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PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON ARTCC

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This statement concerns the accident/incident involving

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

(signatute and date)

ZBW Form 721 0-45 (Revised 8/98)

Page 1

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PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON ARTCC

ZBW ARTCC-148 ML1 1

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PERSONNEL STATEMENT FEDERAL AVIATION ADMINISTRATION BOSTON ARTCC

ZBW-ARTCC-148 AAL1 1

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ZBW Form 7210-45 (Revised 8/98)

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