Nyc Box 2 Aa 11 Dot-faa Docs Fdr- Faa Personnel Statement- William Smith- New York- Cpc- 36r 464

ZBW-ARTCC-148

AAL11

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

at

nnl— II (aircraft identification)

/VC-4J / 3 / K

}

Ivj^J

it/fr^

,. on ,,,, , 9// .„ 16i

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

My name is

/Co///'ft/it

O/fr//yi

- - ,^

(month, day, year and time)

- I am employed as an

L Ptl )

(name and operating initials in parenthesis) ~\.

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

I was working the

UTC.

UTC to

position from (time)

(sector and position)

(time)

Text of statement:

+.

I £

4W

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

_ . (signature and date)

ZBW Form 7210-45 (Revised 8/98)

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