On September 4, 2005, at 1754 eastern daylight time, a homebuilt VariEze, N220EZ, was substantially damaged during a forced landing near New Cumberland, Pennsylvania. The certificated private pilot incurred minor injuries. Visual meteorological conditions prevailed, and no flight plan had been filed for the local flight, which originated at Capital City Airport (CXY), New Cumberland, Pennsylvania. The personal flight was conducted under 14 CFR Part 91. According to a Federal Aviation Administration (FAA) inspector, the airplane had been airborne about 5 minutes when the engine lost power. The pilot then force landed in a field, and the airplane nosed over. During a post-accident examination of the airplane, the propeller was replaced, and the engine was started and operated for about 5 minutes at 1,700 rpm. The fuel system was also examined, and the fuel screens in both fuel tanks were found to be covered in a "fine muddy silt." A subsequent fuel analysis revealed that "particulate contamination and gum levels [were] very high." The fuel tanks had been open during the airplane's construction, and the airplane had about 30 hours of operation at the time of the accident. The pilot held a private pilot certificate. On his latest application for an FAA third class medical certificate, dated May 1, 2003, he reported 70 hours of flight time. Despite multiple requests and a verbal assurance that he would do so, the pilot did not return a NTSB Form 6120.1, as required per 49 CFR 831, which may have provided additional information regarding this event.