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Clock MM/DD/YYYY HH MM PLEASE FILL IN APPROPRIATE SPACES AND CHECK ALL ITEMS WHICH APPLY TO THIS EVENT OR SITUATION. REPORTER O Captain O First Of cer O Trainee O Dispatcher hrs Last 90 Days Time in Type yrs O Other O VMC o Class E O IMC o Special Use O Mixed o TFR O Marginal ATC EXPERIENCE O Student o Flight Instructor O FPL O Developmental O Sport/Rec o Multiengine radar O Private o Instrument non-radar O Commercial o Flight Engineer supervisory O ATP military CONDITIONS / WEATHER ELEMENTS...
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