Infringement Form

* = required field

1Introduction

2Details

3Causal factors

Why we are collecting this information:

You do not have to fill in this form but it will help us in improving air safety in the future.

The reason we collect the information in this form is to establish more information about the causes of airspace infringements which can then help in identifying ways of preventing or mitigating them and improving safety in the future.

How we will use this information:

Information we collect from these forms will be statistically analysed to help identify common factors and trends. The form will be shared with the relevant ANSP and the UK Civil Aviation Authority under the principles of the MOR scheme as detailed in CAP382.

The CAA will treat the data as a supplementary occurrence report. As such it will not disclose the name of the person submitting the report, or of a person to whom it relates, unless required to do so by law or unless, in either case, the person concerned authorises disclosure.

In addition to the above, the information we collect from these forms may be summarised into tables or charts and shared with other organisations for the purpose of improving safety. All personal data is removed from the information before any of the summaries are shared.

Who we will share your personal data with:

We will not share your personal data with anyone outside the ANSP or the CAA.

How to find out more:

For further information on how your information is used, how we maintain the security of your information, and your right to access information we hold on you please see the CAA’s General privacy notice and Freedom of Information link.
http://www.caa.co.uk/Our-work/About-us/General-privacy-notice/
http://www.caa.co.uk/Our-work/Information-requests/Freedom-of-Information/

Thank you for your help.
Name*
Email*
Phone number
Confirmation*
- I have read the above information

Date of event*
DD slash MM slash YYYY

Date of event (DD/MM/YYYY)
Time of event*
Please select the time period of the event in UTC, as closely as possible
Location*

Please give the approximate position at point of infringement, preferably as a range and bearing reference from a key feature (e.g. 7Nm East of Gatwick)
Altitude/FL*
Please select the altitude or flight level at time of infringement.
Infringed Airspace*
Please select the airspace concerned (e.g. Gatwick CTR, Stansted TMZ). Where more than one area of airspace is concerned please also use the second drop down list.
Details of Aerodrome Traffic Zone*
Details of Temporary Restricted Airspace*
Additional Infringed Airspace (if applicable)
Please indicate the second area of airspace concerned if applicable (e.g. Gatwick CTR, Stansted TMZ).
Details of additional Aerodrome Traffic Zone
Details of additional Temporary Restricted Airspace
Crew Experience
Pilot-in-command
Total Hours*
Please select the interval which represents your Total Hours flying experience
Hours on type*
Please select the interval which represents your Total Hours flying on this aircraft type
Last 90 days*
Please select the interval which represents your Total Hours flying in the last 90 days
Last 28 days*
Please select the interval which represents your Total Hours flying in the last 28 days
Last 24 hours*
Please select the interval which represents your Total Hours flying in the last 24 hours
Licence*
Please select either: STUDENT / NPPL / PPL / CPL / ATPL / FAA / LAPL / OTHER
If other, specify*

Please Specify Licence Type if it is not listed.
Base airfield*

Please give the name of the airfield most commonly flown from by the pilot (i.e. Stapleford (EGSE))
Was this a training flight with an instructor?*
Please select YES if PIC held a Flying Instructor (FI) rating, otherwise NO
Pilot Recency
Hours in last 12 months*
Please select the interval which represents your flying experience in the last 12 months
Days since last flight*
Please select the interval which represents the time since your last flight
Days since last flight on type*

Please select the interval which represents the time since your last flight on type
Aircraft
Registration*

Registration Number (e.g. G-ABCD or N634C)
Type*

Please state the aircraft type
Category*
Please select either: MICROLIGHT / GA SINGLE / GA TWIN / HELICOPTER / BALLOON / OTHER
Typical IAS*

Please give a typical cruise speed for the aircraft (in knots)
Ownership Type*
Please select either: CLUB / PRIVATE OWNER / GROUP-SHARE / OTHER
Transponder
Equipped?*
Is the aircraft transponder equipped? Please select YES/NO as appropriate.
Type*
Please select either: MODE A / MODE C / MODE S as appropriate to the transponder type
Mode C (ALT) on?*
At the time of the infringement was the transponder reporting altitude,i.e. usually was Mode C selected? Please select YES/NO as appropriate
Mode A code

Please enter the 4-digit Mode A squawk code selected at time of infringement
Any comments relevant to use
Please add any comments related to use of the transponder
Flight
From*

Name of departure airfield (or departure location)
To*

Name of destination airfield (or destination location)
Nature of Flight*
Please select the most appropriate from: LOCAL TRAINING / CROSS-COUNTRY TRAINING / LOCAL RECREATIONAL / CROSS-COUNTRY RECREATIONAL / COMMERCIAL / OTHER
VFR/IFR*
What flight rules were being followed? Please select: VFR or IFR
VFR Chart Used
Please indicate which VFR chart was used: CAA 1:500,000 / CAA 1:250,000 / JEPPESEN / OTHER
Relevant Route details
Please summarise the planned route. E.g. (EGHJ-Ford-Burgess Hill-MAY-EGKH)
Weather
Visibility*

Please indicate the approximate visibility during the flight (in Km) or indicate GOOD if visibility was not a relevant factor.
Cloud*

Please state the the approximate cloud cover (e.g. NIL/FEW/SCT/BKN/OVC at #### level)
Other Significant Wx

Please state any other relevant weather factors (e.g. strong southerly wind)
ATC (at time of infringement)
ATC Contact*
At the time of the infringement was the flight receiving a service from an ATC unit? Please select YES or NO. (Note: If monitoring a frequency only please select NO)
ATS Unit?*

Give the name of the ATC/ATS unit providing the service (e.g. Farnborough)
ATS Service*
Please select either: BASIC / TRAFFIC / DECONFLICTION / RADAR CONTROL
Use of GPS
GPS Used*
Please select YES or NO according to whether a GPS unit of any sort was used during the course of the flight. Select YES even if only used as a back-up means of navigation
Type of GPS

Please give the name of the GPS unit if YES indicate before (Enter manufacturer & model)
Was the aircraft equipped with a GPS or airspace warning device that issues an audible or visual alert when proximate to controlled airspace?*
Were you using an Airspace Alerting Device (i.e. Aware) at the time of the infringement? (YES/NO)
Any comments relevant to use

Please add any comments related to the use of GPS on the flight
GA Organisation Membership
GA Organisation*
- AIRCRAFT OWNERS AND PILOTS ASSOCIATION (AOPA)
- LIGHT AIRCRAFT ASSOCIATION (LAA)
- BRITISH MICROLIGHT AIRCRAFT ASSOCIATION (BMAA)
- BRITISH GLIDING ASSOCIATION (BGA)
- BRITISH BALLOON AND AIRSHIP CLUB (BBAC)
- OTHER
- NONE
If other, please specify*
Description
Brief Outline and Cause of Incident*
Please provide some feedback regarding the causes of this incident (e.g. mis-identification of ground features / mis-understanding of controlled airspace limits / GPS problems / weather / briefing...)
Suggestions
Suggested Actions to Prevent a Recurrence*
Please indicate any remedial actions taken following the incident and provide any suggestions which might help prevent similar incidents.

Infringement Form

Why we are collecting this information:

How we will use this information:

Who we will share your personal data with:

How to find out more:

Thank you for your help.

Crew Experience

Pilot-in-command

Pilot Recency

Aircraft

Transponder

Flight

Weather

ATC (at time of infringement)

Use of GPS

GA Organisation Membership

Description

Suggestions

Information

Personnel - Pilot

PLANNING

Unaware of:

PILOT PERCEPTION

PILOT DECISION

PILOT ACTION

Interaction with Environment

PILOT ACTIONS

PILOT/ CONTROLLER COMMUNICATION

AIRSPACE

WEATHER

Pilot or Aircraft Equipment Related

NAVIGATIONAL EQUIPMENT

COMMUNICATIONS EQUIPMENT

GPS EQUIPMENT

AIRCRAFT TECHNICAL & EMERGENCIES

Contextual Factors

DOCUMENTATION - CHARTS & AIRSPACE GUIDES

TRAINING & EXPERIENCE

COCKPIT DISTRACTIONS

PERSONAL FACTORS