Da Form 2397-4, Feb 2009 Technical Report Of U.s. Army Aircraft Accident printable pdf download

Da Form 2397-4, Feb 2009 Technical Report Of U.s. Army Aircraft Accident

TECHNICAL REPORT OF U.S. ARMY AIRCRAFT ACCIDENT

REQUIREMENTS CONTROL SYMBOL

PART V - SUMMARY OF WITNESS INTERVIEW

CSOCS-309

For use of this form, see DA Pamphlet 385-40; the proponent agency is OCSA.

1. NAME OF WITNESS (LAST, FIRST, MI)

2. OCCUPATION/TITLE

3. GRADE

4. DATE OF BIRTH

5. ADDRESS (Include ZIP Code) (If military, include organization)

6. TELEPHONE NUMBER

(Duty/Work)

7. DATE OF INTERVIEW

(YYYYMMDD)

8. EXPERIENCE AND BACKGROUND

9. LOCATION AT TIME OF ACCIDENT

10. INTERVIEWER

(Name and Grade)

11. Promise of confidentiality.

a. Was a promise of confidentiality offered to the witness?

Yes

No (If yes, read blk 14a to the witness and complete

blk 15. If no, read blk 14b to the witness.)

b. Confidentiality was requested by the witness.

Yes

No (If Yes, interviewer sign and date statement below.)

THE WITNESS MADE THIS STATEMENT UNDER A PROMISE OF CONFIDENTIALITY.

SIGNATURE OF INTERVIEWER

DATE

(YYYYMMDD)

12. SUMMARY OF INTERVIEW

a. Date (YYYYMMDD)

b. Time

c. Acft Serial No.

13. CASE NO.

PREVIOUS EDITION IS OBSOLETE.

DA FORM 2397-4, FEB 2009

PAGE 1 OF 2

APD PE v1.OO

Da Form 2397-4, Feb 2009 Technical Report Of U.s. Army Aircraft Accident