Identification Mark
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23
Date
Aircraft Make
and Model
t
Aircraft
Identification Mark
Points of Departure & Arrival
Miles
Flown
Flight
No.
Remarks, Procedures,
Maneuvers, Endorsements
i\-)9 cAsz--6_
E.-6-nf3
EGO 1"3
LF?f3
L
C-,--115L't
G-- tt sck 6
Ni CIT.&
1.1
(--40
.'(5
'06x)
13\
n2
Number
of Landings
t./l
Aircraft Category...
t
133 1. Pi, nit.-
13.73-
kt
1(
1*(-2
ILS`f
rJ
Lrf)-2_
it
C
It
I
\
I=;)-<urK
c1(3 j\jr
R)CY.
N
rl1
-7 5
6. 5
tst3______
IS-c(c Lc-
1511(r,
r. rLLj
to
Lpo
G
_ c;.L ,
Deul, • 113 te\-11:1, ki .00 S L.M
_____V .> NN6ft?-t. , flu4v4v70 LA-kna. ri, c Lrwt
ri(),Lqiug, 4LCI"
A 110\Y-- Le65 Rio) 1,1o"
\LID 50(1‘u ')c /)110t)(-': PW5 r.)1) L/r)-1- P.Abri
kt_\\t Pt (.)s ())3c,v&,-
114-\ 3-s7p,,+1.1:1-7.)(3:)[5(-31-13(1l.)(-2
3 --‘;53.6:- ri •
____MMIPMEIMM
PR /1-
LILA 5(4 6 ,f-)5 OLA: PIO ;DI
,61.,___________________________________________________________
=lc's)
et
-1
c--F)
Oci
1 \
I certify that the statements made by me on this form are true.
Pilot's Signature
L
f
Page Total
/‘
5/
Amount Forward
Total to Date
6SS 3
fr..D-ot)
6S3B
3 1
t 1)
HOUSE OVERSIGHT 022816
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