Aircraft Safety / Part / Assembly / Incident Feed Back - Sirius Satellite Radio TL-3000 Pilot Operating Handbook

Pilot Operating Handbook
TL-3000 Sirius
Notice! The information contained in this document is for reference and information only.
The pilot is the final and only responsible party for the safe operation of this aircraft.
Aircraft Safety / Part / Assembly Incident Feed Back Form
Aircraft Safety / Part / Assembly Incident Feed Back Form
Report Date:
Aircraft Serial Number:
Aircraft Hours:
Conditions:
(circle )
Detailed Description: (Include conditions in flight. Continue on back if required)
Affected assembly or part name
Dealer Name:
Warranty Claim Filed:
CONTACT INFORMATION
Owner:
Address:
City, State, Zip
Phone / Fax:
Email:
Print Name:
Signature:
TL Form 1001 30 June 10 / © 2010 TL-Ultralight, sro / Reproduction of this document in any part is forbidden.
1 Feb 11, Chg 4
Copyright © 2011
_______
1.
Periodic Inspection
2. Pre-flight Inspection
3. Engine Start
4. Taxi
5. Take off
6. Climb
7. Level Off
8. Cruise
9. Decent
10. Pattern
11. Approach
12. Landing
13. Other
YES - NO
Reproduction of this document or any of its parts is forbidden.
Handling, Service, & Maintenance
Submitted date:
Aircraft N Number:
Aircraft Location:
Notes
Part Number
Contact:
Claim Number:
Section 9
Time in
Total Time
Service
9-18