On November 14, 2000, about 1442 mountain standard time, a Piper PA-18, N8415Y, sustained substantial damage when it collided with terrain shortly after take off from a private airstrip 30 miles northeast of Broadus, Montana. The airplane was being operated by the pilot as a Title 14 CFR Part 91 personal/pleasure flight when the accident occurred. Visual meteorological conditions prevailed and no flight plan was filed for the local flight. The private pilot, the sole occupant of the airplane, sustained serious injuries and was airlifted to Billings, Montana. There was no fire and no report of ELT activation. During a telephone conversation with the National Transportation Safety Board on June 4, 2001, the pilot stated that he was departing from the private, snow-covered runway. He reported that the airplane "stalled" shortly after becoming airborne and impacted terrain in a nose low attitude. To date, the National Transportation Safety Board has not received a completed Form 6120.1/2 (Pilot/Operator Aircraft Accident Report) from the pilot.