SSCAA

New ATC Air Traffic Incident Report

Description

Air Traffic Incident Report

For use when submitting and receiving reports on air traffic incidents. In an initial report by radio, shaded items should be included.

The Incident

Location of incident for airborne events

From
From

Location of incident for surface events

Location
Location

Information regarding reporting aircraft at the time of the incident

Aircraft direction of bank
Aircraft direction of bank
Restrictions to visibility
Use of aircraft lighting
Other aircraft sighted
Other aircraft sighted
Avoiding action taken (evasive)
Avoiding action taken (evasive)
Radar identification
Radar identification

Other aircraft

Information about the other aircraft involved in the incident, if known

If above not known, describe aircraft
If above not known, describe aircraft
Number of engines
Number of engines
Aircraft direction of bank
Aircraft direction of bank
Lights displayed
Avoiding action taken (evasive)
Avoiding action taken (evasive)

Proximity of aircraft

Flight Meteorological Conditions

Weather Elements

Reported by

Information about person submitting report

Qualification

ATS use only

Supplementary Information by ATS Unit