Weight Balance Weight Arm Moment Power % RPM MP KTAS GPH

B. Empty Wt. Winds Aloft @ KTS Fuel on Board

Pilot & Front Pax. Takeoff C.G. Cruise Altitude Departure Time
Climb
Time Fuel Distance
Center Pax. Check Points CH Dist. GS Time Fuel
Leg Est. Est. Est.
Rear Pax.
Act.
Total Act. Act. Rem.
Baggage 1 Freq. Id.

Baggage 2 Check Points CH Dist. GS Time Fuel

Leg Est. Est. Est.
Zero Fuel Wt.
Act.
Total Act. Act. Rem.
Useable Fuel
Landing C.G.
Freq. Id.

Ramp Wt. Check Points CH Dist. GS Time Fuel

Leg Est. Est. Est.
Start Taxi T/O
Act.
Total Act. Act. Rem.
Gross T/O Wt. Freq. Id.

Fuel Burn
Check Points CH Dist. GS Time Fuel
Gross Land Wt. Leg Est. Est. Est.

Act.

Departure Cruise Destination Freq. Id.

Total Act. Act. Rem.

Temp. Check Points CH Dist. GS Time Fuel

Leg Est. Est. Est.
Altimeter Setting
Act.

Indicated Alt. Freq. Id.

Total Act. Act. Rem.

Pressure Alt. Check Points CH Dist. GS Time Fuel

Density Alt. Leg Est. Est. Est.

Act.

Departure ATIS Info Destination Freq. Id.

Total Act. Act. Rem.

ATIS ID
Check Points CH Dist. GS Time Fuel
Time Leg Est. Est. Est.

Wind Act.
Total Act. Act. Rem.
Visibility / Obstruction Freq. Id.

Sky Cond.
Temp / Dew Pt.
Check Points CH Dist. GS Time Fuel
Leg Est. Est. Est.
Altimeter Act.

Rwy /Traffic Freq. Id.

Total Act. Act. Rem.

Takeoff Performance Climb Performance

Check Points CH Dist. GS Time Fuel
Leg Est. Est. Est.
Ground Roll Over 50’ Obstacle Time Fuel Distance Act.

Freq. Id. Total Act. Act. Rem.

Cruise Performance
Check Points CH Dist. GS Time Fuel
%BHP RPM MP KTAS GPH Leg Est. Est. Est.

Act.
Total Act. Act. Rem.
Endurance Landing Performance Freq. Id.

Hours Minutes Over 50’ Obstacle vREF

Check Points CH Dist. GS Time Fuel
Ground Roll
Leg Est. Est. Est.

Compass Heading Planning Total Act. Act. Rem.

Act.

Freq. Id.

+ + +
VFR TC
- = - = MH
- = Est. Est.
WCA TH M Var Dev CH Totals Act.
+ + Act. Rem.
IFR TC
- WCA
= MH
- =
Dev CH
 Departure Destination Diversion Checklist Power % RPM MP KTAS GPH
ATIS 1. Note time and point of diversion Winds Aloft @ KTS Fuel on Board
Apch. 2. Determine the alternate Climb
Cruise Altitude Departure Time Time Fuel Distance
Tower 3. Turn to approximate heading
Check Points CH Dist. GS Time Fuel
Ground 4. Plot and measure course to alternate Leg Est. Est. Est.

Act.
5. Measure total distance
Unicom Freq. Id.
Total Act. Act. Rem.

6. Acccurately determine GS and CH

CTAF
7. Acccurately determine ETE, ETA, & Check Points CH Dist. GS Time Fuel
FSS Estimated Fuel Leg Est. Est. Est.

Act.
ClncDel 8. Amend Flight Plan Total Act. Act. Rem.
Freq. Id.

ICAO Flight Plan Check Points CH Dist. GS Time Fuel

Leg Est. Est. Est.
Priority Addressee(s)
Act.

<= FF <= Freq. Id.

Total Act. Act. Rem.

Filing Time Originator

Check Points CH Dist. GS Time Fuel
<= Leg Est. Est. Est.
Specific Identification of Addressee(s) and/or Originatior Act.
Total Act. Act. Rem.
Freq. Id.

3 Message Type 7 Aircraft Identification 8 Flight Rules Type of Flight

Check Points CH Dist. GS Time Fuel
<= (FPL <= Leg Est. Est. Est.
9 Number Type of Aircraft Wake Turbulence Cat. 10 Equipment
<=
Act.
Total Act. Act. Rem.
Freq. Id.
13 Departure Aerodrome Time
<= Check Points CH Dist. GS Time Fuel
15 Cruising Speed Level Route Leg Est. Est. Est.

Act.
Total Act. Act. Rem.
Freq. Id.

<= Check Points CH

Leg
Dist.
Est.
GS
Est.
Time
Est.
Fuel
Total EET
16 Destination Aerodrome HR MIN ALTN Aerodrome 2nd ALTN Aerodrome Act.

<= Freq. Id.

Total Act. Act. Rem.

18 Other Information
Check Points CH Dist. GS Time Fuel
Leg Est. Est. Est.
Act.

<= Freq. Id.

Total Act. Act. Rem.

SUPPLEMENTARY INFORMATION (NOT TO BE TRANSMITTED IN FPL MESSAGES)

19 Endurance Emergency Radio Check Points CH Dist. GS Time Fuel
HR MIN Persons on Board UHF VHF ELT
R
Leg Est. Est. Est.

P U V E Act.

Survival Equipment Jackets Freq. Id. Total Act. Act. Rem.

Polar Desert Maritime Jungle Light Fluores UHF VHF

S P D M J J L F U V Check Points CH Dist. GS Time Fuel
Dinghies Leg Est. Est. Est.
Number Capacity Cover Color Act.

D C <= Freq. Id. Total Act. Act. Rem.

Aircraft Color and Markings

A Check Points CH
Leg
Dist.
Est.
GS
Est.
Time
Est.
Fuel
Remarks
N <=
Act.

Freq. Id. Total Act. Act. Rem.

Pilot-in-Command
C )<= Totals
Est. Est.

Filed By Accepted By Additional Info Act. Rem.

Act.