Electronic NVWG Form 173-1 Member-Paid Flying Worksheet

Civil Air Patrol Nevada Wing Form 173-1

Member-Paid Flight Worksheet
Date of flight*

MonthDayYear
Name of pilot (student name if applicable)*
CAPID of pilot*
E-mail of pilot*
Your E-mail Address
Phone # of pilot*

Area CodePhone Number
Aircraft type*
Aircraft N-number*
Mission number*
Mission symbol
Sortie number(s) (airplanes only)
Number of hours (Hobbs)*
For gliders, enter number of sorties
Total amount*
Paid by*
For flying authorized to be paid by other than member, name of approving authority (or "Memo" if one of the types of flying always authorized)
If paying by check, where was check left/sent?
As established by the Nevada Wing Financial Management Policy, pilots utilizing member-paid flying (generally B and C missions) are responsible for paying for fuel. Pilots are also responsible for hourly maintenance costs of the aircraft except where specified in the memorandum distributed to all pilots on 2 November 2023.

Pilots will be billed via an automated system for payment via credit card or ACH. If this is not acceptable, a check should be made out to "Civil Air Patrol" (not "CAP" or anything else) and mailed to the NVWG Director of Finance, Lt Col Pete Goertzen, 10345 Running Falls St, Las Vegas, NV 89178.
Signature*

Clear
Please verify that you are human*
Any additional comments?
Optional Courtesy Copies

You and finance personnel will receive copies of your submitted form. If you'd like anyone else to have a copy, enter their e-mail addresses below.
Optional first email to CC
example@example.com
Optional second email to CC
example@example.com
Optional third email to CC
example@example.com
Should be Empty:

Civil Air Patrol Nevada Wing Form 173-1

Optional Courtesy Copies