DA Form 2397-u Unmanned Aircraft System Accident Report (Uasar)

DA Form 2397-u - also known as the "Unmanned Aircraft System Accident Report (uasar)" - is a United States Military form issued by the Department of the Army.

The form - often mistakenly referred to as the DD form 2397-u - was last revised on February 1, 2010. Download an up-to-date fillable PDF version of the DA 2397-u down below or look it up on the Army Publishing Directorate website.

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UNMANNED AIRCRAFT SYSTEM ACCIDENT REPORT (UASAR)
REQUIREMENTS CONTROL SYMBOL
Use for all UAS Aviation Accidents
CSOCS-309
For use of this form, see DA Pamphlet 385-40; the proponent agency is OCSA.
a. Date (YYYYMMDD)
b. Time (Local)
c. UA Tail Number
1. ACCIDENT CASE
INFORMATION
2.
ACCIDENT CLASS/
a. Classification
b. Category
3. UAS MTDS
A
B
C
D
E
F
Flight
Flight Related
Aaircraft Ground
CATEGORY
a. Number of Aircraft
b. In Flight/Mid-Air Collision
4. PERIOD OF DAY
5. AIRCRAFT
6.
NEAREST MILITARY INSTALLATION
Dawn
Day
Dusk
Night
Involved
Yes
No
INVOLVED
Unknown
7.
ACCIDENT
a.
b.
c. City
d. State
e. Country
f. Grid and/or Lat/Long
On-Post
On Airfield
LOCATION
Off-Post
Not on Airfield
8. ORGANIZATION INVOLVED
a. Unit Designation
b. Unit Identification Code (UIC)
c. Home Station
d. Army Headquarters
9. ACCOUNTABLE ORGANIZATION (If same as block 8 leave blank)
a. Unit Designation
b. Unit Identification Code (UIC)
c. Home Station
d. Army Headquarters
a. UA Total Loss
b. UA Damage or replacement Cost
c. Number of
d. Man-Hours Cost
e. Other UAS Sub-System
10. ACCIDENT
(Excluding Man-hours)
Man-Hours
$
Cost
$
Yes
No
$
COST DATA
h. Injury/Occupational Illness
f. Other Damage Cost-Military
g. Other Damage Cost-Civilian
i. Total Cost
(This UAS)
j. Total Cost (All Aircraft)
$
$
$
$
$
a. Mission
a(1). Type Mission
a(2). Aircraft Mode
a(3). Level of Interoperability (LOI)
11. GENERAL
Single-ship
Multi-ship
Manned/Unmanned Teaming
1
2
3
4
5
NA
DATA
a(4). Simultaneous UA Operation?
Yes
No
b. Flight Plan
c. Flight Rules
(If Yes, specify number & MTDS)
Military
Civil
Operation's Log
VFR
IFR
d. Mission/
d(1). At what level was mission/training conducted?
d(2). Who approved the mission/training? Rank & Position:
Training
Bde
Bn
Co
Plt
Sqd
Team
Crew
d(3). Was a mission brief completed?
d(4). Who was in charge during the mission?
d(5). Who was the senior leader present during the
Rank & Position:
mission/training? Rank & Position:
Yes
No
e. Risk
e(1). RM Performed?
e(2). Who performed the RM? Rank & Position:
e(3). RM Approved?
e(4). Who accepted risks? Rank & Position:
Management
Yes
No
Yes
No
(RM)
e(5). What was the level of the risk after controls applied?
e(6). How was the RM process communicated?
(Check all that apply.)
Low
Moderate
High
Extremely High
Worksheet
Verbal Brief
Order
Not Communicated
e(7). Accident event identified/considered during RM process?
e(7)a. What was the level of the identified risk?
If yes, complete blocks 11a(7)a thru 11e(7)d)
Moderate
High
Extremely High
Yes
No
Low
e(7)b. Was the control measure(s)
e(7)c. Who was responsible for implementing the controls?
e(7)d. Was the potential for accident event
applied?
Rank & Position:
accepted as residual risk?
Yes
No
Yes
No
f. Digital Source
f(1). DSC installed?
(If yes, enter type of DSC)
f(2). Data captured and preserved?
(If yes, specify storage location)
Collector
Yes
No
Yes
No
(DSC)
g. Fire
h. Hazardous Material Spillage
i. Did accident occur while on an exercise or at a training
If yes & a Class A, B or C accident,
facility/center?
None
Inflight
Postcrash
attach DA Form 2397-6)
(If yes, enter the name)
Other (Specify)
Yes
No
Yes
No
12. SUMMARY
(Attach a continuation sheet(s) as needed)
PAGE 1 OF 3
DA FORM 2397-U, FEB 2010
APD AEM v1.00ES
UNMANNED AIRCRAFT SYSTEM ACCIDENT REPORT (UASAR)
REQUIREMENTS CONTROL SYMBOL
Use for all UAS Aviation Accidents
CSOCS-309
For use of this form, see DA Pamphlet 385-40; the proponent agency is OCSA.
a. Date (YYYYMMDD)
b. Time (Local)
c. UA Tail Number
1. ACCIDENT CASE
INFORMATION
2.
ACCIDENT CLASS/
a. Classification
b. Category
3. UAS MTDS
A
B
C
D
E
F
Flight
Flight Related
Aaircraft Ground
CATEGORY
a. Number of Aircraft
b. In Flight/Mid-Air Collision
4. PERIOD OF DAY
5. AIRCRAFT
6.
NEAREST MILITARY INSTALLATION
Dawn
Day
Dusk
Night
Involved
Yes
No
INVOLVED
Unknown
7.
ACCIDENT
a.
b.
c. City
d. State
e. Country
f. Grid and/or Lat/Long
On-Post
On Airfield
LOCATION
Off-Post
Not on Airfield
8. ORGANIZATION INVOLVED
a. Unit Designation
b. Unit Identification Code (UIC)
c. Home Station
d. Army Headquarters
9. ACCOUNTABLE ORGANIZATION (If same as block 8 leave blank)
a. Unit Designation
b. Unit Identification Code (UIC)
c. Home Station
d. Army Headquarters
a. UA Total Loss
b. UA Damage or replacement Cost
c. Number of
d. Man-Hours Cost
e. Other UAS Sub-System
10. ACCIDENT
(Excluding Man-hours)
Man-Hours
$
Cost
$
Yes
No
$
COST DATA
h. Injury/Occupational Illness
f. Other Damage Cost-Military
g. Other Damage Cost-Civilian
i. Total Cost
(This UAS)
j. Total Cost (All Aircraft)
$
$
$
$
$
a. Mission
a(1). Type Mission
a(2). Aircraft Mode
a(3). Level of Interoperability (LOI)
11. GENERAL
Single-ship
Multi-ship
Manned/Unmanned Teaming
1
2
3
4
5
NA
DATA
a(4). Simultaneous UA Operation?
Yes
No
b. Flight Plan
c. Flight Rules
(If Yes, specify number & MTDS)
Military
Civil
Operation's Log
VFR
IFR
d. Mission/
d(1). At what level was mission/training conducted?
d(2). Who approved the mission/training? Rank & Position:
Training
Bde
Bn
Co
Plt
Sqd
Team
Crew
d(3). Was a mission brief completed?
d(4). Who was in charge during the mission?
d(5). Who was the senior leader present during the
Rank & Position:
mission/training? Rank & Position:
Yes
No
e. Risk
e(1). RM Performed?
e(2). Who performed the RM? Rank & Position:
e(3). RM Approved?
e(4). Who accepted risks? Rank & Position:
Management
Yes
No
Yes
No
(RM)
e(5). What was the level of the risk after controls applied?
e(6). How was the RM process communicated?
(Check all that apply.)
Low
Moderate
High
Extremely High
Worksheet
Verbal Brief
Order
Not Communicated
e(7). Accident event identified/considered during RM process?
e(7)a. What was the level of the identified risk?
If yes, complete blocks 11a(7)a thru 11e(7)d)
Moderate
High
Extremely High
Yes
No
Low
e(7)b. Was the control measure(s)
e(7)c. Who was responsible for implementing the controls?
e(7)d. Was the potential for accident event
applied?
Rank & Position:
accepted as residual risk?
Yes
No
Yes
No
f. Digital Source
f(1). DSC installed?
(If yes, enter type of DSC)
f(2). Data captured and preserved?
(If yes, specify storage location)
Collector
Yes
No
Yes
No
(DSC)
g. Fire
h. Hazardous Material Spillage
i. Did accident occur while on an exercise or at a training
If yes & a Class A, B or C accident,
facility/center?
None
Inflight
Postcrash
attach DA Form 2397-6)
(If yes, enter the name)
Other (Specify)
Yes
No
Yes
No
12. SUMMARY
(Attach a continuation sheet(s) as needed)
PAGE 1 OF 3
DA FORM 2397-U, FEB 2010
APD AEM v1.00ES
UA
13.
FLIGHT
Flight
Phase of Operation
Altitude
Altitude
Airspeed
UA Overgross
14. TYPE EVENTS
MSL
AGL
Weight for
DATA
Duration
(Enter max of 3 codes from Table
KIAS
Weight
(Enter max of 3 codes from Appendix
3-4 of DA Pam 385-40 or specify
Conditions
F table F-3 of DA Pam 385-40 or
the phase if there is no code for it
specify the type event which best
Yes
No
in the table)
describes the accident/incident event
if there is no code for it in the table.)
a. At
Hours
Emergency/
Tenths
Onset
b. At
Hours
Impact/Acdt
Tenths
or Termination
c Flight Ctrl
Check all that apply:
Malfunction
Human
Environmental
Materiel
Hardware
Software
Component/Part
Not Applicable
(For blocks 15a-c, D=definite, S=Suspected, U=Undetermined and N=No/None)
a. Human Factors (Check box D, S, U or N.
15. ACCIDENT CAUSE FACTORS
If D or S, complete blocks 15a(1)(a)-(e))
a(1). System Inadequacies
(Enter max of 3 codes in each block below from table B-5 (Additional codes in table
D
S
U
N
B-1) DA Pam 385-40 or if there is no code in the table, write in that which best describes the failure)
a(1)a. Support Failure
a(1)b. Standards Failure
a(1)c. Training Failure
a(1)d. Leader Failure
a(1)e. Individual Failure
b. Materiel Factors
b(1). Type (Check all that apply.)
(Check box D, S, U or N. If D
D
S
U
Component/Part
Hardware
Software
N
or S, complete blocks 15b(1)-(2))
b(2). Component and Part
(Part that initiated failure/malfunction)
UAS Subsystem
Major Component
Part
(UA, GCS, GDT, TALS, etc.)
a. Nomenclature
b.
Type, Design,
and Series
c. Part Number
d. NSN/
Manufacturer's
Number
e.
Manufacturer's
Code
f.
Serial Number
(Enter the applicable Failure Codes (max 2) using
Materiel
Maintenance
g.
Cause of Failure/
table 1-2, DA Pam 738-751 (TAMMS-Aviation))
Malfunction
Design
Manufacture
c. Environmental Factors
c(1). General
(Check all that apply.)
c(2). Weather Conditions
(Enter max of 3 codes from Appendix F
(Check box D, S, U or N, as appropriate.)
table 3-26 of DA Pam 385-40 or specify the
D
S
U
VMC
IMC
Icing
Turbulence
N
weather condition if there is no code for it in
the table.)
c(3). Environmental Signal Factors
3
Uplink
Downlink
Interference
E
NA
Other (Specify)
c(4). Other Environmental Factors
(Enter max of 3 codes from Appendix F table 3-27 of DA Pam 385-40 or
specify the weather condition if there is no code for it in the table.)
(Check box D, S, U or N. If D or S,
a. Type of Link Lost
b. Type of Link
16. LOSS OF LINK
complete blocks 16 a-d)
LOS
BLOS
C-Band
Ku-Band
D
S
U
N
Uplink
Downlink
Unknown
Other (Specify)
c. UA distance from the GCS at time of LOL
d. LOL Factors
(Check all that apply.)
Human
Environment
Materiel
Hardware
Software
Component/Part
17. TAKE OFF/LANDING DATA (Complete block 17a if accident occurred during take-off phase and block 17b if during landing phase.)
a. Take-Off
a(1). T/O Method
a(2). T/O Accident Factors
(Check all that apply.)
(T/O) Phase
ATLS
Launcher
Manual
Human
Environment
Materiel
Hardware
Software
Component/Part
b. Landing
b(1). Landing Method
b(2). Landing Accident Factors
(Check all that apply.)
Phase
ATLS
TALS
FTS
Manual
Human
Environment
Materiel
Hardware
Software
Component/Part
PAGE 2 OF 3
DA FORM 2397-U, FEB 2010
APD AEM v1.00ES
18. TYPE OF STRIKE
Wire
Bird
Tree
Object
Lighting
Antenna
N/A
Other
(Specify)
(Complete for each crew member with access to flight controls, personnel injured/occupational illness, personnel having a contributing
19. PERSONNEL DATA
role in the accident; use additional forms if needed.)
a. Name (Last, First, MI)
(1) SSN
(2) Grade
(3) Gender (4) Duty (5) SVC
(6) UIC
(7) Contributing
(8) On Fit
(9) Lab Test
(Assigned) Role
Ctrls
Neg
D
Male
S
Yes
Pos
Female
U
N
No
Not Required
(10) Activity (a) Hrs Slept
(11) Individual Status
(12) Injury/Occupational Illness
(13) MTDS
(14) Total
Flt Hrs
Flt Hrs
(a) RL
1
2
3
Msn Prep
Msn Qual
(If "yes" complete and attach
(b) Hrs Worked
DA Form 2397-9)
NA
(SUAS Operators)
(b) FAC
1
2
3
(YYYYMMDD)
(c) Hrs Flown
(c) Redeployed Date
No
Yes
(3) Gender (4) Duty
(5) SVC
b. Name (Last, First, MI)
(1) SSN
(2) Grade
(6) UIC
(7) Contributing
(8) On Fit
(9) Lab Test
(Assigned) Role
Ctrls
Male
Yes
Neg
D
S
Pos
N
Female
U
No
Not Required
(10) Activity (a) Hrs Slept
(11) Individual Status
(12) Injury/Occupational Illness
(13) MTDS
(14) Total
Flt Hrs
Flt Hrs
(a) RL
1
2
3
Msn Prep
Msn Qual
(If "yes" complete and attach
(b) Hrs Worked
DA Form 2397-9)
(b) FAC
1
2
3
NA
(SUAS Operators)
(YYYYMMDD)
(c) Hrs Flown
(c) Redeployed Date
Yes
No
(4) Duty
(3) Gender
c. Name (Last, First, MI)
(1) SSN
(2) Grade
(5) SVC
(6) UIC
(7) Contributing
(8) On Fit
(9) Lab Test
(Assigned) Role
Ctrls
Male
D
S
Yes
Neg
Pos
Female
U
N
No
Not Required
(10) Activity (a) Hrs Slept
(11) Individual Status
(12) Injury/Occupational Illness
(13) MTDS
(14) Total
Flt Hrs
Flt Hrs
(a) RL
1
2
3
Msn Prep
Msn Qual
(If "yes" complete and attach
(b) Hrs Worked
DA Form 2397-9)
NA
(SUAS Operators)
(b) FAC
1
2
3
(YYYYMMDD)
(c) Hrs Flown
(c) Redeployed Date
No
Yes
20. FINDINGS AND RECOMMENDATIONS (See instructions in DA Pam 385-40, para 2-24, for writing findings and recommendations. Use additional sheets if needed)
Duty
Failure/error Code
SI 1
RM 1
RM 2
RM 3
Role
USACRC
use only
Phase of OP
Task/part no.
SI 2
RM 1
RM 2
RM 3
21. LIST OF ATTACHMENTS (ECOD/ACOD, CCAD, PQDR, DA Forms 2397-series, etc.)
22. BOARD PRESIDENT/ASO/POC (Name, Signature, and Date)
a. Grade
b. Branch
Address and Tel No. (DSN and Com)
E-Mail
23. COMMAND REVIEW (Only required for class A, B & C)
Rank
Reviewer
Organization
Name
(Last, First, MI)
Comments
Signature
a. Unit
Concur
Non-concur
Commander
b. Reviewing
Concur
Non-concur
Official
c. Approving
Concur
Non-concur
Aauthority
Aproved for entry into ASMIS
USACR/SC
d. DA Review
(YYYYMMDD)
PAGE 3 OF 3
DA FORM 2397-U, FEB 2010
APD AEM v1.00ES

Download DA Form 2397-u Unmanned Aircraft System Accident Report (Uasar)

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