Date 44.—.... Of.S.; 	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 	Ai2:41..N;& 	(.1....C.IlFe 	W1i!
G-1)510 	),'\i 	-"Vig 	17.1----si. 	i(ylL; l C-i)-, 	3e'--• , T6,5 • t.hd:11-1.170/ VC n't`li'Ll-N-iser113)A. 	--) 	• •
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(,........ Lipu L., 	f3e: D 	1 842,
1-) 	1043 	Z41 Ao, 	CI
L.V
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lb 	251...1•/K,)t—f)/(.1Z., 	0 (- \JO 	.0 E. Vlj 	14 01-121;;'46 1 •I'ea.2-P -r 0 a tri , ';•rfat).6, 3,:77-,4,A4,1-14 0 .-,.. 5p L A.hfOpts6,, Nvi-f-KO•faibil- C=f)r.U.Aid 	7
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a t 	k t 	N) CA 17.::. 	-\--e.ilf) 	.ce-l- D 	13,,---t., 	I G iv\ Lv 	9
I,
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I ) 	0 .., o 	•T4:-.--- 13 	iis-m• 	:Se--:-. , LN,/ 	1 	(7)  	__
I certify Pilot's Signature 	that the statements made by me on this form are true. --.....\\ a .;:C.CA. 1 V. 	Page Total 	1A.)
Amount Forward 	b4i-7 Lt{›- 	. CNSC.) 	0 	3 	3 	i 7.:
Total to Date 	 kl.i-i 640 	C(681:1 	... 	..) 	7-