Date 	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 	Res fi...aPii- 	G LLOZ-g- 	\-k-.-1--L'i.:..C;r1;:a
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v 1
IC 	1 t 	7T-,5T 	T(.(13 	13L11 	zc-= / 	V\ 	Li 	o
1
S \ 	\( 	\ ( 	MOW 	TE-C3 	121-B 	a6,, Gn 	i 	-1
1 	t( 	I t 	76---65 	C 0 	ply 	----.)G.s.m pp2, \ sle.-d-Npru:.- 	z_ 	t-\
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e 	'-- 	I/
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1 uI 	tc 	) t 	V Nii 	SP---'0 	I 314a6-.- 	\ 4 	I 	-)-,
1 Lit 	i ( 	il 	SC2D 	L (-).5 	t3LII 	Te 	\ / 	I 	7--
nso 	T---- 	i ,,/ 	1 	0
il 	i ( 	i
\cc 	LC 	i ( 	9 i',). 	--*S, 	I3s/ 	z-.6.-- 	V\
,s6.	a ) c...-- m wokeg..., fk--0_ pAry_rivoi 	‘A 	•`.' 	-1
II 	TIT'51- 	'Y.:: t5 	t561f 	vt2e-ao-sr-- 4- 01.c.,01,0Apo -16. ‘..'..4 ez..gat-,,,oesico 	1 r• . '7 I 	3 	-7
25 	'' - 	. IL 	-76-. 0 	I) i3 C 	k3-5-5- 	i RePo5), iT-0/J
I certify Pilot's Sig, 	that the statements made by me on this form are true. I(':\^:) al-R-CA RP-11476's.k.a"---.  	Page Total
Amount Forward 	I:=2, Ci 0- `ric-1 5c (•.> 	-1-1 (:)% 	-; 	3 	A I
Total to Date 	‘30.6 s9 Cl (6 • 	13153 	-7 	3 	-5 	I t 2-