Date . 140(> 	Aircraft Make. and Model 	Aircraft Identification Mark 	Points of Departure & Arrival 	Miles Flown 	Flight No. 	Remarks i Procedures, Maneuvers, Endorsements 	Number of Landings 	Aircraft Category...
From 	To 	AcgrPifiW,"-- 	Gi-c-na-/L 	•1---.(a)
2-Lk 	Ci--\15113 	Ncic)%cs-- 	5c)c-, 	1 	-1
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2_. 	)___.
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I k 	se g- 	VAK 	V3k1;"/ 	• - ..-4-,..... i 	V\ 	I 	SS
\ I NY 	"TC---- 6 	L\ 	(6
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IC 	C (3r 	.-T 6. 13 	, As. 	[C---"'
t 3  k 3  	. tc t ( 	1. ( 	-S- 0 	LG-A- 	13(iii ____ 	71'.4e-1 Re:J.- PasTTTOI) (L.ore- PARIS 	S
k t 	LG Pi 	LP G 	13cis 	. -.1,-, E-1 \dor:. 1ioLONG- 	. 	i 	1
I l 	I—cD 	L- G 6 6 	\39 6 	---7--r) 	1/) 	1 	3
t 1 	-(.-i 6 f5 	F3 G- iz 	tyn
I certify Pilot's P' 	that the sta ntS made by me on this form are true. • t, 're qiULC611 LeR1/6)€Le.--- 	Page Total 	‘.3 \O 	5-9 	i 	(.. 1)
Amount Forward 	6 . 1 /5 (?00 	1?-75 	ci 	3 	It 2_
Total t* Date 	(.23.3 (C>iS- 	161 3 	6 	.' 	5 	Ili,