LOADING
Registration: SXASGWeight (Kg)Arm (m)Moment (kg m)
Corrected / Licenced Empty Weight000
PIC and Front Passenger00.940
Rear Passengers01.850
Baggage Area 102.410
Baggage Area 203.120
Usuable Fuel01.220
TOTAL00

PERFORMANCE
DEPARTURE
Takeoff AirportLGTT
Elevation (ft)861
QNH (mb)1013
Pressure Alt (ft)785
Temperature (C)13
Density Alt (ft)785
Wind360o 0 Kts
RWY in use03
HeadWind (kts)0
CrossWind (kts)0
Takeoff Mass (Kgr)0
Condition of RWY factor for take-off1
Safety factor for take-off1.33
TODR (m)0
TORR (m)0
DESTINATION
Landing AirportLGTT
Elevation (ft)861
QNH (mb)1013
Pressure Alt (ft)785
Temperature (C)13
Density Alt (ft)785
Wind360o 0 Kts
RWY in use03
HeadWind (kts)0
CrossWind (kts)0
Landing Mass (Kgr)0
Condition of RWY factor for landing1
Safety factor for landing1.43
LDR (m)0
LRR (m)0

GENERAL INFORMATION
Date2025-11-07
Crew Information
Pilot's Full Name
Instructor/Examiner's Full Name
Passengers Information
Pax No1
Full Name
Nationality
Address/City/Country
Age
Pax No2
Full Name
Nationality
Address/City/Country
Age
Pax No3
Full Name
Nationality
Address/City/Country
Age
Additional Information
Remarks

Aeroclub Mesogeion - ΟΜΜ - Issue 02 – Revision 17 – eff. 01/03/2025- Organization's Management Manual – Vol. III

GENERAL DECLARATION
(OUTWARD/INWARD)

Operator: AEROCLUB MESOGEION
Marks of Nationality and Registration: SXASGFlight No.: PVTDate: 2025-11-07
Departure from: LGTTArrival at: LGTT
(Place)(Place)

FLIGHT ROUTING
(“Place” Column always to list origin every en-route stop and destination)
PLACENAMES OF CREW*
LGTT
LGTT
DECLARATION OF HEALTH
NUMBER OF PASSENGERS
ON THIS STAGE**
Departure place:
Embarking ________
Through on same flight _________


Arrival place:
Disembarking ________
Through on same flight _________
FOR OFFICIAL USE ONLY
I declare that all statements and particulars contained in this General Declaration, and in any supplementary forms required to be presented with this General Declaration, are complete, exact and true to the best of my knowledge and that all through passengers will continue/have continued on the flight.


Signature_______________________________________________
Authorized Agent or Pilot-in-Command

* To be completed when required by the State.
** Not to be completed when passenger manifests are presented and to be completed only when required by the State.




ICAO ANNEX 9 - APPENDIX 1.1


 MD 4.7