UAS Exemption Monthly Flight Report

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Overview

Cover
Flights
Land Now
Encounters
Communications
Corrective Actions

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Sheet 1: Cover

Unmanned Aircraft System (UAS) Exemption Monthly Flight Report
Public Burden Statement A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number. The OMB Control Number for this information collection is 2120-0800. Public reporting for this collection of information is estimated to be approximately 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. All responses to this collection of information are required to obtain or retain a benefit (49 U.S.C. § 106(l) and (m)). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Aviation Administration, 10101 Hillwood Parkway, Fort Worth, TX 76177-1524.
Complete and submit the UAS Exemption Monthly Flight Report by the tenth day of each month for the previous month's flights.
Instrument/UAS Exemption Flights (10/24)

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Sheet 2: Flights

Unmanned Aircraft System (UAS) Exemption Monthly Flight Report

Report Month/Year

Certificate of Waiver, Exemption, or Authorization Number

Total Number of Flights

Total Number of Flight Hours

Number of Flights Transporting HAZMAT

Number of flights delayed or cancelled (automatically or manually) due to other aircraft in vicinity of planned departure, enroute, delivery, or landing areas

Number of occurrences when the UA and any AE were unable to communicate with each other for more than 6 seconds (Provide details on the "Communications" tab.)

Number of occurrences when there was a system communications latency for more than 6 seconds (Provide details on the "Communications" tab.)

Number of occurrences when the PIC was unable to positively control any UA in flight for more than 6 seconds (Provide details on the "Communications" tab.)

Number of "Land Now" events (Provide details on the "Land Now" tab.)

Number of flights that had interventions, incidents, or accidents (Provide details separately in the appropriate report.)

Number of rejected loads (package deliveries only)

Used automated data service provider (ADSP)?

Name of ADSP

Number of encounters identified where a UA operated less than 6000' horizontally and less than 500' vertically of a manned aircraft (Provide details on the "Encounters" tab.)

For any corrective actions to previously-reported interventions, incidents, or accidents, provide an update on the "Corrective Actions" tab.

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Sheet 3: Land Now

Land Now Events
Use this form to provide details of each "Land Now" event.
Was the "Land Now" event performed automatically or manually?	Causal factor(s) of "Land Now" event	Corrective action(s) taken in response to "Land Now" event

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Sheet 4: Encounters

Encounters
Use this form to provide data about each identified encounter where a UA operated less than 6,000 feet horizontal distance and less than 500 feet vertical distance of a manned aircraft.
		Range at Closest Point of Approach for each Encounter
Cooperative or Non-Cooperative Sensor or Visual Observer?	Encounter Type	Closest Horizontal Value (in feet)	Closest Vertical Value (in feet)	Closest Slant Range Value (in feet)	Number of avoidance maneuvers performed automatically using onboard DAA systems	Number of collision avoidance maneuvers performed manually

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Sheet 5: Communications

Communication Loss Events
For each occurrence related to loss of communication for more than 6 seconds reported on the "Flights" tab, list the duration of each occurrence and the outcome of the event.
Type of communication loss	Duration of occurrence (in seconds)	Outcome of event (e.g., link restored, "Land Now" performed, UA returned to base, etc.)

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Sheet 6: Corrective Actions

Corrective Actions
Use this form to provide updates on corrective actions to previously reported interventions, incidents, or accidents.
Date of Intervention, Incident, or Accident	Corrective Action Update