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 Región de Formulario

Confidential Hazard Identification Report (Volunteer SSP)

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This voluntary and confidential hazard identification report will not have penalties and will protect sources of information, unless in exceptional cases the authority determines that in accordance with our National Law the benefit of disclosure or use of any particular circumstance exceeds a negative action that may have an impact on aviation safety

Name:

   

Email:

   

Phone Number:

   

Company

   

Address:

   

Location of the event:

   

Date and time of the event:

        

 

Description of Hazard: An event that may have an impact on aviation safety and has not resulted in a serious incident or accident?

 

 

 

Please attach photo files into a single file:

If appropriate, if not leave blank

 

 

               

 

The safety data that are detailed in this Voluntary and Confidential Hazard Identification report will not be used for purposes other than related to Aviation Safety.

We encourage you to promote voluntary reporting of events that could affect aviation safety and we appreciate your contribution to our collection and processing of data on safety.

 

 

    

      

 

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Dirección General de Aviación Civil
Costa Rica
2016