FLIGHT INFORMATION
Origin: Actual Time of
Departure:
Destination: Estimated Time of
Arrival:
Estimated Time En
Route: Flight Altitude:
Dispatcher Name: HAZMAT Onboard:
RECORDS SECURED LOCATION LOCATION
Weight and Balance: Mx Cargo Manifests:
Dispatch Release: Flight Plan:
Flight Load Sheet: Mx Records:
FEDERAL AGENCIES
NOTIFIED
Time Person Contacted Phone Number Follow
Up/Action Required
FAA
NTSB
State Department
American Red Cross
FBI
Department of Health
and Human Services
FEMA
OTHER AGENCIES/CONTRACTORS
NOTIFIED
MLT
Apple
AIG Insurance
AON Insurance
DOD
AIRCRAFT
INFORMATION
Tail Number: Total Seats:
Type/Model: Mx Records Secured
By:
MELs: Tech Pubs Cockpit
Airframe Hours: Recreated By:
Airframe Cycles: Aircraft Damage
Sustained:
CRASH SITE
Coordinates: Distance and Directions from Named Towns:
Nearest Airport:
Accident Weather:
Current Weather:
Time of Incident:
Nearest Champion
Station(s): Fire/Rescue/Ambulance:
Nearest NWA
Station(s): Police:
Agency Contacts: Medical
Examiner/Coroner:
CREW INFORMATION
Name Hours Last Proficiency Check PF or PNF Certificate # Base
First Officer:
Flight Engineer:
J/S #1:
J/S #2:
Name Seat
Occupied
F/A
#1:
F/A
#2:
F/A
#3:
F/A
#4:
F/A J/S #1:
F/A J/S #2:
D/H Pilot #1:
D/H Pilot #2:
D/H Pilot #3:
D/H F/A #1:
D/H F/A #2:
D/H F/A #3:
D/H F/A #4:
PASSENGER
INFORMATION HAZMAT
Total Passengers
Onboard: Onboard?
Number Injured: Common Name:
Ambulatory: Special Requirements:
Non-Ambulatory:
Number Deceased:
Number Non-Injured:
Unknown Condition:
TOTAL (Must = Total
Pax):
GO TEAM
Name Specialty
Estimated Time of Go
Team Departure: Flight Number:
Mode of Transport: Departure Location:
Hotel Name/Phone
Number/Fax Number: