Nyc Box 2 Aa 11 Dot-faa Docs Fdr- Faa Personnel Statement- Myron Smith- Operations Supervisor- 39ra 477

ZBWARTCC148

PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON ARTCC

AAL1T

ML??

This statement concerns the accident/incident involving

at

(aircraft identification)

fo

, on

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

My name is

/*lyn.o*)

?/"/<>/

ML

UTC.

(month, day•, year and time)

-t?

->,.

. I am employed as an

(name and operating initials in parenthesis)

D Pf/Wfto *JS

I was working the

S^/* c^/g \//S ?/t- _ (occupation) X/?-3 J_ (sector and position)

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

positionfrom// ^^ (time)

UTC to /3 °* (time)

Text of statement:

^

fir

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

_ //

(signature and date)

ZBW Form 7210-45 (Revised 8/98)

Pa9e 1

UTC.

PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON ARTCC Text of statement continuation: 7"

ZBW Form 7210-45 (Revised 8/98)

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