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Relationship to the Victim
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Have you or your loved one received any settlement money from this claim?
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Was the injury due to someone else's negligence?
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Have you already filed a personal injury or wrongful death suit?
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Do you have an attorney assisting you with this claim?
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Do you want an attorney or Air Crash Consultants to contact you?
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Did the incident occur within the past three years?
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Date of Wrongful Death Incident: (This field is not required; it is here for your convenience. If your accident is not listed, select "OTHER" or skip this field.)
Other
September 6 2014 Láser Piper PA-31-350 Navajo
August 10 2014 Sepahan Airlines Flight 5915 HESA IrAN-140
July 24 Air Algérie Flight 5017 Swiftair McDonnell Douglas MD-83
July 23 2014 Transasia Airways Flight 222 ATR-72
July 17 Malaysia Airlines Flight 17 Boeing 777
March 8 2014 Malaysia Airlines Flight 370 Boeing 777-200ER
February 17 2014 Ethiopian Airlines Flight 702 Boeing 767-300ER
February 16 2014 Nepal Airlines Flight 183 de Havilland Canada DHC-6
November 29 2013 LAM Mozambique Airlines Flight 470 Embraer 190
November 17 2013 Tatarstan Airlines Flight 363 Boeing 73
October 16 2013 Lao Airlines Flight 301 ATR-72 ATR-72
October 3 2013 Associated Aviation Flight 361 Embraer 120
August 14 2013 UPS Airlines Flight 1354 Airbus A300 freighter
July 7 2013 Rediske Air de Havilland Canada DHC-3
July 6 2013 Asiana Airlines Flight 214 Boeing 777
May 16 2013 Nepal Airlines Flight 555 de Havilland Canada DHC-6
April 29 2013 National Airlines Flight 102 Boeing 747 freighter
April 13 2013 Lion Air Flight 904 Boeing 737
February 13 2013 South Airlines Flight 8971 Antonov An-24
January 29 2013 SCAT Airlines Flight 760 Bombardier CRJ200
June 3, 2012-Dana Air Flight 992
June 2, 2012-Allied Air
May 9, 2012-Sukhoi Test Flight
April 20, 2012-Bhoja Airlines
April 2, 2012-UtAir
Aug 16, 2010 —AIRES Flight 8250
May 22 2010-India Express Flight 812
May 12 2010-Afriqiyah Airways Flight 771
Jan 25 2010-Ethiopian Airlines Flight 409
Oct 26 2009-S-Air Flight 9607 Hawker-Beech Belarus
June 29 2009-Yemenia Airways Flight 626
June 01 2009-Air France Flight 447
May 20 2009-Tentara Nasional Indonesia-AU
May 5 2009-Cessna Veracruz
April 11 2009-Cessna 210M Concepcion Bolivia
March 26 2009 -Arrow Cargo, Manaus
March 12 2009-Cougar Sikorsky Flight 91/491
Feb 12 2009-Colgan/Continental Connection Flight 3407
Feb 7 2009-Manaus Aerotaxi
Feb 21 2008-Santa Barbara Airlines Flight 518
Sept 16 2007-One-Two-Go Flight 269
July 17 2007-Tam Lineas Aereas Flight 3054
May 12 2007-Bell Ferry Flight
Sept 29 2006-Gol Transportes Aereos Flight 1907
July 9 2006-S7 Airlines Flight 778
Nov 19, 2005-CessnaT210N Dana Point CA
Nov 5 2005-Cessna 500
Sept 17 2005-Piper PA-46-310P
August 14, 2005-Helios Airways Flight 522
Nov 30, 2004-Lion Air Flight 538
Oct 4, 2004-Hendrick Motorsports Beechcraft Super King Air 2004
May 17, 2004-Incair SRL Cessna T210J
June 29 2012 Tianjin Airlines Flight 7554 Embraer E-190
September 12 2012 Petropavlovsk-Kamchatsky Air Flight 251 Antonov An-28
September 28 2012 Sita Air Flight 601 Dornier Do 228
October 7 2012 FlyMontserrat Flight 107 Britten-Norman Islander
November 30 2012 In the 2012 Aéro-Service Ilyushin Il-76T Ilyushin Il-76T freighter
December 25 2012 Air Bagan Flight 11 Fokker 100
December 29 2012 Red Wings Airlines Flight 9268 Tupolev Tu-204
Dec 15 2008-Linea Aerea Puertoriquana
Nov 4 2008-Mexico City Learjet
October 21 2008-Cuidad Victoria, Tamaulipas
September 19, 2008-Global Exec Aviation Learjet
Aug 30 2008-Conviasa
August 24 2008-Iran Aseman/Itek Air Flight 6895
August 20 2008-Spanair Flight JK5022
July 2 2008 - UTAir Nizhnevartovsk
May 30 2008-Taca Airlines Flight 390
May 30 2008-Poulin L/Cullen D Lancair Legacy
May 24 2008-Island Express Helicopter Service
April 3 2008-Aero JL
Sept 14 2009-Aeroflot Nord Flight 821
Sept 6 2008-Kuzmino Russia
March 1, 2008 - RUSSIA – UGRA
May 11 2008-Cessna Santa Cruz
Dec 28 2014 Indonesia Air Asia Flight 8501
Feb 4 2015-TransAsia Airways Flight 235
March 5 2015- Delta Air Lines Flight 1086
March 24 2015- Germanwings Flight 9525
March 29 2015- Air Canada Flight 624
April 14 2015- Asiana Airlines Flight 162
April 25 2015- Turkish Airlines Flight 1878
April 7 2015- Cessna 414A Central Illinois Regional Airport
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I understand that submitting this form and the information contained herein does not constitute a Consultant/Attorney/Client relationship. I understand the response to the above question is general information and I will not be charged. I understand that state laws may vary, and therefore, I will not rely upon this information as legal advice. Since this matter may require advice regarding my home state, I agree that local counsel may be contacted for referral of this matter.
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