National Transportation Safety Board (Ntsb) Investigation Party Form printable pdf download

NTSB Investigation No.___________________________________

Date of Accident: __________________________________________

Accident Location: ________________________________________

CERTIFICATION OF PARTY REPRESENTATIVE

I acknowledge that I am participating in the above-referenced accident or incident investigation, on behalf of my

employer who has been named a party to the National Transportation Safety Board (NTSB) safety investigation,

for the purpose of providing technical assistance to the NTSB’s evidence documentation and fact-finding activities.

I understand that as a party participant, I and my organization shall be responsive to the direction of NTSB person-

nel and may lose party status for conduct that is prejudicial to the investigation or inconsistent with NTSB policies

or instructions. No information pertaining to the accident, or in any manner relevant to the investigation, may be

withheld from the NTSB by any party or party participant.

I further acknowledge that I have familiarized myself with the attached copies of the NTSB Accident/Incident

Investigation Procedures (49 C.F.R. Part 831) and “Information and Guidance for Parties to NTSB Accident and

Incident Investigations,” and will comply, and, if the party coordinator for my party, take all reasonable steps to

ensure that the employees and participants of my organization comply, with these requirements.. This includes, but

is not limited to, the provisions of 49 C.F.R. §§ 831.11 and 831.13, which, respectively, specify certain criteria for

participation in NTSB investigations and limitations on the dissemination of investigation information.

No party coordinator or representative may occupy a legal position or be a person who also represents claimants or

insurers. I certify that my participation is not on behalf of either claimants or insurers, and that, although factual

information obtained as a result of participating in the NTSB investigation may ultimately be used in litigation (at

the appropriate time, and in a manner that is not inconsistent with the provisions of 49 C.F.R. § 831.13 and 49

U.S.C. § 1154), my participation is to assist the NTSB safety investigation and not for the purposes of preparing

for litigation. I also certify that, after the NTSB Investigator-in-Charge (IIC) releases the parties and party partici-

pants from the restrictions on dissemination of investigative information specified in 49 C.F.R. § 831.13, neither I

nor my party’s organization will in any way assert in civil litigation arising out of the accident any claim of

privilege for information or records received as a result of my participation in the NTSB investigation.

Signature

Date

Name & Title

Party Organization/Employer

In aviation investigations this form may also be referred to as “Statement of Party Representatives to NTSB Investigation.”

National Transportation Safety Board (Ntsb) Investigation Party Form