GPS Anomaly Reporting Form

* Indicates a required field

Name*:

Email*:

Phone: (e.g. 123-456-7890)

Date and approx. time of anomaly*: (e.g. mm/dd/yy HH:mm)

Where did you experience the anomaly? (Bearing from nearest Airport, Navaid, Fix, City or Lat/Long):

If contacted, what is the name of the Aviation facility you reported the GPS Anomaly to (ARTCC, TRACON, ATCT, FBO etc.)?:

Make/Model/SW Rev. of GPS receiver used:

What was your altitude at the time of the anomaly: (e.g. 12500)

What was your mag. heading at the time of the anomaly: deg. (e.g. 275)

How many satellites were being tracked at the time of the anomaly:

Summary: (Please provide ANY additional information, unusual screen displays, etc):

Note: The information you provide will be used to correlate your event with any other reported GPS anomalies and assist in an investigation.

FAA for…