Date: 11-15-19
Revision: 2
Page: 1-6
VASHON AIRCRAFT RANGER R7 MAINTENANCE MANUAL
CONTINUED OPERATIONAL SAFETY REPORTING
FORM
NAME (Last, First)
COMPANY/ORGANIZATION
ADDRESS
Number and Street
City
AIRCRAFT MODEL
State/Province
Postal Code
AIRCRAFT SERIAL NUMBER
RANGER R7-
Country
AIRCRAFT REGISTRATION NUMBER
TELEPHONE NUMBER(S)
DESCRIPTION OF SAFETY OF FLIGHT ISSUE OR SIGNIFICANT SERVICE
DIFFICULTY:
SIGNATURE
DATE
FOR VASHON AIRCRAFT USE ONLY
COS Log Number:
Date Received:
