LINK re ACAS 2

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Notification of Serious Incidents

If while on an instrument flight rules (IFR) flight plan, compliance with a ACAS/TCAS resolution advisory was necessary to avert the
substantial risk of collision between two or more aircraft, please provide the information below.
Submit
Request ID
Name of Operator

*Date of event (UTC)
*Time of event (UTC)
*Flight origin(ICAO identifier )
*Flight destination(ICAO identifier)
*Aircraft Registration #
*Aircraft Type
*Aircraft Call Sign / Flight Number



*Location (approximate) of event
*Altitude at Time of Event
*Reported to ATC
*Evasive Action Taken

Yes

No

Yes

No



*Crew Summary of Event



Contact e-mail address
Contact phone number
Note: If requesting feedback on this event, you must state your request in the “Crew Summary of Event” field of the web-based form, and must provide your contact information (e-mail / phone) in
the spaces provided.

Submit
Enter the code

http://vmstappsntsb02/reportna/Inquireform.aspx?param=HL10

3/28/2017