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Report on your personal behalf
Submit an occurrence report as a private individual.
NOTE: ‘Occurrence’ means any safety-related event which endangers or which, if not corrected or addressed, could endanger an aircraft, its occupants or any other person and includes in particular an accident or serious incident.
What should not be reported via this channel
Incidents or events with no aviation safety content
Personnel problems, personality conflicts and industrial relations issues
Legal / commercial disputes
For those issues, please report to appropriate authority / organization.
When to report
When the reporter wishes others to learn and benefit from the incident but is concerned about protecting the reporter’s identity.
When there is no other appropriate reporting procedure or channel. (especially for members of the general public)
When reporter has tried other reporting procedure or channel without the issue having been addressed.
Download and save the form below into your computer.
Use this free Adobe Acrobat / Reader DC (2017 or newer) to fill the forms on Microsoft Windows (7 or newer) only. Other PDF applications or other operating systems may not work or corrupt the PDF forms.
Warning: DO NOT alter the form's structure; additional pages in the PDF (e.g. pictures or scanned reports) will be discarded without further notice; please attach your desired attachments when sending the form via email.
Send the filled up form with your desired attachments to firstname.lastname@example.org
Please provide your contact details in the email to allow us contacting you when deemed necessary.
Thank you for your Voluntary Report.
The purpose of Voluntary Reporting is to enhance aviation safety through the collection of reports on actual or potential safety deficiencies that would otherwise not be captured by mandatory reporting systems.
You are encouraged to make a voluntary report when you have any information that could help in improving aviation safety but it has not been reported through any existing channel or you wish for others to learn and benefit from any occurrence or hazard, but are concerned about protecting your identity.
If you have any problems with the form, please contact email@example.com.
Tel. 02-568-8800 extension 1301