Date .tej--- ’.“2,k l•-.,1”.,… \LA/ Aircraft Make and Model Aircraft Identification Mark Points of Departure & Arrival Mites Flown Flight No. Remarks, Procedures, Maneuvers, Endorsements Number of Landings Aircraft Category…
From To
.g, - L IT; !Al! -'''' ”- ’ ’ - i , .,,•-, 1 , ,..... `,.. -I , … 7 , ,…/.,
---‘1 1 — ’ li- tv , ‘i L:c?, y - - „ 1 ..-S- L<-> -1 0. I’-) ,..
• r,
/..:: p i-Li.-;-c-
\ 1 ’,. ‘-, LC’ r)- 7 -, 1__- f ,-7 —1- . , ’ - 1 , 9 (¶
; -3,14 Itj-; 5- 1 , 1 1 L,IL)vv vo 10 i__ f.,_ T.’ , \ —’ — - ..-… _ •i :)…”-iH. 1 r -:. t.i.i JO • -) ) I 1 —) ’ E- ’ C115.11 1L14 Ii- um 1,71,0,,,) or ,om::: AAIL(..1,—”.-, ’,—/,(,I, :1 .=:.:,, 1 c:00/ - -s.(,..,..:,-,ii-;(—,:…-i-’,.m.1’!:..\•-t’j'''L L—1—.”''',” ?” \ ''',1’1’ , R s.6.4,v . ‘k..1;,…)1..: . 4-1-(..,..yrL ’ . °)..,..1. ‘v_r:…c.L-1, ;.:(,^,..”’Ots:.•) , .— 1 I. =.: I ’-’ -’ C •, ’ 1 1 ) I ,:li- (i7 < 1 • i i-i—.• . -V-… ; !’A ’-(1)-/-4-:::`— ’..-…’, ,.,.. ‘OA IN-’ ‘,if -I c./. ,’-”./.. , — A ”- 1 …-3 I ’ “:N .L TE S-sri- -1- LS) it, 1 I v-; ) ..-. ----1.— 17-,-.,.11 C 1-0 Cr,:il N.—, , M 1:1C-AIN-,:., i.,, ’ 4 -c-s.’ ic-F,…\ ..’,—IL -7)… ’ - , 1 (.1. L ” , 4_,-(1A ’ ,:,:,,, r., o_.1.,,,,:„. _____________ \ / ,,-‘k- ii,,— .c‘-( .i-¶
- : . 1 (:’ ’ N L” -.,f:i-,— _ — ’ , 1-,,,,,•,..„.6,(Z.c.- 431(tr11),:6—))I1(..-1.1r))—11-4)0,k1,-4:1Y G :(4.0,..kf la, La ,i3vi.,.i…- 1’ . 9. 3 ‘3.. …-v, …r_ …),…s,_ o ( , t 1.A. t7 0 —L *-Y”L- 0 / 73?-7— )(_‘,1’,N M, \ ,, A L S :.-1,1 .:) :2,, I certify that Pilot’s Signature the statements made by me on this form are true. \ (1-,…, ’ d; ‘Td -0---Oir r V ’ Page Total 7 ’., .) Amount Forward 6.b1 j t 1. itt ''''''..’-rifo 1 ‘3 ‘3 . \ ‘ • Total to Date ’,, (..-1 0 . ILI/ 1 .,… . ‘3 3