Nyc Box 2 Aa 11 Dot-faa Docs Fdr- Faa Personnel Statement- Stephen Schmalz- Cpc- 21r 474

ZBW-ARTCC-148 AAL 1 1

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

/7 / / L- 1J.

at

(aircraft identification)

, A'/

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

.on T/ff/tl // (month, day, year and time)

UTC.

. I am employed as an

My name is ^V^/^en f. Sc^L^al^ (name and operating initials in parenthesis)

by the FAA at the Boston ARTCC, Nashua, NH. (occupation)

I was working the

position from

UTC to fill (time)

(sector and position)

UTC.

(time)

Text of statement:

a it

*•£/;» tit *

tut

,"fu^. T t

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)

7

7

Page 1

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

fat.

0?£ serfr ping /

ZBW Form 7210-45 (Revised 8/98)

Gr&hi'

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