Form 5200-7 Bird/Other Wildlife Strike Report

Bird/Other Wildlife Strike Report

faa-form-5200-7-wildlife-strike-report-draft

Bird/Other Wildlife Strike Report Paper

OMB: 2120-0045

Document [pdf]
Download: pdf | pdf
U.S. Department
Of Transportation
Federal Aviation
Administration

FAA Form 5200-7 Bird/Other Wildlife Strike Report
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor
shall a person be subject to a penalty for failure to comply with a collection of information
subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a currently valid OMB Control Number. The OMB Control Number for this information
collection is 2120-0045. Public reporting for this collection of information is estimated to be
approximately 5 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, completing and reviewing the
collection of information.
All responses to this collection of information are voluntary; 14 CFR 139.337, Wildlife Hazard
Management, requires the FAA to collect wildlife strike data. No assurances of confidentiality
are given. Send comments regarding this burden estimate or any other aspect of this collection
of information, including suggestions for reducing this burden to: Information Collection
Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX
76177-1524.

Directions for FAA Form 5200-7 Bird/Other Wildlife Strike Report
1. Name of Operator - This can be an airline (abbreviations okay - UAL, AAL, etc.), business
(Coca Cola), government agency (Police Dept., FAA) or if a private pilot, his/her name.
2. Aircraft Make/Model - Abbreviations are okay, but include the model
(e.g. B737-200).
3. Engine Make/Model - Abbreviations are allowed (e.g., PW 4060, GECT7, LYC 580).
4. Aircraft Registration - This means the N# (for USA registered aircraft).
5. Date of Incident - Give the local date, not the ZULU or GMT date.
6. Local Time of Incident - Check the appropriate light conditions and fill in the hour and
minute local time and check AM or PM or use the 24 clock and skip AM/PM.
7. Airport Name OR Airport ID - Use the airport name or 3-letter code if a US airport. If a
foreign airport, use the full name or 3-letter code and location (city/country).
8. Runway used - Self-explanatory.
9. Location if Enroute - Put the name of the nearest city and state.
10. Height AGL - Put the feet above ground level at the time of the strike (if you don't know,

use MSL and indicate this). For take-off run and landing roll, it must be 0.
11. Speed (IAS) - Speed at which the aircraft was traveling when the strike occurred.
12. Phase of Flight - Phase of flight during which the strike occurred. Take-off run and landing
roll should both be 0 AGL.
13. Part(s) of Aircraft Struck or Damaged - Check which parts were struck and damaged. If a
part was damaged but not struck indicate this with a check on the damaged column only
and indicate in comments (#21) why this happened (e.g., the landing gear might be
damaged by deer strike, causing the aircraft to flip over and damage parts not struck by
deer).
14. Effect on Flight - You can check more than one and if you check “Other,” explain in
Comments (#21).
15. Sky condition - Check the one that applies.
16. Precipitation - You may check more than one.
17. Bird/Other Wildlife Species - Try to be accurate. If you don't know, put unknown and
some description. Collect feathers or remains for identification for damaging strikes.
18. Number of birds seen and/or struck - check the box in the Seen column with the correct
number if you saw the birds/other wildlife before the strike and check the box in the
Struck column to show how many were hit. The exact number, can be written next to the
box.
19. Size of Bird(s) - Check what you think is the correct size (e.g. sparrow = small, gull =
medium and geese = large).
20. Pilot Warned of Birds - Check the correct box (even if it was an ATIS warning or
NOTAM).
21. Remarks - Be as specific as you can. Include information about the extent of the damage,
injuries, anything you think would be helpful to know. (e.g., number of birds ingested).
22. Aircraft time out of service - Record how many hours the aircraft was out of service.
23. Estimated cost of repairs or replacement - This may not be known immediately, but the
data can be sent at a later date or put down a contact name and number for this data.
24. Estimated other cost - Include loss of revenue, fuel, hotels, etc. (see directions for #23).
25. Reported by - Although this is optional, it is helpful if questions arise about the information
on the form (a phone number could also be included).
26. Title - This can be Pilot, Tower, Airport Operations, Airline Operations, Flight Safety, etc.
Date - Date the form was filled out

FAA Form 5200-7

Page ii of ii

OMB CONTROL NUMBER 2120-0045
EXPIRATION DATE: 3/31/2020

BIRD / OTHER WILDLIFE STRIKE REPORT
U S. Department of Transportation
Federal Aviation Administration

1. Name of Operator

2. Aircraft Make/Model

4. Aircraft Registration

5. Date of Incident
/
Month
Day

3. Engine Make/Model

6. Local Time of Incident
Dawn
Dusk

/
Year

Day

7. Airport Name

8. Runway Used

10. Height (AGL)

11. Speed (IAS)

12. Phase of Flight

13. Part(s) of Aircraft Struck or Damaged
Damaged

Struck

A. Radome

H. Propeller

B. Windshield

I Wing/Rotor

C. Nose

J. Fuselage

D. Engine No. 1

K. Landing Gear

E. Engine No. 2

L. Tail

F. Engine No. 3

M. Lights

G. Engine No. 4

N. Other: (Specify)

14. Effect on Flight

15. Sky Condition

None

No Cloud

Fog

Aborted Take-Off

Some Cloud

Rain

Precautionary Landing

Overcast

16. Precipitation

Snow

Engines Shut Down

None

Other: (Specify)
18. Number of birds seen and/or struck

17. Bird/Other Wildlife Species

Number of Birds

Seen

19. Size of Bird(s)
Small

Struck

Medium

1
2-10

Large

11-100
more than 100
20. Pilot Warned of Birds

Yes

No

21. Remarks (Describe damage, injuries and other pertinent information)

DAMAGE / COST INFORMATION
22. Aircraft time out of service:
hours

23. Estimated cost of repairs or replacement (U.S. $):
$

24. Estimated other Cost (U.S. $)
(e.g. loss of revenue, fuel, hotels):
$

Reported by (Optional)

Title

FAA Form 5200-7 (03/20) SUPERSEDES PREVIOUS EDITION

HR

MIN

AM

PM

9. Location if Enroute
(Nearest Town/Reference & State/Airport)

Struck

A. Parked
B. Taxi
C. Take-off Run
D. Climb
E. Enroute
F. Descent
G. Approach
H. Landing Roll

Night

Date

Damaged

NO POSTAGE
NECESSARY IF
MAILED

U.S. Department
of Transportation

Federal Aviation
Administration

IN THE
UNITED STATES

800 Independence Ave. S.W.
Washington, D.C. 20561
Official Business
Penalty for Private Use, $300

BUSINESS REPLY MAIL
FIRST CLASS PERMIT NO. 12438 WASHINGTON D.C.
POSTAGE WILL BE PAID BY FEDERAL AVIATION ADMINISTRATION

Federal Aviation Administration
Office of Airport Safety and Standards, AAS-310
800 Independence Avenue, SW
WASHINGTON, DC 20591

FOLD AND TAPE HERE


File Typeapplication/pdf
File TitleBird / Other Wildlife Strike Report, Form 5200-7
SubjectWildlife Haxards
AuthorF A A Airport Safety and Operations (202) 267-8731
File Modified2020-03-20
File Created2020-03-20

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