Appendix 9       
Form 765 (C) (Revised Dec., 1941)   
In every case copies of this form are to be rendered as follows:-
(i) One copy direct to Air Ministry, C.I. (Accidents)   If this incident has been reported
 to the Air Ministry by signal, quote
 Reference No. and date.
(ii) Two copies direct to Air Ministry, (S.4. Statistics)  
(iii) One copy direct to Ministry of Aircraft Production (R.M.I.)   A.175 27.7.43
(iv) One copy through usual channels to Command Headquarters    
[ In addition and only if casualties to airman are involved ]
(v) One copy direct to Records Office
1.   Unit          350 (Belgian) Squadron Group No.  12 Command  Fighter Serial No.
of Form       6.7.43 
2.   Date of Incident       27.7.43 3. Nature of and purpose for which flight authorised:- 
     Time    11.00 hrs.  
  (i) Operational or non- operational... Non-Operational
(a)  Name of Aerodrome or landing ground    ACKLINGTON+ (ii) day or Night flying?....  Day
(b)  Place (if (a) not applicable) (iii) Purpose.... Practice Formation
(c)  County    NORTHUMBERLAND  
Part (a) to be completed if the incident occurred on, or whilst taking off from or approaching to land on an aerodrome or landing ground This flight is being included in this Unit's flying hour summary on: Form 765A  /  765B ....(Delete as necessary)
4.  Type of airframe and engine and extent of damage (see footnotes to this section)
Details of Airframe and Engine Airframe Engines
Single or Port Starboard Centre Port Centre Starboard
Mark or series V.B. 45      
RAF No. and makers' No. for engines. A.R. 383 38001/21731      a a a a
Total hours run b 99.45          b b b b
Date last installed in airframe ----- 24.5.43         b b b b
c. Extent of damage Cat.  B.        
a. To be quoted whenever an engine is damaged or fails
b. To be quoted only for incidents involving defect or failure of airframe or engines
c. To be indicated as :-
E = Missing, unrepairable, reduction to scrap or instructional.        B = For repair at contractor's works or R.A.F Depot.
AC = For repair by contractor's working party.      A = For repair by nearest R.A.F. unit.       U = No damage.
5. ALL OCCUPANTS OF AIRCRAFT                  and                    FLYING EXPERIENCE OF PILOTS
Names to be entered in order of duty: 1st Pilot, 2nd Pilot, Pupil Pilots, etc.
Degree of injury to be classified as: Missing, Killed, Injured (admitted to Sick Quarters or Hospital), Slightly Injured (not admitted to Sick Quarters or Hospital), Uninjured. (Quote as M, K, I, I(s) or U as appropriate
Flying Experience of Pilots  and Pupil Pilots. See note (ii)
Part A Part B (see note (i) below) Part C
Total Solo (Day and Night) Solo (Night) Instru-
Link Trainer
Total quoted in part 4 All types Total quoted in part 4 All Types
Duty Name and Initials (Nationality to be quoted if not British) Rank No. Degree of Injury
Pilot VERPOORTEN F. (Belgian) Sgt. 1424934 U 181 219        
            (plus 293 hrs. Solo in Belgium)    
NOTE (i) Part B only to be quoted if incident occurred during night flying. (ii) Quote to nearest hour. (iii) Part C only to be quoted if loss of control at night or in bad visibility or cloud by day is a possible contributory factor.
A. Picketing or at moorings.
 B. Starting up.
 C. Stationary other than A or B.
  D. Taxying.     E. Taking off.
 F In flight.    G. Landing.
 H. Towed or manhandled.
 J. Not known.

Complete A or B or C, etc., as appropriate.
 If yes, state "In air" or "On ground" as appropriate. If no fire state "No"
A Day (daylight)  B. Dusk (Half light of evening)
C. Dawn (half light of morning)
D. Dark (no moon or moon obscured)
E. Moonlight. F. Not known.

Quote as A or B or C etc., as appropriate and amplify in Part 12 (B) if necessary.
9.IF INCIDENT OCCURED when taxying on, taking off from or landing on a runway state "Yes"
G No A Yes
10. SUMMARY OF PILOT'S REPORT (or a description of circumstances which terminated in the accident if the pilots report is not available). In cases of engine failure information should be given as to the behaviour of the engine and manipulation of the engine controls immediately before failure.

Duration of flight since last take off: Hours....-.....Minutes....55...... If engine failure occurred during take off quote height......N/A.

Pilot had been on practice formation at 20,000 ft. and came in to land following other aircraft and doing powered approach. When circling round with 0 boost and 2,400 revs he saw black smoke pouring out of port exhaust pipe. He checked up on all gauges and found all O.K. He throttled back, fine pitch and lowered under-carriage. At 700 ft., minus 4 boost and 130 A.S.I. he lowered flaps. At 500 ft. his engine cut out and he glided to 200 ft., trying all throttle and pitch positions without success. He then raised undercarriage and crash landed in a field just on the border of the aerodrome. During all his period of approach, black smoke was still pouring from his port exhaust.

11. REPORT BY APPROPRIATE SPECIALIST OFFICERS (A. E. Nav., &c.) :(i) If technical failure is involved information as to the nature and cause of the failure is required; precise information as to the extent of the damage arising as a result of this failure is not required. (ii) If the non-embodiment of an authorised modification is considered to have contributed to the accident, the serial number of the modification and reason for non-embodiment should be stated.

Cockpit examined at scene of crash showed oil and coolant temperature gauges normal. Engine controls normal, switches and petrol off. Engine investigated; petrol flow and carburettor O.K. Restrictor fitted petrol pump O.K. Petrol filter clean. Pressure oil filter normal. Scavenge oil filter O.K. Magneto and drive O.K. Tappet cover removed both blocks. Valves appear O.K. Camshaft drives intact. Defect therefore obscure and internal. Engine will be sent to Rolls Royce for 1022 strip examination for report to be sent to Station Engineer Officer R.A.F. ACKLINGTON. Traces of glycol were reported on breather outlet pipe but no glycol had been found in the filters.

Is form 1022 or 1023 being rendered? If "Yes" stated which ...... Signature .....R. FLANAGAN P/O Engineer Officer 350 (Belgian) Squadron.
12. REMARKS BY UNIT COMMANDER (to be given under three separate headings) :-

PART A. Remarks as to circumstances of the incident. (If it occurred at night on or near an aerodrome the nature of the lighting system in use at the time is to be noted in Part A.)

PART B. Diagnosis of all contributory factors. The manner in which any particular factor contributed to the incident is to be clearly indicated.

PART C. General remarks (including any recommendation with with regard to personnel, training, airframes, engines, accessories, etc., and notes of any action taken as a result of this incident)

A. Accident occurred when landing. Engine failure at 60 feet when the pilot was unable to reach runway.

B. No apparent external failure - the engine is being sent to Roll's Royce for further examination.

C. The pilot has shown great professional abilities when about to crash. In a few seconds he put his undercarriage up, switched off the contact, and managed with great skill to avoid huts in front of him and crash in a small corn field.

Signature..............BOUSSA S/L...................... Commanding.........350 (Belgian) Squadron..................... Date   29.7.43
13. REMARKS BY STATION COMMANDER (and notes of any action taken as a result of this incident) : -

(i) Was any assistance rendered in rescue work after the accident which is considered worthy of recommendation? Yes or No.........If any such assistance was rendered, the recommendation is to be forwarded separately.

(ii) Remarks.

(i) No.

(ii) Accident apparently due to technical failure. Pilot did very well in carrying out all emergency measures, and making a safe belly landing.

Signature............E. GRAHAM W/CDR................... Commanding...................... Date...