(Write your answers on a sheet of paper.)
AIR MAIL SERVICE
Ship No. _______________ Pilot ______________________________
Date (of forced landing) October 15, 1923 _________ Hour ______________ Minute _____ _____ .M.
LOCATION OF FORCED LANDING
State ___________________________________ County ___________________________________
Post Office (nearest) ____________________ R.R. Station (nearest) ___________________________________
Owner (of the landing site) ___________________________________
Damage to property (what and how severe) ___________________________________
Cause of landing (describe) ___________________________________
Damage to ship (describe) ___________________________________
How repaired (Were repairs performed at landing site? If yes, how and by whom?)
How gotten away (By what means was the mail removed from landing site? How was the airplane removed from the site, if not flown out?)
Date (mail removed from site) ___________ Hour ___________ Minute _____ _____ . M.
Cost of oil _______________ Cost of gas _______________
Cost of watchman (to secure airplane, if left at the landing site) _______________ per hour
Cost of repairs _______________
Pilot's Signature ______________________________
(For further details use the back of this sheet).