GUIDELINES FOR COMPLETION OF ALTITUDE DEVIATION REPORT FORM

Download ADR form here (PDF) - ADR form (15 Feb 07)

Follow State Guidance as to any additional reporting process and addresses for this Form.

Use this Form to report altitude deviations of 300 feet or more which occur above FL 245.

Guidance for Completion

Complete the Form as soon as practicable after the occurrence. Fill in as many Boxes as possible. If the information requested is NOT KNOWN, use N/K.

Box 1: Insert the Day (DD), Month (MM), Year (20YY).

Box 2: Insert the hour (hh) and Minute (mm) of occurrence in UTC.

Box 3: Self-explanatory.

Box 4: Insert the location using latitude/longitude, a place name, aerodrome, bearing/distance from a NAVAID or significant point, etc.

Box 5: Insert the ATS route.

Box 6: Insert the Callsign and/or registration.

Box 7: Use ICAO aircraft type designators, as in Field 9 of the ICAO flight plan.

Box 8: Insert either the Cleared Flight Level (CFL), altitude (A), or height (H) in feet. If metric add m. Insert altimeter setting if relevant.

Box 9: Insert the aircraft's flight level during the altitude deviation as observed by ATC.

Box 10: Insert the amount of time (in seconds) spent deviating from Cleared Flight Level. Insert the overall deviation time until the aircraft:

    a. returned to its Cleared Flight Level, as inserted in Box 8; or
    b. was cleared to a different flight level, as inserted in Box 11, if applicable.

Box 11: Insert the Cleared Flight Level after the altitude deviation if different from the Cleared Flight Level before the altitude deviation.

Box 12: Insert the cause of deviation from one of the following categories:

• Pilot error;
• Controller error;
• Pilot-controller loop error (e.g. pilot misunderstands cleared flight level and reads back wrong cleared flight level, controller does not notice the error);
• Equipment (e.g. autopilot failure);
• ACAS resolution advisory manoeuvre;
• Turbulence;
• Other;
• Unknown.

Box 13: If separation was lost, insert the horizontal and vertical spacing at the closest point.

Box 14: Self-explanatory.

Box 15: Insert additional remarks concerning any cause or factors believed relevant to the occurrence, as applicable.