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Preliminary Reporting Form: Harmful Radio Interference to Aircraft in cooperation with ICAO Frequency Spectrum Management Panel Note: Only applicable fields need to be filled. Please submit the report to Head, ATM Engineering and Aviation Frequency Spectrum, IATA at [email protected] . Originator of this report Organisation Department Street / No. Zip-Code / Town Name / Surname Phone Number E-mail address Date and time of report Description of interference Aircraft Type and Registration Date and Flight Number Airway/route flown Positions/Coordinates of the first point of occurrence Time (UTC) Waypoint: Latitude: Longitude: UTC: Positions/Coordinates of the last point of occurrence Time (UTC) Waypoint: Latitude: Longitude: UTC: Flight level or altitude at which it was detected Manufacturer, type, model of impacted equipment Degradation of performance level [ ] Complete outage [ ] False reading [ ] other (Please describe.) Problem duration [ ] continuous [ ] intermittent Event summary including description on impacts on aircraft operation Description of potential source of harmful interference (if known) Other information Version 1.0 (April 2016)
