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Aircraft Crash (supplement)


DECEDENT: _________________________________ CASE#: _____________



INFO SOURCES:  ____ NTSB
  ___ OTHER.   LIST WITNESS AND INVESTIGATOR NAME(S) AND CONTACT INFO:

 




DESCRIBE CRASH SITE, DEGREE OF FRAGMENTATION/DISPERSAL OF AIRCRAFT, & STATE OF REMAINS:






INCIDENT/CRASH WAS WITNESSED:  ____NO  ____YES (BY WHOM, DESCRIBE ACCOUNTS):




DECEDENT WAS: ____PILOT ____CO-PILOT ____STUDENT PILOT ____PASSENGER  ____OTHER: 


IF PILOT: RATING TYPE: __________  YEARS EXPERIENCE: ________  HOURS FLYING TIME: ________
SEATING POSITION/LOCATION IN AIRCRAFT (IF KNOWN):
SAFETY RESTRAINT WORN: ____NO  ____UNDETERMINED   ____YES, TYPE:
WERE OTHER FATALITIES INVOLVED: ____NO ____YES (HOW MANY: ____________________)


TYPE OF AIRCRAFT:  _______________________________________  ìNî NUMBER ON TAIL: ____________
AIRCRAFT OWNED BY: ____________________________________      MAKE ___________________

MODEL ______________  SER# ______________________________ AIRCRAFT#: _____________________ 


AIRCRAFT WAS:  ____LANDING ____TAKING OFF ____CRUISING  ____PARKED  ____OTHER: 


DID THE AIRCRAFT: ____BURN  _____EXPLODE  _____OVERTURN   ____COLLIDE  _____OTHER: 


ANY EVIDENCE OF AIRCRAFT DEFECT OR MALFUNCTION? ____NO  ____YES (EXPLAIN):

DISTANCE OF CRASH FROM NEAREST AIRPORT (IF APPLICABLE):


FLIGHT WAS: ____PRIVATE ____COMMERCIAL ____AGRICULTURAL ____OTHER: 


FLIGHT PLAN FILED? ____NO  ____YES (DESCRIBE): 


IN RADIO CONTACT? ____NO  ____YES (DESCRIBE): 


DISTRESS MESSAGE RECEIVED? ____NO ____YES (DESCRIBE):


IF BODIES WERE THROWN FROM THE AIRCRAFT, BE SURE TO DRAW A DIAGRAM OF THE SCENE ON A SUPPLEMENTAL REPORT INCLUDING POSITIONS OF BODIES AS FOUND. EACH BODY BAG SHOULD BE NUMBERED AND EACH NUMBER SHOULD BE IDENTIFIED ON THE SUPPLEMENTAL REPORT.   BE SURE TO DOCUMENT LOCATION AND COLLECT ANY PERSONAL EFFECTS THAT MAY FACILITATE BODY IDENTIFICATION.  AIRCRAFT PARTS ARE NOT TO BE SENT IN WITH BODY.



NAME OF INVESTIGATOR:  ________________________________________   DATE:  ______________


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