,
Date tg- 20:4 	Aircraft Make and Model 	Aircraft Identification Mark 	Points of Departure & Arrival 	Miles Flown 	Flight No. 	Remarks, Procedures, Maneuvers, Endorsements 	Number of Landings 	Aircraft Category...
From 	To 	0,Eg 9 VYit, 	C,..1...i-Or.ao 	1-}6-(4)-12
P8 	CAN- 6 	ks.63 	I / 1 	9_
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al K 	.313/"IlrNP ivv'W-V- Ifi- cit a 5 CO U /TA Y LR-Mv-rmaLIZ,,c4,-,„ pm-tc-ri lidycvs-v 	\ i 	2 	i
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7 u ti 	9:1 K- 	pi. o.Ns-50t-jc-c,s 	\ / 	-7 	_
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I Li 	6- I K-9 0 	NC/KAT& 	_ "W6-1--- 	'VE:V 	i5-6(.. 	T6/ G"P4'. ) 	1 .6.... 	1 I ( 	S 	1
c -LI I 13 	IV 61c46 C-M 	P 6 I_ 	'I- 5 NI 	 pc,,,,,,,. ,-A-1/ 1 	1 	It 	1
3.P 	, i 	‘ l 	6 t\A 	sf 13 •-• 	1/1 	1. / 	i 	I
2--c-i 	G- 1 1 Cq 6 	N) cVc-1--Cel" 	Te---, 	e aT- 	1,315-7 	-3"Y2/6-in, ne L.•,,,../)-,.2_ 1 	I /1 	a. 	L
2c-- 	C-(12_ \ 13 	N cic,c6(rin 	90 g 	LPy1.-- 	-------pp,---5, 	‘./ 1 	1 	3
r-I.L. 	\ ' 	,, 	L/4 L 	1A c1\1 	10-3-6;•, .0....." 5,CA....mr462t. 	I/ 1/ 	1 	q
L. Griiadial.tLe Lifeses (IPT > YP3r
C) 33 	fjPt-TSY r ..,coo$s -:-C;Vc.:Ziss/ZP;we-criwC6a"
.a. 	G \ \s1 C.3 	N cloco-6.- 	`P 1- 	T4.-'- 13 . 	_..., VU°415 	26,6ti, II. 1)F,SC:ezt- 101*- .-(--wi I L6- '....' C;4./..ni9L 47 . 	17 i 1 	.a. 	5"
I certify Pilot's Signature 	that the statements made by me on this form are true. .. lex-14.-  	Page Total 	i (2 1 5-- 	-33 	6-
Amount Forward 	6 3 I -73 	k--C‘,. 	Lt 	3
Total to Date 	ba4 1-4- (05 	.sa-3.3 	9 	3 	_--,3 - 	11-). 	C,
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