Dd Form 175 (May 1986) - Military Flight Plan
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1PRIVACY ACT STATEMENT
DATE
AIRCRAFT CALL SIGN
AIRCRAFT DESG AND
AUTHORITY:
10 USC 8012 and EO 9397.
ROUTINE USES:
To provide data required to process flight plans with appropriate air traffic
TD CODE
PRINCIPAL PURPOSE:
To aid in accurate identification of
service authorities. A file is retained by the agency processing the flight plan.
personnel participating in the filed
DISCLOSURE:
Voluntary; however, failure to provide the SSN could result in denial of flight plan
flight.
processing.
BASE OPERATIONS USE
TYPE
POINT
PROPOSED
TRUE
FLT
OF
DEPARTURE
ALTITUDE
ROUTE OF FLIGHT
TO
ETE
AIRSPEED
PLAN
DEPARTURE
TIME (Z)
REMARKS
RANK AND HONOR CODE
FUEL ON BD
ALTN AIRFIELD
ETE TO ALTN
NOTAMS
WEATHER
WT AND BALANCE
AIRCRAFT SERIAL NUMBER, UNIT, AND HOME STATION
SIGNATURE OF APPROVAL AUTHORITY
ACTUAL DEP TIME
BASE OPERATIONS USE
CREW/PASSENGER LIST
(Z)
ATTACHED
SEE PSGR
DUTY
NAME AND INITIALS
RANK
SSN
ORGANIZATION AND LOCATION
PILOT
IN
COMMAND
MILITARY FLIGHT PLAN
DD Form 175, MAY 86 (EG)
Previous editions are obsolete.
Reset
Adobe Professional 7.0
Designed using Perform Pro, WHS/DIOR, Feb 96
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