j é ey 45N meee
+n
“nts
gis a wee
Aircraft Points of Departure & Arrival SR Identification Mark Flown
eke}
J See Sete leer ne somemnaeniatent's en ee ee a
i Remarks, Procedures, on : Maneuvers, Endorsements i ae ane a! on
Date Aircraft Make and Model
@ 5 | S ws
; jJ pe wd 2 ft Ud [ple ae |
=a ie ~ Ht [ ‘ 1
+
me GS [wy) Ww
V4
Siar
~ _ 7
eb: ~ c -
Col
L4} rt} TT". BIAS
E TNSAGB IN AOA PRE C= vsiB Ll
4c TAI TS
—-|— > ~
==) NA OATE
a =) N
S) 3
O re pie YP wD
\(
x va)
c 79
a ISS sh i: a
pat uk - ” = ~ = +N, 12 oa
Pes
| canlify that the statements made by me on this form are true.
Page Total Amount Forward
Total to Date
Pilot's Signature
DY»
HOUSE_OVERSIGHT_022816