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Bird Strike Reporting Form

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					                                                BIRD STRIKE REPORTING FORM

Send to:      kaiafso@isaf-kia.nato.int

Operator                                                        Effect on Flight
Aircraft Make/Model                                                                none              penetration of airframe
Engine Make/Model                                                    aborted take-off                        vision obscured
Aircraft Registration                                         precautionary landing                      engines shout down
Date        day             month               year                  forced landing                        engine ingestion
Local Time                                                                          fire          engine uncontained failure
       dawn         day             dusk          night     penetration of windshield                         other (specify)
Aerodrome Name                                                  Sky Condition                     Precipitation
Location if En Route                                                        no cloud                                       fog
Height AGL                                 ft                            some cloud                                       rain
Speed (IAS)                                kt                               overcast                                      snow
Phase of Flight                                                 Damage (aircraft)                 Injury (index of)
           parked                     en route                             destroyed                                      fatal
               taxi                    descent                            substantial                                   serious
       take-off run                  approach                                   minor                                    minor
              climb                landing roll                                    none                                   none
Part(s) of Aircraft                                                       unoknown                                    unoknown
                                    Struck        Damaged       Bird Species
                       radome                                   Confirmed Bird Species
                   windshield                                   Number of Birds
    nose (excluding above)                                                                 Seen             Struck
                  engine no. 1                                                        1
                              2                                                    2-10
                              3                                                 11-100
                              4                                                  more
                      propeller                                 Size of Birds
                   wing/rotor                                                    small
                      fuselage                                                 medium
               landing gear                                                      large
                            tail                                Pilot Warned of Birds
                          lights                                                    yes                no
           Pilot/static head                                    Remarks (describe damage, injuries and other pertient
                       antenna                                  information)

                      tail rotor
   helicopter transmission
              other (specify)

Reported by                                                           Report Number:


                  THIS INFORMATION IS REQUIRED FOR AVIATION SAFETY

				
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posted:4/20/2010
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