Pilot Profile

PILOT PROFILE

a. Full name______

b. Age______

c. Residence Address and Phone______

d. Business Address and phone #______

e. Ratings______When Recieved______

______

f. Recent number of hours in type______

g. Total number of hours in type______

h. Currency in ratings-Dates______

______

i. Recent medical history.______

______

j. Personal or business problems______

______

k. Medical restrictions______

l. Drinker/Non-Drinker______Smoker/Non-Smoker______

m. Police record______What offence______

n. Suicide history______

o. Accident or Incident history.______

p. Closest friends name/address/phone

q. Previous occurrence of being overdue.______Why?______

______

r. ______

s. ______

t. ______

FLIGHT INFORMATION PAGE 1 OF 2

a. Enroute weather at time of flight.______

______

______

b. Did pilot obtain current weather briefing and from who.______

______

c. Flight Plan.______IFR/VFR______

d. Intended route of flight.______

______

______

e. Initial cruise altitude.______

f. Total fuel onboard. Gallons______Hours Duration______

g. Destination airport and weather at destination.______

______

______

h. Position reports made. Where______

When______

i. Were all enroute navigational stations operable. NOTAMS______

______

j. Any Pireps reported by other aircraft.______

______

k. Did pilot request transponder radar following.______

l. Alternate airports on flight plan or reported.______

______

m. How much fuel taken at fuel stops.______When______

Where ______

FLIGHT INFORMATION PAGE 2 OF 2

n. Time actually departed from every airport

Airport______Time______

Airport______Time______

o. Airports within 25 miles of enroute flight.______

______

______

p. What was the purpose of the flight.______

______

q. What cargo was loaded on board.______

______

Estimated weight______Weight/Balance done______

r. Was the aircraft going to or returning from the trip.______

s. Was the pilot observed making a pre-flight inspection of the aircraft

______

t. Were the pilot/passengers seen leaving the flight ramp.______

Time______By whom seen______

u. Did the pilot/passengers plan to eat and/or drink enroute.______

Where______

v. Did pilot or passengers use a taxi or rental car at the destination.

Company______Phone #______

w. Did the pilot or passengers get picked up at destination.______

Who______Color car______License#______

x. Were the same passengers on the return trip.______

z. Was there anything unusual taken on the trip that was not consistent

with the intended purpose of the flight.______

PASSENGER PROFILE

a. Full name/address/phone #s

______

______

______

b. Any known passenger medical problems______

______

c. Are any known passengers rated pilots.______What ratings______

______

d. If passenger is a pilot are they current with their ratings.______

e. Passenger personnel/business problems.______

______

f. Passenger suicide history.______

______

g. Passengers drinker/non-drinker.______

h. Accident/Incident history.______

______

i. Passenger police record.______What offense.______

______

k. Passengers closest friends names/address/phone.

______

______

l. Any property interests.______

m. Passengers flown recently with this pilot.______Where______

______

AIRCRAFT INFORMATION

a. Aircraft "N" number.______Make______Model______

b. Predominant color.______Trim color______

c. Fuel capacity. Standard______Auxiliary______

d. Engine & size.______

e. Fuel burn/GPH______

f. Navaids installed. VOR,s #______type(s)______

Directional Gyro______Compass______Turn/Bank______

Altimeter______Airspeed Indicator______Rate/Climb______

Radios._____Type(s)______

Loran____Type______GPS___Type______

Glide Scope._____Type______ADF____Type______

Weather Radar____Type______Transponder___Mode C______

g. Are all these instruments known to be working.______

h. Any aircraft modifications.______

______

i. Normal Cruise speed______A/C Cruise Speed______

j. Range in miles______Range/Hours______

k. Altitude Ceiling.______Iceing Equipment______

l. Oxygen______# units______hours usage______

m. Any recent/old accidents and who repaired.______

______

n. Last annual______By______Last Oil change______

o. Discrepancies from annual______

______

p. Maximum useful load______General condition______

r. Survival equipment______Artic______Desert______