Cub Crafters CARBON CUB SS CC11-160, Maintenance Manual

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CUB CRAFTERS, INC.
CC11-160 MAINTENANCE MANUAL
Manual number SSC10000AMM
1
Date: 04/18/2013 Page: 5
CONTINUED OPERATIONAL SAFETY REPORTING FORM
NAME (Last, First)
COMPANY/ORGANIZATION
ADDRESS
Number and Street
City AIRCRAFT MODEL
CC11-_________________
State/Province Postal Code AIRCRAFT SERIAL NUMBER
CC11-_________________
Country AIRCRAFT REGISTRATION NUMBER
TELEPHONE NUMBER(S)
DESCRIPTION OF SAFETY OF FLIGHT ISSUE OR SIGNIFICANT SERVICE DIFFICULTY:
SIGNATURE DATE
FOR CUB CRAFTERS' USE ONLY
COS Log Number: Date Received: