°ate 	Aircraft Make and Model 	Aircraft Identification Mark 	Points of Departure & Arrival 	Miles flown 	Flight No. 	Remarks, Procedures, Maneuvers, Endorsements 	Number of Landings 	Aircraft Ca egory...
Tr— SAO.- 	From 	To 	(\til CU) 	Cr LZOCO-
It; 	0-1n-31W 	N 4\ oC.11-& 	LETA Pi 	GMt.1
(-5,-. re\ MC:" 	ji_\ 	sec( c--(1A,M,M A? 	7
r5 h 1 1
Vb 	% 4 	t t 	G-pArAC-- 	1._ Q Ai__ 	,,3-&.,Geg (2-1- 	,m, (vim, c Re-not-iv( 414 1. ILO, 4 5e4ner iCaVrCer 000Cz 0 f *TOM, "AL'S(' ,4 	- 	it
1-c-l< 	k.23 	, ?ettr-Ipm,ftP,tat,Fra-roorioirpticv‘uccoctordi 	S 	(8
Nc• 4 	3'6"i #1. FrilA1-4, 	2_ 	2_
G -1\59 P.) 	‘ 4 N9oct;:st, 	0 0 ic 	,Th'ic 	1 S- 	6 flc:76.. 	1,104.ar, < cacicy. 	1
----
p 0 t 	r•i\v te 	t5-3 	'3-&"1 k C6PA 4 	2, 	q
Li 	i 4 	(4 	pA V "( 	6E0 	Mil 	.z4 2 1 I Riv"1-4-# 	1
4- 	I i 	, , 	(3 et 	'Tee 	tz,5 	se‘, 1 R, (Amt.& 	9 	4
IA
6 	c -- vi P 	NI-Y.15p 	A C#::.6- 	C_-_6- 	t-, 1.. <41C-Cik, „rut 	3/3 	1
(4., 	1 0 (.3.-L3 	IN] Li-14PN-, 	-Lo,R0 	_th
\S 	(.3-12-1.-3tI3f 	N9 ots-G: 	IN( 	..-TPT`ic 	t z€, 	C-e- \\cc-v- EL-F61yr -rec-51 Arai' 	f /I 	CA
IC+ 1-1  	t/ 	t i 	31N14 	POT. 	12:1 	tsc,Tur.A., <-0.0A:A C. -ck\Gcic po 	I
C.3-1159-137 	j\) 9 oftst,- 	OF- 	-V(5-5 	16, Gm, , ( itho v n.o. 	10 ,, 	3 	1
i -riAl-ce 	2_ 	11
'9--.\ 	rlY;17-1-3) 	N`l or&-sc 	96.c 	-CPS -1-  	k D.(6.6) 	2_'4
-2,56 	t.4. 	1 1 	CC ( \<. 	Lc: J.) 5 	c),----c'i 	111.11111rce 	(7 	9-
I certify Plloi's 	that the statements made by ma on this form are true. - 14 A 71 Sly (.11\ al keili ICe , c-X-1;1 — 	Page Total 	....1s...c: 	till 	0 	.194
Amount Forward 	LtS14c17.3/4.. 	`8"" \ t V.a 	( 	'-) 	3 	\ \L 1_,
Total to Date 	b SS) 6 -1.0o 	" „„ -11)-1 	1 	\