SECTION 1 –
Date (mm/dd/yyyy):	Location:
Aircraft Name:	Registration #:
Remote Pilot in Command:
Person Manipulating Controls:
Visual Observer(s):
Total Mission Flight Time:	Total sUAS Hours at Time of Crash:
UAV Airworthiness:	In-service	Out-of-service
Description of Crash:
Damage Sustained to sUAS:
Estimated cost to Repair/Replace:	$
Crash Investigated by:	Date (mm/dd/yyyy):
Cause of Crash Determination:	Yes	No
Crash Investigator Comments:
SECTION 2 – Signatures
Remote-Pilot-in-Command (Print)	Remote Pilot-in-Command (Signature)
Crash Investigator (Print)	Crash Investigator (Signature)
sUAS Program Manager (Print)	sUAS Program Manager (Signature)