Nyc Box 2 Aa 11 Ua 175 Azzarello Fdr- Faa Personnel Statement- Michael Hilliard- Operations Supervisor- Osc- Boston Atct485

Sep

17

Dl

09/17/2081

O4:55p 17:1(3

I

17B1J

61756'

PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON AIRPORT TRAFFIC CONTROL TOWER ACTION: Complete in accordance with FAA Order 8020.11 , Paragraph 75, Peraormcl Statement. BACKOROUND: Much of the information concerning Ihe circurojtanccs surrounding an accident/incident cnn be retrieved via gome. Type of recorded data source. However, some of the facts concerning whw you Jrw w>d what you did miy not h»v= trcn completely captured. The purpose of thU statement is to provide any E»cis within your personal knowledge that you believe will provide a more complete understanding of the circumstances surrounding this accident/ incident. Therefore, speculations, hearsay, opinion?, conclusions, an<J/or other extraneous data are not to be included in this statement. Additionally, this statement jwty be released to the public through FQIA or Htig»tion activities including discover, deposition, and actual court testimony. INSTRUCTIONS: This State mejlt Is tO be printed, Signed and dated by you, and your signature oelo-w certify lot accuracy of this statement. It will neither be edited nor typed and., once stoned, will COTiStinitt your original statement

This statement concerns the accident/incident involving O/AA— 1 / S> at Boston, MA on \t approxwnately fZj^\. My name is _ I am employed as by the FAA at the Boston ATCT. I was working the position from /Q(S\>

UTC to llt^r UTC.

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

Attachment, Operational Equipment Configuration.

CD

Operational Equipment Configuration is not included.

Signanue and Date

p. H