PRIORITY                                          <<=FF  ADDRESSEE(S)
 
 
 
 
 
           FILING TIME                                                       ORIGINATOR
   
               →
 
  « ≡
           SPECIFIC IDENTIFICATION OF ADDRESSEE(S) AND/OR ORIGINATOR
 
  3 MESSAGE TYPE                                             7 AIRCRAFT IDENTIFICATION         8 FLIGHT RULES               TYPE OF FLIGHT

   «≡ (FPL                             —                                                          « ≡
        9 NUMBER                               TYPE OF AIRCRAFT                            WAKE TURBULENCE CAT                                10 EQUIPMENT
 —                                                  /                          « ≡
                         13 DEPARTURE AERODROME                                                               TIME
          —                                     « ≡
 15 CRUISING SPEED                     LEVEL                                         ROUTE
                 
                  « ≡
  16 DESTINATION AERODROME     TOTAL EET HR.MIN         ALTN AERODROME          2ND ALT AERODROME
    —                       →           →          « ≡
  18 OTHER INFORMATION
  —  
  ) «≡    
                                                                                                                                                   EMERGENCY RADIO      UHF          VHF         ELBA 
    19 ENDURANCE  HR.MIN                        PERSONS ON BOARD                                                                       U         V         E    
-E/ → P/                                                 → R/                   
SURVIVAL EQUIPMENT POLAR         DESERT        MARITIME        JUNGLE         JACKETS           LIGHT          FLUORES          UHF            VHF       

 →

S

    /

P

  

D

  

M

 

J

   →

J

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L

  

F

 

U

 

V

  

 

 

 

 

 

 

 

 

 

 

 
    DINGIES                                                                           COVER                                     
     D               NUMBER      CAPACITY                          C                 COLOUR
       /          →   →    →   ) «≡
     A       /     AIRCRAFT COLOUR AND MARKING
        
     N       /    REMARKS
          ) «≡
     C        /    PILOT IN COMMAND
          ) «≡
   FILED BY                                              SIGNATURE OF ATS-OFFICER
  

 

Time: