Occurrence Report - Reg (EU) 376/2014

Just culture & confidentiality. This form is for reporting safety occurrences (mandatory and voluntary). Information is collected, protected and handled in accordance with Regulation (EU) No 376/2014. Personal details of the reporter are kept confidential and are not used to attribute blame. You may submit anonymously. Report within 72 hours of becoming aware of the occurrence where possible.

1. About this report

Type of report

Mandatory: required by 376/2014. Voluntary: any other safety information.

Anonymity

Submit this report anonymously

If ticked, your contact details below are not required.

Your name

Role / function

Organisation

E-mail

Phone

2. When & where

Date of occurrence (UTC)

Time (UTC)

State / area of occurrence

Location / aerodrome (name or ICAO)

3. What happened

Headline / short title

Class of occurrence

Occurrence category

Damage

Injuries

4. Aircraft & flight (if applicable)

Manufacturer

Model / type

Registration

Serial number (MSN)

State of registry

Mass group

Propulsion

Type of operation

Phase of flight

Flight number

Departure

Destination

Persons on board

Injuries (number)

5. Description

Narrative language

Weather / conditions

Description of the occurrence

Events / what was observed

Your assessment (possible causes, contributing factors, suggestions)