Airplane Weight and Balance Form
PDF, 1 page from the NTSB's investigation of the Amateur-built CHALLENGER II accident near Clarion, Pennsylvania, September 20, 2014. Shown as the NTSB released it (fetched from the NTSB as you open it).
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About this document
It is item 7 in the NTSB's docket for case ERA14LA450, titled "Airplane Weight and Balance Form" by the NTSB, 1 page. The NTSB removes some personal details before releasing docket documents; this site shows them as released and does not alter them. The docket at the NTSB.