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 / 1 r3 y- ,R- (0. E TOTAL (41, ( ? ., 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 / / / '1 /1 / i / / /( / / .33 33 3, (...3 / 3 13 / 3 / 2 1 7 / 7 ..).o 0 7 5-- / •)--- /' (5--- / 3 y v 61 07 : (f) 0 d g /// O ()ZS" 17/ /3<" (0 t41.9 (.) 3g81. e sYtti I e,o(e, F? 3t?- 30 (11 _ ,qo i r F ---1--1 3 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 , # .-- /1)/3-7— '1 r 9 4 1 / 1 1 1 - 0;2 rc.-- • 3¶
- Pia,/ - 7 42619 f 6.7 , 4, 4 c..‘ "ti el p 47W ik P 34 t , i ,3
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DAY
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,
Sr ATIZAVADITII" IDENTIFICATION MARK POINTS OF DEPARTURE & ARRIVAL REMARKS (Sea Index) , PROCEDURES, MANEUVERS, ENDORSEMENTS Aill# 7 " • LNA. AIRCRAFT CATEGORY AND
FROM • ... TO SINGLE ENGINE LAND MErELIAll 14IEN E LAND -np ! 4 l
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I certify PILOT'S that the statements de me this form are true, SIGNATURE PAGE TOTAL At
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
/ / / I / i
/ 1 1 / / /
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.33 33 3.3
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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
.7- kr /15-/z.5"- 4/4?5, 4,4d(ii-i-?? --' /7-133- i 9
7-2-0 HS/2-6". /y/ashii /-Rat- —,•Pz (._ - I I
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SIGNATUk. ,ent7d y me his fr om are true, PAGE TOTAL CU ?
AMT. FORWARD
.. .- _ TOTAL TO DATE Ci5b ib-;79/29
CLA S. 121#1,4T
IANSSTArOTR COUNTRY
i
/ /
• 33
1,3
"3
/ 7
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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 , .
-Y /8/7-5 — -- t 0
2D /--/5/2-6-- /y/2,S7/5 Pat- -cv2 (- - 1 1
2s/7/6 pe5t- 0)2.1,.... -pal- 1 1
73 ,,612,s //7/"-s--/I a-4r - I 0'2
— 7-C:.• .3
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, /77/3,F- - -7----Y3 • Jc--- ..10/3 --- 7
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---s<7",47-- — /1.7=7--a / 7
...,,, ,.. / 1-( 03 .1 7 e, / 7 /9 C141.7-7L- Rei- C /Vil • / D :35 C)4114-- Cfll It -- 1 /--, , i) , / 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 7 3 -7 / i i ----) / 7 c:- / ,-,---' ( 7 / • ' le p I 30. 3 /.// 0 /377 /9in 01 /1/ D 1Y/ P Hio , -MK 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/ -7 ,--7-p_-:72, i2/C 7 1 -11 -IV c ..-A--23 / ak s- 7 S rreP F A-55 ti/7. 1 9___ fr/vy , v ..,....k . Li‘ -f p ,a,-- ers73 0/ ---/----4, --i--;:c.--/- ( 61 4 P00- 77,57- -7r23 YAP' S4 1" 57/(4-c 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- e9P7 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 --eas' -7-6---6 — 4DM- ...771-D -. i 7 i ea 3 2-1,95; , v('- r ,,,.... , ),--ia-- PO:r -7-66. I . a 5--- -25 i 94i pgl- ---rli 9=7:4 7r73 -arD --raj (,c. 1 .----2 1 703 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 t--7¶
- 3
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IDENTIFICATION
NUMBER
410
POINTS OF DEPARTURE & ARRIVAL
FROM
Pe-r
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CAM
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certify that the statements made Nj o thIs arm are true.
PILOTS SIGNATURE
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NO. NO AIRCRAFT CATEGORY and CLASSIFICATION
INSTR. LOG
APPR.
AIRPLANE
SINGLE ENGINE
LAND
AIRPLANE
MULTI-ENGINE
LAND
7
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3
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7
AS FLIGHT
INSTRUCTOR
CROSS-
COUNTRY 111
_
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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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1 /
0 ci 01,
I I 0 1
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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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. 13 ,,,.20 L3 5b03--A PM P - toitite- iPorP(Q - iv, r s 6t trre—fk4,:i. - ) ,Ifi of c 44,
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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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'iL 0 L
CP i D
_ 13 i I
/ 0
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1 3 5.0i-0
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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
)02b3"-A- Fa I - LA it 11 —P8 / PleeP DEE -....5)6,1k-7-0)Z L7- oil ,e/ CF..) Pimp H.e A Li- plecs
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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
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AIRCRAFT MAKE
and MODEL
&,4
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to,
2061,
0643 AAi:? Aw -L
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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
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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
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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
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eatte.4-fs LOtpL NriAPH Pill P.' P13 - 1,10 - 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 Dpc. RD-cope- -ro-o 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- , ,i...L6kji -71 -To b k # 67 i r If Kerri- 61,-T- yeJi ,I, " S T-7- Ser givis zif -ID b Dqty tr i r Mi--7"-- ZOCI+1- — Li5J , ( `‘'",::,,,I.'t C) "1°3 0 2—SZIM e-r41 1)73 t'6i5 L.414L. ?Al etAtetet Q'-'ef 3 6 z,,,s-fr, 7 4 c.rkt Fria EA -5, c-a c_?-P... g—r,,, - 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—) / /1 ,a667_cfateri2.5,1, sne /A41,61,1 , 021;5 c1662 chid/ 5147i*ho BE& (foil 77ui9- 0609 ,//zOicu DATE ghler/8005 a 0 u/W070/0 41e0/4 ciii9e47 4,47S Sip/t c51441- At TAW px- '.576 AtT.gAJC. s7b01-- AMtif ,5 74 c,(6k A1722,t fc-MY S y -re-tt CA) (VOR eLAtIr) 110vCif tie) (,%14- iew LI) -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