Nyc Box 2 Aa 11 Dot-faa Docs Fdr- Faa Personnel Statement- Ronald Regan- Tmo- Watch Desk- New York Tracon480

PERSONNEL STATEMENT FEDERAL AVIATION ADMTH1STRATION NEW YORK TRACON 1515 Stewart Ave.. Westbury.NY 11590 BACKGROUND' Much of the information concerning the circumstances of this accident/incident can be retrieved via recorded daia sources. However, some of the facts concerning what you sew and what you did may not have been completely captured. The purpose of this statement is to provide any facts within your personal knowledge that you believe will provide a more complete understanding of the circumstances surrounding this accident/incident. Therefore, speculations, hearsay, opinions, conclusions, and/or other extraneous data arc not to be included in this statement. This statement may be released to the public through FOlA or litigation activities including pretrial discover)', depositions, and actual court testimony.. INSTRUCTIONS: This statement is to be printed and signed by you and your signature below certifies ixs accuracy. It will neither be edited nor typed and. once signed, will constitute your original statement. This statement concerns the IrrM^ent/Accident involving on

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UTC. My name is f^O^/^L^l> fitl <*Pr(v inanr) as an (ATCS} (5ATCS) by the FA.^ at New York TRACON. 1 was working the. position from

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Complete this section ONLY for accidents: Operational equipment configuration was: Radar Channel: (A) or Beacon Channel: (1) or (2). MTI set at miles. Polarization in use: (LP) or (CP\o Map in use: (1

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Interview Statement Tbs iafonnaaon pivcn by you will become put of ifa= records in iht Privicy Act System, OFM/GOVT-L The FAA's antboriry to oboin the information is comzined in 49 US.C Sccnon 13A*. 49 UJS.C Scoion 1348. and 5 U^.C. Sraion 301. Pruviomg of this information is mandatory. Tbe principal uie of the iafonmwion provided ii to

urad/autf s *ud rcccnunrad ATC imptovcmcnt. Inronaarion provided bs H'^^1""^ xs 2 rooxme nxc in acemd wiih tfae syxam dcsntjpoon of OPM/GOVT-L Uoda this authority, discioium HUT be mad: to union reprcscmarivcs and to tb± NTSB. Failure ID provide tfae inlmmanon lEtjurficd -wDl remit in disciplinary action under FAA

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