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Saturday 16 December 2017

Aircraft Accident and Incident Investigation Department

Verbally report all accidents and serious incidents immediately to +268 7604 4310, in addition to submitting this form

You can also download, fill in the PDF Form and send to The Swaziland AAIID, P.O. Box D361, The Gables, H126 , Swaziland or fax form to: +268 2518 4199 or email form to: notification@swacaa.co.sz

Alternatively, you can fill in the online form below.

Personal particulars of the reporter:

Crew Air Traffic Controller CAA Owner Rescure/fire service Aerodrome operator Operator AME Other

Crew and operator particulars:

Accident/incident details:

Number of persons on board: If known, names and nationalities of all serious injuries and fatalities, please enclose additional page/s as necessary.

Aircraft damage:

Destroyed Substantial Minor Nil
None Rejected Takeoff Precautionary Landing Engine/s shut down Other

Weather conditions:

Other information relevant to the event

VFR IFR
VMC IMC
Daylight Night Dawn Dusk
Aircraft standing Taxiing Takeoff Climb En-route Manoeuvring Descent Approach
Landing Other

Type of operation

Flying training – solo Flying training – dual Military Sports aviation Gliding Air transport – passenger Air transport – cargo *Charter *Private *Agricultural – cargo *Aerial work Other

Wildlife strike

No Yes

Please fully describe the accident or incident

All relevant documentation should be forwarded to the Swaziland AAIID. Include your suggestion as to how this type of occurrence could be prevented.

Factors contributing to the occurence

No Yes
No Yes
No Yes
No Yes
No Yes
Distracting events/interruptions Environment (noise, visibility) Equipment Design Fatigue Interpersonal problems at work Knowledge or experience Medical/physiological factors High workload
Pre-occupation Training Recency Other

Results of operator's technical and/or operational investigation at time of submitting report or Chief pilot/CFI comments where applicable

Action carried out by operator to prevent recirrence

FOR ACCIDENTS ONLY

For accidents (occurrences involving fatalities or serious injuries to any person in the aircraft or on the ground, substantial damage or destroyed aircraft) only, please include the following information:

Additional pilot in command details

ELT information

Fixed Portable
Manual activation Automatic Did not activate
Cockpit Cabin Rear/tail Other

TERMS & CONDITIONS

Information may be disclosed to other organizations or individuals in the interest of safety. Where possible, the Swaziland AAIID will remove information that directly identifies an individual (i.e. names, license numbers and addresses). However, other indirect identifiers (i.e. times, dates and locations for the occurrence of incidents) will usually be disclosed in the interests of safety. If the information is the subject of an investigation it will only be used in accordance with the Swaziland Civil Authority Aviation Act.

By clicking the 'CLICK HERE TO SEND FORM' button below, I hereby confirm that I have read and understood the terms

Verbally report all accidents and serious incidents immediately to +268 7604 4310, in addition to submitting this form