C42 SERIES Pilot Operating Handbook
24.3 Service Problem Report Form -Aircraft
Aircraft Type: ___________________ Serial No. ___________________
Year of Manufacture: _____________ Engine type: _________________
Manufacturer: _______________________________________________
Owner: ____________________________________________________
Airframe: ___________________________________
Total Flight Hours until Defect: __________________
Engine: ____________________________________
Airframe: ___________________________________
Total Flight Hours (Pilot) on Aircraft: _____________
Description of damage: ________________________________________
__________________________________________________________
__________________________________________________________
Damage Report: _____________________________________________
__________________________________________________________
__________________________________________________________
POH Issue 4 Rev. 5
Name: __________________________
Date: ___________________________
Signature: _______________________
Appendix
Page 83 of 91
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