Aviation Event Reporting Questionnaire

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Fatality (during the operation, or within 30 days) Serious injury — §830.2 definition (hospital >48h, fracture, severe laceration, internal organ injury, 2nd/3rd-degree burns >5%) Substantial damage to the aircraft (§830.2 definition; excludes engine, prop tip, gear, fairing, dents) Damage to property other than the aircraft > $25,000 Aircraft is overdue and believed to have been involved in an accident

Flight control system malfunction or failure Crew member unable to perform duties from in-flight injury or illness Turbine engine structural component failure (excluding compressor / turbine blades) In-flight fire Aircraft collision in flight Large multi-engine: pressurization failure, evacuation, runway departure, >50% display loss in IMC, ACAS RA conflict PIC declared an emergency under §91.3 — exercised emergency authority

Bird or wildlife strike (any contact, even minor) Laser illumination from the ground GPS interference / jamming / spoofing affected the operation Hazardous materials / dangerous-goods incident Security incident — unauthorized airspace, suspicious passenger / pax, bomb threat, hijack Suspected Unapproved Part (SUP) — counterfeit, undocumented, or improperly modified part ATC deviation — pilot deviation report (PDR) likely (altitude bust, runway incursion, lost comm to ATC) Near miss / loss of separation between aircraft

Aircraft / engine / part failure or malfunction discovered (regardless of damage) — Part 121/135/145 op? Maintenance discrepancy — needs squawk + maintenance entry on this tail before next flight In-flight engine shutdown (precautionary or actual)

Pilot experienced a medical event (incapacitation, hospitalization, new diagnosis, new medication of concern) §61.15 — alcohol / drug-related motor-vehicle action (DUI conviction, license suspension, refusal of test)

Part 91 personal / instructional Part 141 / 61 flight school operation (instructional or rental) Part 135 commuter / on-demand Part 121 air carrier Rented aircraft (FBO / club) Owned aircraft (insurance carrier in play)