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Transport Safety Bureau
Air Accident/Incident Notification Form
Date of Occurrence
Date and Time (local time or UTC) of the Accident or Incident
Select Time
Type of Occurrence
Aircraft Type , Model, Manufacturer and Serial Number
Registration Marks and Nationality
Owner
Qualification of the Pilot-In-Command and nationality of crew and passengers
Last point of departure and point of intended landing of the aircraft
Position of the Aircraft Accident/Incident with Reference to some easily defined Geographical point and Latitude and Longitude
Total Number on Board
InjuriesPilotCrewPassengerTotal on BoardOther
Fatal
Serious
Minor
None
Total
Description of Occurance
Physical characteristics of the accident or incident area, as well as an indication of access difficulties or special requirements to reach the site
Presence and description of dangerous goods on board the aircraft
Contact Details (Optional)
Name
Contact Number
Company Name
Email
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