lex) JYERS, i d., Nufirt 41; 	AIRCRAFY CATEGORY AND 
NO. LDG 	AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTIENGINE LAND 	1---,P , 	, 
q 1 
1 	1 
1•.f 
It 
• 3 	-3 
/ 	3 
1 	3 
• 	7 
l 	,I 
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., FORWARD 	671,5& 	,a9(6 	? 	;:3 	7 
AL TO DATE 	tf6-6 	5,-;.79') 	. 	5 	r 
CLA S. 	CONDITIONS OF P LIGHT 	TYPE OF PILOTING TIME 	T.-Dour, 
R1	IANsaRROTR 	MIL 	DAY 	NIGHT 	ACTUAL INSTRUMENT 	AIRC RAFT IHOODED) 	LINK ()EI FLIGHT SIMULATOR 	.IMMIL • ,... „ 	i 	PILOT IN (eln°cMI) sA070 	SECONDM IN COMMAND 
/ 	? 	/ 	9 	/ 
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ARTURE & ARRIVAL 	REMARKS, (See Index) PROCEDURES, MANEUVERS, ENDORSEMENTS 6,1(4#7 	AIRCRAFT CATEGORY AND 
TO 	N, LoG,o 	AIRPLANE SINGLE ENGINE 	AIRPLANE MULTIENGINE LAND 	17*P , # 
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AMT. FORWARD 	CA574, 	4' 	,z94-6; 	023 	'? 
TOTAL TO DATE 	V 61, 	10,79'79 
. CLA S. 	 CONDITIONS Of FLIGHT 	TYPE OF PILOTING TIME 	T DUI Of 
R digY 	AS FLIGHT 	Can 	DM 	NIGHT 	ACTUAL INSTRUMENT 	AIRCRAFT (HOODED) 	LINK DR FLIGHT SIMULATOR 	.it.9e- &MK TWO 	PILOT IN COMMAND (I ncl. Solo) 	SECOND IN COMMAND 
19 	/ 	_9 	/ 	9 
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13 	11 	3 
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/ 	I 	/ 	6 
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A 8 	7 	07, 	F 	0 	o 	a r 	? 
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DATE 19.-e : 	AIRCRAFT MAKE AND MODEL 	AIRCRAFT IDENTIFICATION MARK 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS, (See Index) PROCEDURES, MANEUVERS, ENDORSEMEN TS IVI417 7.II, 	AIRCRAFT CATEGORY AND 
FROM . 	TO 	No. LDG 	AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTIENGINE LAND 
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7-2-0 	HS/2-6". 	/y/ashii 	/-Rat- —,•Pz 	(_._ - 	I 	I 
i--45-/s-0(/2s--t-tr6 	It--7/3,7.- ogz- 	-P/az- 	i 	/ 
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AMT. FORWARD 
.. .- _ 	TOTAL TO DATE 	Ci5b 	ib-;79/29 
CLA S. 121#1,4T 
IANSSTArOTR 	COUNTRY 
i 
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1,3 
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9TE 	 AIRCRAFTor.E°KE I 	I D E (ITRARGATErl ON MARK 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS, (See Index) PROCEDURES, MANEUVERS, ENDORSEMENTS iV/444( • 	AIRCRAFT CATEGORY AND 
FROM . 	TO 	No LDG 	AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTIENGINE LAND 	, 	. 
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I certify PI LOT'S 	that the statements SIGNATURE 	de y me this form are true, / .xr 	PAGE TOTAL' 	• 	•t4 ( 
AMT. FORWARD 	6/67,0 	(p 	,A9.(6; 	1....3 
TOTAL TO DATE 	(166 	10-;79')9 
DATE I99.,  	AIRCRAFT MAKE AND MODEL 	AIRCRAFT , IDENTIFICATION MARK 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS, (See Index) PROCEDURES, MANEUVERS, ENDORSEMENTS ',II(PI` i.mt, 	AtRCRAFT CATEGORY AND 
FROM 	TO 	NO LDG. 	AIRPLANE SINGLLEANTGINE 	AIRPLANE  MUL1LIAENNDGINE 	 
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I certify that the statements PILOT'S SIGNATURE 	orm are true, _ 	PAGE TOTAL
AMT. FORWARD 	14-5-& 	.A97 	•--3 
..- 	TOTAL TO DATE 	71,5-6-' 	30/A 	I 
CLASS. ROTORCRAFT ' HELICOPTER 
AS FLIGHT INSTRUCTOR 	CROSS COUNTRY 
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YEAR 	AIRCRAFT MAKE and MODEL 	AIRCRAFT IDENTIFICATION NUMBER 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS PROCEDURES, MANEUVERS, ENDORSEMENTS it /10/140$4 	'S I rl APR. 	,0 LOG 	AIRCRAFT CATEGORY and CLASSIFICATION 
AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
DATE 
FROM 	TO 
40 	iirkil'it 	ereZ3 	e/ 
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I certify that the malts : i el 	. de by me an this farm are true. s 	PAGE TOTAL AMOUNT FORWARD TOTAL TO DATE 
PILOTS SIGN ' 
F 
q-
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AG FLIGHT 
INSTRUCTOR 
CROSS-
COUNTRY 
3-7 
YEAR ,-./)and 	AIRCRAFT MAKE MODEL 	AIRCRAFT IDENTIFICATION NUMBER 	1 POINTS OF DEPARTURE & ARRIVAL 	REMARKS PROCEDURES, MANEUVERS, ENDORSEMENTS 	Na INSTR. APPR. 	NO. LDG 	AIRCRAFT CATEGORY and CLASSIFICATION 
DATE 	AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 	*77 P 
FROM 	TO 
1111 	46-- 	-----Tczq 
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I certify that the statements made by 	form are true. 	PAGE TOTAL AMOUNT FORWARD TOTAL TO DATE 
PILOT'S SIGNATURE 	I 
• 
AS FLIGHT INSTRUCTOR 	CROSS- CON COUNTRY DAY i IQ 
XLTI°GROCAt =it 
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DATE 
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AIRCRAFT MAKE 
and MODEL 
AIRCRAFT 
IDENTIFICATION 
NUMBER 
410 
POINTS OF DEPARTURE & ARRIVAL 
FROM 
Pe-r 
'74 
CAM 
f-Kic 
therr  
-<51-
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certify that the statements made Nj o thIs arm are true. 
PILOTS SIGNATURE 
TO 
7-en 
--II 74 
Pstegg—
Col# 
-1'473 
PO-f-
-1-66 
5At/ 
Pi3_1; 
NO. NO AIRCRAFT CATEGORY and CLASSIFICATION 
INSTR. LOG 
APPR. 
AIRPLANE 
SINGLE ENGINE 
LAND 
AIRPLANE 
MULTI-ENGINE 
LAND 
7 
,4 
3 
s-
7 
AS FLIGHT 
INSTRUCTOR 
CROSS-
COUNTRY 111 
_ 
‘-12 
(A_7' 
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a- sz  
REMARKS 
PROCEDURES, MANEUVERS, ENDORSEMENTS 
(46i 
PAGE TOTAL 
AMOUNT FORWARD • 
TOTAL TO DATE 
ti 
TO 
TEAR 
DATE 
AIRCRAFT MARE 
and MODEL 
AIRCRAFT POINTS OF DEPARTURE & ARRIVAL 
IDENTIFICATION ' 
NUMBER 
FROM 
I certify that the statements made by me an this harm are true. 
PILOTS SIGNATURE 
REMARKS 
PROCEDURES, MANEUVERS, ENDORSEMENTS 
PAGE TOTAL 
AMOUNT FORWARD 
TOTAL TO DATE 
NO. INSTR, APR. 	CO.AIRCRAFT LOG 	CATEGORY and CLASSIFICATION 
AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
_ 
— 
— 	— 
HOTORDRAFT 
HELICOPTER 
YEAR 11 	AIRCRAFT MAKE and MODEL 	AIRCRAFT IDENTIFICATION 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS NO- PROCEDURES, MANEUVERS, ENDORSEMENTS INSTR APPR 	NO. LOG 	AIRCRAFT CATEGORY and CLASSIFICATION 
AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
DATE 
FROM 	TO 
1/30 	10613 	s- pp 	P 8 1 ,- Lci. 	_ Pm ap 	-s.EF 1A/P 4r), ,, 1? i--e 	1 	,),. ...41,0 	.,/,7i,--i 
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I certify that t e at en made by me on this term are true. 	1 PAGE TOTAL 1 AMOUNT FORWARD TOTAL TO DATE 
PILOT'S A 
AS FLIGHT INSTRUCTOR 	CROSS-COUNTRY .i 
ROTORCRAFT HELICOPTER 
o 	7 
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YEAR 9?  	AIRCRAFT MAKE and MODEL 	AIRCRAFT IDENTIFICATION RIMIER 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS PROCEDURES, MANEUVERS, ENDORSEMENTS 	NO, INSTR, 	NO LDS 	AIRCRAFT CATEGORY and CLASSIFICATION 
AIRPLANE SINGLE ENGINE LANE 	AIRPLANE MULTI-ENGINE LAND 
DATE 
FROM 	TO 
...g? 2 141z 	57)0,j—ft 	pm in 	pigi.f> 	c, z?, h.,/ i. 	ANZTV7.04 
1 i I D Z 0 6 L3 	5-041-4 	Pm p11 	44 / 	A-rib 4 157 1 ...r Vrei'Yi: 	0/ 	1-0 	A 	jef„ 	11:14 	e x  
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I certify that the statements re by o "s fikini are true.  	m i' *1--- l'Iti LA1491 A PACE TOTAL AMOUNT FORWARD TOTAL TO DATE 
RIOT'S SIGNA E 
AS FUGHT INSTRUCTOR 	CROSS- 1 COUNTRY —I 
HOTORCRAFT HELICOPTER 
I 	I 
D 	7 
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332
YEAR ' C21 	AIRCRAFT MAKE and MODEL 	AIRCRAFT IDENTIFICATION NUMBER 	POINTS OF DEPARTURE & ARRIVAL 	REMARKS PROCEDURES, MANEUVERS, ENDORSEMENTS 14 /4 	ND kNSTR. APPR. 	NO. LDG 	AIRCRAFT CATEGORY and CLASSIFICATION 
AIRPLANE SINGLE ENGINE LANE 	AIRPLANE MULTI-ENGINE LAND  
DATE 
FROM 	TO 
VI° 	a() 16 L3 	AISMS-11- 	PM 4)- bet:WE-Air- 	AT1,27;14-- 	Pfrt p ( ) 	"7 
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la 	21),6 0 	500Th 
L2,3 	a( 01-3 	Az:DTA 	Pal- -tA,A1-- 	Pa--r 
102A( 	(9-0(0 L3 	5-6nsa 	017P - 6vP156, 	u - P7iP 
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'.-1.0 	.04063 	50,5-P 	Pmr- 6-0 	11- veo- Pm? 
20‘3 	gzo-/ci. 	Pin Pilt- /2/ —F--N- Per-240 
. certify that the sNtementn made by me thL fa re N. 	PAGE TOTAL AMOUNT FORWARD TOTAL TO DATE 
PILO SI A ORE / 
AS FLIGHT INSTRUCTOR 	CROSS- I COMIIIIY _ I 
TronF7IELI 
t 	q 	oci 
) 	3, 	07 
2, 	I 	0 	Z 
i 	11 	0 	7-
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9 	a 
34 
a 	ec, 	cR 
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02- 	5' 	0Z 	3 
3 	/ 	cR7 
2(0 	0 
olik 	7 	707 	3 
33 	a 	4 
•"1_, 
2,0 ig 
lO LS 
AIRCRAFT MAKE 
and MODEL 
&,4 
ciV 
to, 
2061, 
0643 AAi:? Aw -L 
/.s 
I certify that tit sz/ tat me ma r on Misfit= are true. 
c  
PIL3rSG ATURE 
AIRCRAFT 
IDENTIFICATION 
NUMBER 
POINTS OF DEPARTURE & ARRIVAL 
REMARKS 
PROCEDURES, MANEUVERS, ENDORSEMENTS 
A 10 et  Z.-01 - Par- 0( - — J-11-x• - E.Ar4 
id 1'0 q eN1)-- P81- t /14:431111, ACYiew /4-11 
•72P11 
P 
PA/7-19,01- A-FAL,..1/7 4 y /1 Al V 
_il.rtx itorviir le) 03 
Ciac%, 
PAGE TOTAL 
AMOUNT FORWARD 
TOTAL TO DATE 
NO INSTR 	N° AIRCRAFT CATEGORY and CLASSIFICATION LOG 
APPS. 	AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI ENGINE LAND 
r, 34.-11.: 4.19 q,ice 	Y 
JO 6- 1 ;PP* 	gd  ;ell:. ) 
.,E.'01. 	61 
.01-1 ecionel-- 	.3-4, 	tri/74L4 	.4X405 
arta.Ai 	J A' 1 l'4,4-.... 	Ute.r'fFZ-16' 
IF-- 21-ecAN 	30 
aro 	7.- i..to,r9A 240r.. I-- 43 t t Ce3IstAtt:51 
f,fte,ys P-Ir 	,&.-. 110 itAs.00 telkx is 5,70 itP,Dfisi TO li;-0 akt 0 
latr • 	Lit lin. 12,2!Li a..J bri STP-4tAtAill 1S0.-1 0....•-p TC) CrZetil 
A.  	,01- , efv5 	•CiS k)L106..0511-A7c 	Gct SLoe-01 2_sscs 	6% lir'jZ< 1 14 f1 
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ROTORGRAFT 
HELICOPTER 
AS FIJGHT 
INSTRUCTOR 
CROSS-
COUNTRY 
)4,0V0 
DATE 
'2 • r' 
73 
3,41-
D5/50 
AIRCRAFT MAKE 
and MODEL 
AIRCRAFT 
IDENTIFICATION 
NUMBER 
POINTS OF DEPARTURE & ARRIVAL 
FROM TO 
REMARKS 
PROCEDURES, MANEUVERS, ENDORSEMENTS 
3_3 rit,-)elp_ 
Ye- - Pi BP v  
DPC 5 4-  
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tiT 37 q nta_  
i, IC 
iL,21.-6L LOL, 
I certify that the statements de Me an this form are true, 
PILOT'S SIG1r)SURE 
PAGE TOTAL 
AMOUNT FORWARD 
• 
TOTA1. TO DATE 
• 
No. INSTR APR. 	NO. LDS 	 AIRCRAFT CATEGORY and CLASSIFICATION 
AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
25EcArk>305- 
C 	i Qz' 
TO -e-7,1•11--r- 	OP-rY740 	i i eytrc. 	Ir. / 
.7e4P.s-W-ce 
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ith 
OY e 	6 	‘47 j 
RCTORCRAFT 
HELICOPTER 
CROSS, 
COUNTRY 
2 
alt• 
401 
AGTONGRAFE 
HELICOPTER 
AS FLIGHT CROSS-
INSTRUCTOR COUNTRY 
3762 
6 
6 
.5-
9 
s-4 
5-
t7t 
1 
7 
5-
4,2 
(71 
.7 
566-
665-
.25'1 , 3 
YEAR 10,35---- 	AIRCRAFT MAKE and MODEL 	AIRCRAFT IDENTIFICATION NUMBER 	POINTS OF DEPARTURE & ARRIVAL 	— — REMARKS PROCEDURES, MANEUVERS, ENDORSEMENTS 	No. INSTR. APRA. 	NO. LOG 	AIRCRAFT CATEGORY and CLASSIFICATION 
DATE 	AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
FROM TO 
rtf.05- 	*I 	(014iii 	Orr- di- - ar 9/7„),Veys—
vile, 	131f67 1 	Atoll* 	a ,tek - 	•. 
/3, 	',4 lip, 	10,3 	11/2/ (sr.- mz__ 
69o-71mo/0J 	277--- 	siy f1-6215a- 	-ad' -37(-
13 	0((07 	' l'r 	ST7 — 	Lt —iefi 
.i/ 	1-).y67 	-i.M5( 	671-- 	N&---&94, 	'115r1; ..9- A. od ---,, 
0 	,9312, fa 	if 
ilZg62 	Airi94ite 	sir 	AN-	, 
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( 	`‘'",::,,,I.'t C) "1°3 0 2—SZIM e-r41 	1)73 t'6i5 L.414L. 
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E certify that It st 	men made by me an this term are true, dco ,,o(o -1 0-RC. vx- FIE 	2. e 0 6747 AR" PAGE TOTAL i AMOUNT FORWARD •,47,A.f 19 TOTAL TO DAM 
PILOT' TU tovit-eivilb 	. 
kefS7 44 
5'.0.?7 
2417 
YEAR AIRCRAFT MAKE 
and MEL 
AIRCRAFT 
IDENTIFICATION 
NUMBER 
POINTS OF DEPARTURE & ARRIVAL REMARKS 
PROCEDURES, MANEUVERS, ENDORSEMENTS 
FROM 
TO 
&( 
L 9-ArAily 8196Z  
igea 09d-rrey Sieksa, 
605 61/-6/25/ey s 26 g ,A;1-1400-L (5,1074,06—) 
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DATE  
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-146 (Ltice 4/32_ 
I certify that th e by rne on thiuflorm are true. 
PILOTS SI 
ViSos V,S. Si 27  
PAGE TOTAL 
AMOUNT FORWARD 
• 
TOTAL TO OATE 
NO Al 
CRAFT CATEGORY an 
APPR. a. a. 2 	up., I ( 	- ---
AIRPLANE SINGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
, 
, 
4,5 	P 
... 
• 	.. 	 
AS FLIGHT, CROSS-
INSTRUCTOR COUNTRY 
ROTORCRAFT 
HELICOPTER 
2 
2 
! 3 13 
0 5 9 97 251 
,nd 
YEAR - DATE 	AIRCRAFT MAKE and MODEL 	AIRCRAFT IDENTIFICATION NEMER 	POINTS OF DEPARTURE & ARRIVAL ' 	REMARKS PROCEDURES, MANEUVERS, ENDORSEMENTS 	NO INSTR APR 	NO LEG 	AIRCRAFT CATEGORY and CLASSIFICATION 
AIRPLANE siNGLE ENGINE LAND 	AIRPLANE MULTI-ENGINE LAND 
FROM 	TO 
I certify that the statements made by me on this term are true. 	PAGE TOTAL AMOUNT FORWARD TOTAL TO DATE 
PLOTS SIGNATURE 
ROTORGRAFT 
HELICOPTER 
AS FLIGHT 
INSTRUCTOR 
CROSS-
COUNTRY