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Date 19 MAY Aircraft Make and Model Aircraft Identification Mark Points of Departure & Arrival Miles Flown Flight No. Remarks, Procedures, Maneuvers, Endorsements Number of Landings Aircraft Category... Aeroplane Glider Helicopter From To 17 G11593 N9065C TEB SAF 1235 1/1 3 3 17 " " N9065C SAF ABE 1236 1/1 2 17 " " N9065C ABE DAL 1237 1/1 1 5 16 " " N9065C DAL PBE 1238 2 3 19 R216TB N500JA PBI-LNB-PBI 1 1 20 " " N500JA PMP PMP 1 21 " " N500JA PMP DAB 2 1 21 " " N500JA DAB PBI 1 21 " " N500JA PBI PMP 1 23 G11593 N9065C PBI TEB 1239 2 7 FLEIGHT TIMES REPORTED TO INSURANCE COMPANY 27 G11593 N9065C TEB PBI 1240 1 2 3 29 " " N9065C PBI TST 1241 2 3 30 " " N9065C TST PBI 1242 2 8 31 " " N9065C PBI SAF 1243 3 7 JUN4 " " N9065C SAF PBI 1244 3 2 7 " " N9065C PBI TEB 1245 2 5 9 " " N9065C TEB PBI 1246 2 3 15 " " N9065C PBI TEB 1247 2 5 I certify that the statements made by me on this form are true. Pilot's Signature: David Malekian Page Total 9 17 321 6 Amount Forward 5267 75099 33 595 Total to Date 6210 75420 33 656