Av Hazard Form

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If you have encountered an aviation situation you deem hazardous, please describe it below, then submit this form.
Please include type of license, ratings held and aircraft operated. Your name, e-mail and telephone number are optional
but useful should our editors need further details.

The following are required fields...

Full Name:
License (highest held):	None Private/Recreational Commercial ATP
Ratings and Certificates (all that apply):	Instrument CFI/CFII Helo A&P
Types rating held:
I currently fly:
Total time (hours):

To help us determine if the responsible agencies are aware of the hazard, please check the appropiate boxes below.

This Av Hazard was also reported to:	Local ATC Local FSDO NASA ASRS Own Company Military
	Other
Copies may be sent to the above	with without
E-mail:
Telephone number:
Message