VOLUNTARY OCCURRENCE REPORTING SYSTEM

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CIVIL AVIATION OF SIERRA LEONE

KINDLY FILL THE REPORTING FORM BELOW;

General Information

From: Full Name

Organization

Email address

Telephone/Mobile

Mailing address

Aircraft

Name

Registration

Nationality

Manufacturer

Model/Type

Owner

Name or organization

Email address

Phone number

Operator

Name or organization

Email address

Phone number

Pilot-in-command

Name or organization

Email address

Phone number

Flight Details

Flight number

Departure date

Departure time

Departure (Location)

Intended destination

Actual destination

Occurrence Details - General

Incident Type (Specify) (Required)

Occurrence date

Occurrence time

Occurrence location

Flight Phase (Specify)

Effect on Flight (Specify)

Occurrence Details - Meteorological conditions at time of incident

Day

Dusk

Dawn

Night

Visibility

Ceiling (feet)

Temperature (⁰C)

Wind (Dir./Speed)

Precipitation

Occurrence Details - Aerodrome conditions at time of incident

Aerodrome Surface Conditions (Specify)

Contamination Type (Specify)

Emergency Response Services (Specify)

Occurrence Details - Aerodrome occurrence

Occurrence at Aerodrome (Specify)

Dangerous Goods (Specify)

Occurrence Details - Location of incident (designator)

Incident Location at Aerodrome

Persons on board

Total Number

Flight Crew Number

Cabin Crew Number

Passengers Number

Injuries/Casualties

Flight Crew

Cabin Crew

Passengers

Persons not on board (if any)

Number of Other Casualties

Condition of Other Casualties

How were they affected?

Dangerous goods on board or released from aircraft?

Yes

Damage to aircraft, environment or property?

Yes

Occurrence summary / Description of events

Post occurrence actions / Maintenance

Do you believe this report requires immediate attention by an Aircraft Accident Investigator?

Yes

Message

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This form will be submitted to: occurrence@sl-aaiib.com
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