**(COMPANY NAME)**

**[RECORD OF TRAINING]{.underline}**

**PILOT NAME:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**POSITION:** PIC \[ \]

**AIRCRAFT:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
SIC \[ \]

**TRAINING RECEIVED:** **REFERENCE:** **ELIGIBILITY:**

Initial \[ \] 135.331, .345 Base Month: \_\_\_\_\_\_\_\_

Transition \[ \] 135.345 Conducted during:

Upgrade \[ \] 135.347 Pre month \[ \]

Recurrent \[ \] 135.351 Due month \[ \]

Requalification \[ \] Post month \[ \]

Instructor \[ \]

Check Airman \[ \]

================================================================================

**CURRICULUM** **INSTRUCTOR** **DATE** **S/U**

**SEGMENTS**

A. Basic Indoctrination \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

B. General Emergency \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

Situation & Drill \[ \] 12 Mo. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

Hands-on Drill \[ \] 24 Mo. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

C. Aircraft Ground \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

D. Special \_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_

E. Flight \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

F. Qualification \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

G. Instr./Ck. Airman Grd. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

H. Instr./Ck. Airman Flt. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

I. International \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

J. Differences: Aircraft. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

K. Hazmat \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

L. Seat Removal \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_

================================================================================

I recommend
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ for the
qualification ride in lieu of the required flight training hours.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Signature Date Title**

I certify the above Record of Training is correct and the training
entered was completed satisfactorily.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Signature Date Title**

**(COMPANY NAME)**

**TRAINING RECORD**

**[PILOT DUTY ASSIGNMENT]{.underline}**

**FAR 135 PILOT RECORD**

**PILOT DUTY ASSIGNMENT / AUTHORIZATION FORM**

**Pilot Name:**

**Certificate(s):**

**Rating(s):**

CURRENT DUTY AND DATE OF ASSIGNMENT / AUTHORIZATION

+----------+-----+-----+------+------+-----+--------+-------+------+
| **Duty   |     | **V | **I  | **I  | **A | *      | *     | **C  |
| Po       |     | F   | F    | O    | /   | *INSTR | *Date | P /  |
| sition** |     | R** | R**  | E**  | P** | UCT.** | /**   | D    |
|          |     |     |      |      |     |        |       | O**  |
| **&      |     | **  | **.2 | **.2 | **  | **/    | **Rea |      |
| Assi     |     | .29 | 97** | 44** | .10 | CK.    | son** | *    |
| gnment** |     | 3** |      |      | 5** | AI     |       | *Ini |
|          |     |     | *    | **C  |     | RMAN** | *     | t.** |
|          |     | **C | *Cht | ommt | **A |        | *Remo |      |
|          |     | htr | r.** | r.** | uth |        | ved** |      |
|          |     | .** |      |      | .** |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+
|          |     |     |      |      |     |        |       |      |
+----------+-----+-----+------+------+-----+--------+-------+------+

+----------------------+---------------+---------------+---------------+
| **TEMPORARILY**      | **DATE        | **DATE TO:**  | **REASON:**   |
|                      | FROM:**       |               |               |
| **REMOVED FROM       |               |               |               |
| DUTY**               |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+
|                      |               |               |               |
+----------------------+---------------+---------------+---------------+

RELEASE FROM EMPLOYMENT:

Action taken:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date Signature Position**

**(COMPANY NAME)**

**TRAINING RECORD**

**[SINGLE-LINE ENTRY]{.underline}**

SINGLE-LINE RECORD ENTRY FORM

**RECORD FOR** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**PILOT NAME:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

  ---------- ------------------------ ------------- -------------------------
  **Date**   **Training / Check**     **Results**   **Instructor / Check
                                                    Airman**

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    

                                                    
  ---------- ------------------------ ------------- -------------------------

**(COMPANY NAME)**

**TRAINING RECORD**

**INSTRUCTOR / CHECK AIRMAN**

**QUALIFICATION RECORD**

This certifies that
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ has
satisfactorily completed the training required for qualification as an
instructor/check airman and is authorized to conduct pilot flight
training/flight checks as indicated below:

Qualified as Flight Instructor:

**AIRCRAFT: INSTRUCTOR OR TRAINING COMPLETION/**

**CHECK AIRMAN: OBSERVATION DATE:**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

================================================================================

**Qualified as Check Airman:**

**AIRCRAFT:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **INSTRUCTOR:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***Type of Checks***

***Authorized: \**** .293 \[ \] Competency Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.297 \[ \] Proficiency (IFR) Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.299 \[ \] Line Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.244 \[ \] IOE Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

===============================================================================

**Qualified as Check Airman:**

**AIRCRAFT:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**INSTRUCTOR:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***Type of Checks***

***Authorized: \**** .293 \[ \] Competency Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.297 \[ \] Proficiency (IFR) Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.299 \[ \] Line Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.244 \[ \] IOE Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

==============================================================================

**Qualified as Check Airman:**

**AIRCRAFT:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**INSTRUCTOR:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***Type of Checks***

***Authorized: \**** .293 \[ \] Competency Date:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.297 \[ \] Proficiency (IFR) Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.299 \[ \] Line Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

.244 \[ \] IOE Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**\*** Per Check Airman Letter Issued by FAA.

**(COMPANY NAME)**

**TRAINING RECORD**

**[PILOT ANNUAL RÉSUMÉ]{.underline}**

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Pilot Name:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **Pilot
Certificate:** Comm. \[ \] ATP \[ \]

**Address:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**Certificate No.:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**City:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**State:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **Zip:**
\_\_\_\_\_\_\_\_\_\_

**Phone No.:** Home: \_(\_\_\_)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Work: \_(\_\_\_)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ **Date of Hire:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--

\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--

**FLIGHT TIME SUMMARY**

A. **Total Time:** \_\_\_\_\_\_\_\_ B. **X-Country:** \_\_\_\_\_\_\_\_
C. **Instrument:** \_\_\_\_\_\_\_\_

SEL: \_\_\_\_\_\_\_\_ Total Night: \_\_\_\_\_\_\_\_ Hood:
\_\_\_\_\_\_\_\_

MEL: \_\_\_\_\_\_\_\_ Night X-C: \_\_\_\_\_\_\_\_ Actual:
\_\_\_\_\_\_\_\_

Turbo Prop: \_\_\_\_\_\_\_\_ Simulator: \_\_\_\_\_\_\_\_

**EMERGENCY CONTACTS:**

Name: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Address: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Address: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Phone: \_\_(\_\_\_)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Phone:
\_(\_\_\_)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Signature Date**

**(COMPANY NAME)**

**TRAINING RECORD**

**[135.267(b) Yes N0]{.underline}**\_\_\_\_\_\_\_\_\_ **[135.267(c)
Hours]{.underline}\_\_\_\_\_\_\_\_\_\_\_\_\_**

**[DAILY FLIGHT AND DUTY LOG]{.underline}**

**PILOT NAME:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
MONTH / YEAR: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_**

+-----+-------+-------+-------+-------+--------+-------------------+
| **  | *     | **    | **D   | **FLI | **STAN | **REMARKS**       |
| DAT | *ON** | OFF** | UTY** | GHT** | D-BY** |                   |
| E** |       |       |       |       |        |                   |
|     | **D   | **D   | **HO  | **HO  | **H    |                   |
|     | UTY** | UTY** | URS** | URS** | OURS** |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 1** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 2** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 3** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 4** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 5** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 6** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 7** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 8** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **  |       |       |       |       |        |                   |
| 9** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 0** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 1** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 2** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 3** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 4** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 5** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 6** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 7** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 8** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **1 |       |       |       |       |        |                   |
| 9** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 0** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 1** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 2** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 3** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 4** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 5** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 6** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 7** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 8** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **2 |       |       |       |       |        |                   |
| 9** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **3 |       |       |       |       |        |                   |
| 0** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+
| **3 |       |       |       |       |        |                   |
| 1** |       |       |       |       |        |                   |
+-----+-------+-------+-------+-------+--------+-------------------+

Flight Hours this Month: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Days off this
Month: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**(COMPANY NAME)**

**TRAINING RECORD**

**[ANNUAL FLIGHT AND DUTY TIME RECORD]{.underline}**

**PILOT NAME:**
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**YEAR:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**FLIGHT HOURS** **DAYS OFF**

JANUARY \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

FEBRUARY \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

MARCH \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

**QUARTER TOTALS:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

APRIL \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

MAY \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

JUNE \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

**QUARTER TOTALS:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

JULY \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

AUGUST \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

SEPTEMBER \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

**QUARTER TOTALS:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

OCTOBER \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

NOVEMBER \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

DECEMBER \_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_

**QUARTER TOTALS:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**[YEARLY TOTALS:]{.underline}** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

***Flight and Duty Limits (FAR 135.267) not to exceed:***

\(a\) (1) 500 hours in any calendar quarter;

\(2\) 800 hours in any two consecutive calendar quarters;

\(3\) 1,400 hours in any calendar year.

\(f\) At least 13 days off per quarter.

**(COMPANY NAME)**

**TRAINING RECORD**

**[INITIAL OPERATING EXPERIENCE]{.underline}**

**FAR 135.244**

**PILOT NAME:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
**AIRCRAFT:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

+-----+---------------------+-------+--------+-----------------------+
| **  | **ROUTE**           | **FLI | **TAKE | **CHECK AIRMAN**      |
| DAT |                     | GHT** | -OFF** |                       |
| E** |                     |       |        |                       |
|     |                     | **T   | **LAN  |                       |
|     |                     | IME** | DING** |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+
|     |                     |       |        |                       |
+-----+---------------------+-------+--------+-----------------------+

REMARKS:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

I CERTIFY THAT THE ABOVE NAMED PILOT HAS SATISFACTORILY COMPLETED
INITIAL OPERATING EXPERIENCE IN ACCORDANCE WITH FAR 135.244, IN THE
ABOVE NAMED MAKE AND MODEL AIRCRAFT.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**CHECK AIRMAN DATE**