Date 49--" 	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 	cY2.67470/t:: 	6:(:-.)....a..g.. 	04_ Li,
ULlk, 	1-Yes-) 	:3-z= I 1..V 	2_ 	5
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\e) 	11 	) 1 	49 e).-x• 	.'1-6-43 	i-A2-TZ=.:_ 	- , LV 	1/
nq3 	/la (g- Pi\ , Lf‘ Jo ju-11,:1,0 	VI 	\ 	1-
724, 	1( 	\ \ 	V3'iL- 	I Le) 	0914 	i Ci-tAf.A i,) 3, ,„, r.4.0.
'9'2-
6'4 	•\/) 	..•
i4 	V 	'-') 	'I
1 	-Y T-5)- 	"T6-43 	neitri 	74: SO- 	1/\ 	3
1/1 	3 	6
I
15 	$1 	1 i 	lz--•• r3 	17 eq.-, 	A t1.1-1 	. • (.... wi,..,,...c.,Q5 K fl i LAI 	/ t 	2. 	3
22. 	) i 	1 \ 	.9 fix._ 	-WTI
1.61 	-1•6.,.. L_V 	\ / 1 	c••••4
.2..ki 	i i 	i 1 	c-'• 0 ••\< 	-1-&)..3 	•e.l.ti 	i .::::-)E..-.1 I__V 	t.,/ 1 	6 ..,
21) 	it 	1,, . 	76:55 	.rA v Y 	mci 	::le.i. . / o,." I 	5
.1( 	1 \ 	1\11\1 	TT---',T 	tcile, 	r :se.-L- 1 L.V 	.- 	3
.2:1 	, i 	\ i 	T1-.3.7- 	Fs 	le 1 1 	1 , 1__\) 	\./ 1
!-'7•11 5' 	% I 	1 1 	Phi, 	T.f2- 13 	V.:::)*-1 	C-71\1\ , l.41 	' 	L)
LS 	cl.) . 1Mui_Plaz. 	/1/\ c_R- 	61\ j: Pr 	 ki)t.... e_c_--,,to --gm.5w. 4.k.3-60.. L."
I certify Pilot's Sic, 	that the statements made 	by me on this form are true. 12.Z ql-/?-- 	Page Total 	I Li\ \ 	!.IS 	L. 	I ) • ' k
Amount Forward 	-7.'C'I 't .11) 	110 	4- 	:77i 	.3
Total to Date 	'':!1.'111.-f.t 	CiBt/
1 \—)autti
45A