If any unsafe condition or occurence linked to a Protoplane product, modification or repair is encountered, please fill out the following form and we shall contact you as soon as possible.

Protoplane Form 939 – Date: 05/15/2015 – Issue: 01

Aircraft concerned

Protoplane product (modification, repair or appliance) concerned

Description of the unsafe condition or potentially unsafe condition

Signatory.

Please be advised that Protoplane will not be able to answer your request if the information provided is incomplete or inaccurate.