Date esi 	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 	AS:g Ptin1/4- 	C; 4122:4 	\ yf. k-• C.Coe,
a_ 	G \\ 51-6 	N) 4:A 0 :c&-. 	so-s-- 	v/kit--( 	t-321 	Y-1,:-..i.-111.11,,ft2.,_..4,-,:--,-,5 6,,c(- TN,T
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133i 	Nr, ri'l,ii- 1.:IF,r4f,:-/,,TT[/,„f• /4'>141:7"-r--;'4j
•-1 	-).,c)LL 3 	N --1.2.?1- 	V 09 	()IA? 	g Ev 1 gl,1 E -6 4-- 4. xi 	t 	L
g‘ 	2.061-.3 	Ai 72-.PP 	?MP-NAT	-PA-1r 	rirwe'-'1,46'..15))). 0 h,i'' s.51 I- A T T , 	• 	I 	Li 6-
9 	r2,4t(L-3 	1'\-N-Y 	9 AV - rid	-PM? 	.-....„,..,,,,,fr--,2z, IA -L. id Re-P GI #, T, s'i v I, 0 6 E Mcwieuv erz
1 	7.06 (.. 3 	N7-249 )1 	ppip-ifhl 	- 	f r4.1±-,2 4. 7;1: .4.1.E.-.;,, m 1 vi 1. , 4i v 	e,c
1-k 	L3 	1\5-1 9_,9)-)- 	'?/t,'.2-/Jva- 	9NAV 	c.a., Ai E-fle,./A..3. p ize-n C 6, , -A . t• o1
I 	t:2--6(;1-3 	N . 12_67 )-• 	PM c ) — N 	- %,k) ppiq 	1....,0,,zie c I ,_&--7-4,-• 0 rxi-ciudetf "I r i6e- e-..) _L. he 4....„, - -
I if 	2461-3 	1,1 7 2.P.fri 	19 m P 	/J S7 	• 	0 	b
iii• 	2,00,3 	N 72,PH 	iys-r 	I' m p 	int.„,k REV) 04 ,2- , " I , -t R 	1 	3, L-1"
\!..; 	, ,_0(.:,(__•3 	NiLV I--k 	( iNkv 	e:- L-L.
N'YXCY 	Fu_ 	V tAP 	3
V.5 	2 O(., L:5 	Ni --I 0-Q " 	Q POei0J,-e/A0--	.°/.1).-;/.4-•;-
N12-621) 	c—)<C-..<-
16 	2.0413 	7, p il 	Pio. P-1-c.. 	I — Piti p 	1,,,, 7 LI 	I 	•3
I b 	z a ‘1., 3 	7-zP ki 	i°1-119 -Lel- 	PmP 	/R/ L -9- 4 2r; /4.. 4.,4 . 9. 	/- Aftpo 	1.-.)et-- 	i 	9
Ll- 	.2_,0c,r_-3 	--)2_.9 l.)- 	fme - c-YL- 	- PM 	I r/c/i--1"/ /5; "7' „.,!,?f, (or,„;(,- 	/ - Ail.., A 	.;-----.,x e- 	1 	1
11—') 	6c-ace 	0--1-Ck.- 	4{-7.1,
I certify Pilot 's P. 	that the statements made by me on this form are true. i aiza  13 • ,,,  	Page Total 	1 -T" 	1 	0 	1 6 	cl
Amount Forward • 	i'..a.sg s.ctv„ 	-1-15 I 	(4_ 	3 	3 	--),-; 	3
Total to Date 	-"' 	1 .1 6'D 	" i 	-./  , 	3 	16 	L
4"•b:1%-/ .1C1 .14-