ("- Registration (1•00) dY707Fft i Cato ,hs-P- 49 Ex j .kyut yi 'them 2. &des Evaluators Record For Airline Transport IftgetOt EXIITIMW Oral o a Galata No. isciancve> CerIllicate/Rallng Signature . 0.4.8646*^ Nt• izsaimec Only 00311ralitn WON 10-11-99- Ogle o o Metall Riga ChM 0 0 novenae Qualification Program 0 0 iniptclors Ripon I have persona& tested this applicant b with or has ol ise verified owl this apgilant complies with artireterOadureE Peacles. an or sassy requitement* with the result Indicated below. 0 APProTet - TamPorary Certiticale Issued 0 Disappreved - Olsapprovel Nap Issued standards. i location of Ter (Facility, City, State) Duration of Test ilmond Oinstater Flight • i Certificateor Rating for Which Tested Type(s) of Aircraft Used Registration NO.(1) 0 Student Pilot Certificate Iasi Certificate a Rating Based on 0 Inagua*, 0 Flight 0 Ground I $116biriftlebded011 0 iiimary Competence 0 Renewal 0 Append . ACCEPTED 0 REJECTED 0 Foreign LISPS 0 rteinetillinient 0 Disapproved 0 Reiss stance of Pilot CMGs& 0 Approved Course Graduate Instnrclor Renews/ Send on 0 filsolal medial test conducted - report Matted 0Other Approved FAA OuallfiCalOn Cdterla 0 Activity 0 Training Course to Aeromedicm Cortillcation Branch. AMA-INJ Caracas IsSult 0 ACquaintarte LJ Test Certificate Denied TreuNng Course MRCS Rime OfedUllitin CArtitield• No. Oats c 4 t 49/4./h 9 ...4.401 7 rmpismazioe cite3C , Aftschnients: 0 Student Pilot Certificate (coos) fii, Allman tanuneation (ID) 0 Nonce of asepenni ArROPOrt of Whiten EUMIAIII100 K _ESIXAtel igiva zil beacoaser 0 Superseded Pilot Comfiest, "ffrernponty Pilot Comilla& (COPS) 0 kiwi/Sheol Graded 0 Answer sheet Omit (Foreign insiument) IL: r FM Form $710.1 Oa) au0Sedell Proviso ES , NSR C052.0044324006 *us. Wof I99S•ilS.)11/11241 SONY Jarsil_UZ/bLb/V EFTA_00249528 PROT11 7 0 2 c9 1 8 I aws Computer Assisted Testing Service 1-800-947-4228 Federal Aviation Administration Airman Computer Test Report EXAM TITLE: Private Pilot-Rotororaft-Helicopter (PRH) NAME: MAXWELL, GHISLAINE N P906122619990629 ID NUMBER: 133784883 TAKE: 1 DATE: 06/29/99 SCORE: 87 GRADE: Pass Knowledge area codes in which questions were answered incorrectly. See appropriate Advisory Circular (AC) Knowledge Test Guide available via the Internet; http://www.fedworld.gov/pub/faa-att. A single code may represent more than one inoorreot response. A01 H317 I46 H340 H348 J37 310 J31 EXPIRATION DATE: 06/30/01 po Ncyr., Authorized instructor's statement. (If applicable) I have given Mr./Ms. additional instruction in each subject area shown to be deficient and consider the applicant competent to pass the test. Last Initial Cert. No. Type (Print clearly) Signature SDNY_ON_02762680 EFTA 00249529 PROT12 1. I ":. :Or 40 .6•13!...V *0 • • t% t (0fil) 1.4444Oo.i.N-/twurio.o4-Julil vlov04I 4.00oeelocsanneg n nommim. "IIIHNNAM :311A1I .1 :?'NAY C20411VCCf 011AM4H 01 tU0400 Nn :3140n:. prov\ao :3PAO a.:;:i %M. (i • •1:i:q if I :;.:K.0%. :aliprftij0:05 • plii ;4, .':toe V..•i.s fnA; 1.•••••• i y .••3 1::i VI/". 1.ten •NOx .4:4n:11 alo-bnt\dui\vov.4O.1o.d..q1 .4:::Wx\O44,4 Iftowir.$1A1 ftldfl1(t.eo • 0 .211Yiptirl ni . r/'10'311i lit;i1.7 fin le Jir•o•Anitri ye.r. -.4444* nivoin /. Ott. .:7. cAia ;r2,I Cali LOk In\Ot\a0 ClUxi HOITA4rIX:4 A:i 0104uvlinoi I.44:411(04vA .:q:'\.04 uuviv :emit it '011.iitgqr. 0W1 loblenvo WIG O1 S. s:wrj'≤lut: dons .1:104 ..411 ;mem v3 trtulutivin (r• es' co 8 4:fOlteg 6 ••••.4.t. 12- 43:; . • :h. ..11.' SDNY_W_02762681 EFTA_00249530 PROT13