ft DatA 0 19-1,-. 1 .ng Aircraft Make and Model Aircraft Identification Mark Points of Departure & Arrival Mlles Flown Flight.. No. Remarks, Procedures, Maneuvers, Endorsements Number of Landings Aircraft Category… From To itifftraist• a e5 6-11596 NcAos3-L-, c(i-1-.. jc, 19 i 02.5 iiiiim=mirni 3.t.—/ &fr‘f 2-5 1 I ) I -TC-115 S OF ost, L) Li 271 ‘ ( It SA F e 0 1 od,Lic, c yt 0 6-3- 4.-.1-77Z-T VD 2. 1 31 C. 1 -1 a NsNiaciS LN(\ • .L N. I) c kY,—(:\ C. C-)U.S.: r- /V ce,..-..-:?sivo rri- -3/3 3 , , \ 1 01A - VO”,i- 1-NI) C))gs,5 \KiPs&Ncit - —,, c-pna-aoli…mcy LA .i\i vrn-,c,-), Nvc1- V, c ,:—tiA”2:4•Wo6Y4i5 1 ‘3 ‘6 Cuv21 S.‘foiv L.,..)-rba. ael,c—,itac.-(4,5 -vt ilx.I.D.Nc., f* r .—{-,\E-.12,G-Lot…y ,eafs (..c.:.0:41—c-’, 1’5 \I 1 T.Nsw…),-16..-mt Colv+ 116:MN t-Li c ;PR .—cE0 ..v._ Ni\ii-41 1,g. i -ze.-, 9… c-c-pou-5 t „0 . I i 1 1 ?uatiwiai 6 1, 1 i F\ IL vi LI 1 wii le., Q(,.7,.. me: LL’, ,)., 1 Li % i 1.1 \IV 14 ---1 .q6.0 viz 2-6,7 9._ ve_mgLes ‘1 v3 0) ii.),0 17:…-( 0 L-S-Vaire— 15 6:— 0 s-1-6-‘6 1 Mg ’—,-/ bi—J-v’LA.`,96/ 61 cl v,. \ l 1-6-16 M f- (3t15.- 3-6.-,LG(…c.-…/1 &Q.-, i 2_ 3 k( c 11-1 2- t\fl 5 ru: L_ 0 ()---c)< - LA) A c 1),(2…zie.x.„ -,,,G,t..t.t fr.&,.;1/4..,v,z_¶
- n-115`1 6 Wiurse-:- ickeT.tv /i-Ayn_PAi 0%, P-‘6.2,- 6 16— & - i \t, ’( vi tykt’iut4 Pi?, r I certify Pilot’s Signat that the statements made by me on this form are true. atA kelki 12-24-42L,)— Page Total Amount Forward Total to Date