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Disturbance Details Tell us about the disturbance.
Disturbance date (required)	Month (required) JanFebMarAprMayJunJulAugSepNovDec Day (required) 12345678910111213141516171819202122232425262728293031 Year (required) 20242023
Disturbance time (required)	Hour (required) 000102030405060708091011121314151617181920212223 : Min (required) 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859
Aircraft type	JetPropellerHelicopterVariousUnknown
Event type (required)
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Would you like a written response?	Yes
Your Contact Details If a written response is requested, name, address, city and zip code details are required. *Please provide email address to obtain email confirmation of complaint submittal.
First name
Last name
Address
City
State	CA
Zip code
Email *
Home phone
Work phone
Cell phone

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