NEW CAPABILITY

Please note you now have the ability to save your Name, Title, Phone and Email (and optionally, your Operator and/or Airport) and have those automatically inserted on future submittals by checking the indicated box just above where you enter that information at the bottom of the form. (Operator and/or Airport are saved by preceding either/both with an asterisk, for example, *ABC Airlines and/or *KXYZ.) When checked, that information will be automatically inserted to save you from re-entering it each time you submit a new Strike Report.

This new capability requires use of a "cookie" saved on your computer, so the use of "cookies" must be enabled (which is usually enabled by default). When the checkbox is checked, this instructional message will no longer appear. If you wish to stop the saving your sender information, just uncheck that checkbox. You may reinstate saving in future submittals, if desired. If you experience any difficulties, please email newmana@erau.edu with your name and phone number and I contact you to assist in resolving any difficulties.

BIRD/OTHER WILDLIFE STRIKE REPORT

Form Approved OMB NO. 2120-0045

1. * Name of Operator/Carrier (To Save)	2. Aircraft Make/Model	3. Engine Make/Model
4. Aircraft Registration	5. Date of Incident       //          mm    dd        yyyy	6. Local Time of Incident Dawn Dusk Hr Min Day Night AM PM
6A. Flight Number	6B. Wildlife/Bird Remains: Collected    Sent to Smithsonian
7.* Airport Name/ID (To Save) Type in a few letters contained within the Airport name or Airport ID. Add more if/as req'd. If found, click that airport name from the listing. If not found, type in the Airport name and if known, the 3/4 letter Airport ID.)	8. Runway Used	9. Location if En Route (Nearest Town/Reference & State)
10. Height (AGL)  ft	11. Speed (IAS)  kts
12. Phase of Flight   A. Parked B. Taxi C. Take-off Run D. Climb E. En Route F. Descent G. Approach H. Landing Roll	13. Part(s) of Aircraft Struck or     Damaged Struck Damaged A. Radome B. Windshield C. Nose D. Engine #1 E. Engine #2 F. Engine #3 G. Engine #4     Bird(s) Ingested? (Check for Yes)	13. (Con't)   Struck Damaged H. Propeller I. Wing/Rotor J. Fuselage K. Landing Gear L. Tail M. Lights N. Other   (Specify, if "N. Other" is checked)
14. Effect on Flight None Aborted Take-Off Precautionary Landing Engine Shutdown Other (Specify)	15. Sky Condition No Cloud Some Cloud Overcast	16. Precipitation Fog Rain Snow None
17. Bird/Other Wildlife Species	18. Number Seen and/or Struck Number Seen Struck 1  2 - 10  11 - 100  more than 100	19. Size of Bird(s)   Small Medium Large

20. Pilot Warned of Birds/Wildlife?  Yes  No

21. Remarks (Describe damage, injuries, and other pertinent information)

DAMAGE/COST INFORMATION

22. Aircraft time out of service:              hours	23. Estimated cost of repairs or       replacement (US $)     $	24. Estimated other costs (US $) (e.g.,        revenue loss, fuel, aircraft inspection,        crew lodging or rescheduling, etc.)     $
Check to save submitter info below (and optionally, Operator and/or Airport) and insert on future submittals. (Uncheck        to stop saving)
Reported by	Title	Date (mm/dd/yy)
Phone	Email

FAA Form 5200-7 (Electronic) Revised 7-14-2008

After submittal, just before the return links at the bottom of the screen, a link is provided for a formatted review of your submitted Strike Report. Please select that link to print a hard copy for future reference. When reporting bird aircraft strikes, please submit bird remains for identification. Place the feathers and other material in a clean plastic zip-lock bag, and send routine cases to: Feather Identification Lab, Smithsonian Institution, NHB, E600, MRC 116, PO Box 37012, Washington, D.C. 20013-7012. For priority cases, overnight ship to: Feather Identification Lab, Smithsonian Institution, NHB, MRC 116, 10th and Constitution Ave., NW., Washington, D.C. 20560-0116. This service is provided without charge to all United States registered aircraft owners/operators, regardless of where the strike occurred, and to all aircraft owners/operators when the strike occurred at a US airport. Be sure and include the Strike Report Number (from the formatted printout mentioned above), phone number and email address on the 5200-7 so you can be be notified of the identification. For additional information regarding remains submittal, please see CERTALERT 03-03 and/or contact the Feather Identification Lab for any other questions regarding collecting or sending remains at 202-633-0801. Thank You.

Please Do NOT Click the "Submit Strike Report" Button more than twice. The 1st click will request you check your entries. The 2nd click will do the actual Submittal. Internet traffic or your own server loading may cause a delay in responding. Please do not click a 3rd time as this will cause duplicate reports to be submitted.      Paperwork Reduction Act Statement: The information collected on this form is necessary to allow the Federal Aviation Administration to assess the magnitude and severity of the wildlife-aircraft strike problem in the U.S. The information is used in determining the best management practices for reducing the hazard to aviation safety caused by wildlife-aircraft strikes. We estimate that it will take approximately 5 minutes to complete the form. The information collected is voluntary. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid 0MB control number. The 0MB control number associated with this collection is 2120-0045. FAA Form 5200-7 (11-97)

Ignore Entries & Return To Primary (FAA) Airport Wildlife Mitigation Home Page | FAA Office of Airports - Washington Mirror (ERAU) Airport Wildlife Mitigation Home Page Prepared for the FAA by Embry-Riddle Aeronautical University Prescott, AZ Revised: ARN, July 19, 2008