Nyc Box 2 Aa 11 Dot-faa Docs Fdr- Faa Personnel Statement- John Schippani New York- Operational Supervisor- Osic 465

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PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON ARTCC This statement concerns the accident/incident involving

r\f\\— "\ \__

at

(aircraft identification)

KUtO V^ftK

NiV _

, on C{\\\\0\>

(write out location identifier before using the three letter identifier)

My name is

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^ Jf t/sf&Qfl/

/

( 3 A J_

(name and operating initials in parenthesis)

n*J y
> \_

Text of statement:

. I am employed as an

/

by the FAA at the Boston ARTCC, Nashua, NH.

position from /£/

(sector and position)

UTC.

(month, day, year and time)

UTC to I 3>5^7 UTC. (time)

(time)

/ '

ti certify, to the best of my knowledge and recollection, the above statement is correct

(signature and date)

ZBW Form 7210-45 (Revised 8/98)

Page 1

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