1. Aircraft Data

2. Flihgt Data

3. Injured Persons on board

4. Number of crew and Passenger

5. Nature of Condition ( Check one more)

Engine:

Breakdown systems, that didn’t stop the flight:

Loss of system or indication vital for airworthiness And safety:

Effects on Flight in others:


6. Stage (Check one)

7. Please fully describe the incident and extent of damage to the aircraft as is known and if available, description of any explosives, radioactive materials, or other dangerous articles carried.