AFI91-206(I) 8 JULY 2004
23
Attachment 4
SAMPLE MESSAGE NOTIFICATION OF POSSIBLE NTSB OR FAA INVOLVEMENT IN A
MILITARY AIRCRAFT MISHAP
FROM: (Applicable military safety center)
TO: NTSB WASHIINGTON DC//AS//
FAA WASHINGTON DC
INFO: (as appropriate)
SUBJECT: Military Aircraft Mishap Involving an FAA Function
1. (Date and time (Z) of the mishap).
2. (Location of accident scene using NM distance and direction from nearest military base or prominent
location or lat/long coordinates).
3. (Aircraft type, model, and serial number).
4. (Unit to which aircraft was assigned at time of mishap).
5. (Last departure base of aircraft).
6. (Specify type of air traffic control clearance).
7. (Aircraft destination).
8. (Last known aircraft position in flight and last known radio contact).
9. (Security classification of mishap).
10. (State if any hazardous materials were onboard the aircraft or none).
11. (Description of mishap).
12. (Identify FAA functions possibly involved).
13. (NTSB or FAA) participation in the mishap investigation (is) (is not) requested.
14. (State if other military investigations are or will be conducted).
15. (Provide POC to be contacted for further information).
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