Title Page

  • Type of Report

  • Subject

  • Conducted on

  • Lead investigator

  • Prepared by

  • Address
  • Document No.

1.General Information

General information

  • Airline :

  • Aircraft Type And Registration :

  • Configuration :

  • Local Date And Time of Event :

  • STA:

  • STD :

  • Location / Parking Bay :

  • Type of Flight

  • Route :

  • Passengers Onboard :

  • Crew Onboard :

2.Investigation Objective

  • The sole objective of this investigation is to prevent aircraft accidents , incidents and injuries to people . it isnot the purpose of this activity to apportion blame or liability

3.Factual Information

3.1 What Happened ?

  • Detailed description of situation

3.2 Staff Involved :

  • Name/s and Personal Number/s

3.3 Injuries to Person :

  • Injuries to Person ? If yes . describe the injuries and write details of injured person

  • Name and Peraonal Number of Injured Person

  • Describe the Injuries

  • Photos of Injuries ?

  • Action Taken

3.4 Damage to Aircraft :

  • Damage to Aircraft ? If yes , describe the damage

  • Describe the damage

  • Photos of Damage

  • Action Taken

3.5 Ground Support Equipment Involved :

  • Type of Equipment

  • Equipment Number

  • Age of Equipment

  • Manufacturing Company

  • Last Overhaul

3.6 Damage to Equipment :

  • Any Damage ? If yes , describe the damage

  • Describe equipment damage

  • Photos of Damage

  • Action Taken

3.7 Additional Information :

  • Write below any other related information

  • Attach Any other related photos

4.Analysis and Root Casues

4.1 Analysis :

  • Write the full anylsis to the mentioned case

  • Media

4.2 Root Causes :

  • Define the root casuses based on the anylsis of the mentioned case

5.Finding

Finding :

  • List all Finding here :

6.Corrective Action

Corrective Action / s :

  • List all corrective action/s taken

7.Preventive Action

Preventive Action :

  • List all preventive action/s taken

8.Observations and Recommendations

Observations and Recommendations :

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