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Use to report any situation that may require a search and rescue effort. Reference: FM 1-108 and FM 1-513.

LINE 1 — DATE AND TIME______________________________(DTG)

LINE 2 — UNIT________________________________________(Unit Making Report)

LINE 3 — CALL SIGN___________________________________(Call Sign of Disabled or Lost Aircraft, Ship, Submarine, or Other)

LINE 4 — TYPE ________________________________________(Type of Disabled or Lost Aircraft, Ship, Submarine, or Other)

LINE 5 — COLOR______________________________________(Color of Disabled or Lost Aircraft, Ship, Submarine, or Other)

LINE 6 — ID___________________________________________(Aircraft Tail or Side Number, Ship/Submarine Hull Number, or Other Number)

LINE 7 — LOCATION___________________________________(Location Disabled or Lost Aircraft, Ship, Submarine, or Other in UTM or Six-Digit Grid Coordinate With MGRS Grid Zone Designator)

LINE 8 — QUALIFIER___________________________________(Location Qualifier: ACTUAL or ESTIMATED Followed by LAND or SEA)

LINE 9 — TIME OF INCIDENT ___________________________(DTG of Incident)

LINE 10 — CAUSE _____________________________________(Cause of Disabled or Lost Aircraft, Ship, Submarine, or Other)

LINE 11 — PERSONNEL ________________________________(Count of Personnel on Board and Qualifier: ACTUAL or ESTIMATED)

LINE 12 — STATUS ____________________________________(Enter Count of Personnel and Their Statuses)

LINE 13 — REQUIRE ___________________________________(Enter RCC or COMBINED ASSISTANCE if SAR Assistance is Required)

LINE 14 — POINT OF CONTACT _________________________(Enter the Point of Contact and Telephone Number)

LINE 15 — NARRATIVE_________________________________(Free Text for Additional Information Required for Clarification of Report

LINE 16 — AUTHENTICATION___________________________(Report Authentication)

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