Air Vall‚e flight 5378, an Airbus A320-212, experienced a tail strike during takeoff from Verona Airport, Italy. The aircraft was operated under a wet lease agreement between Air Vall‚e and BH Air. The aircraft was operating a multiple destination flight originated in Hurghada, Egypt (HEGN), having an intermediate stop in Verona and a final destination of Rome-Fiumicino (LIRF). At departure from Hurgada, 77 passengers with destination Verona were seated in the forward and central cabin and 87 passengers with destination Rome Fiumicino were mainly seated in the central and aft cabin. Baggage and cargo with destination Verona were located in the forward (no. 1) compartment while those with destination Rome Fiumicino were located in the aft (no. 3) cargo compartment. After landing in Verona only passengers, baggage and cargo with final destination Verona were disembarked. Before takeoff from Verona the captain received an approved Load and Trim sheet from the handling agent and where the seating of the transit passengers was different from that of the incoming flight, equally balancing their distribution on board in the three cabin areas. This was not detected or not considered by the captain, as the passengers remained in the same seats they had occupied in the previous flight. The captain decided that no refueling was necessary and the aircraft departed from Verona with 87 passengers seated, as per their original seats assignment in Hurgada, mainly in the center and aft cabin, and with remaining baggage and cargo in the after (no. 3) cargo compartment where it was originally loaded in Hurgada. During the initial part of the take off run, as soon as the throttle levers were advanced to FLEX position, the aircraft started an uncommanded early rotation causing a tail strike on the runway. The takeoff run was continued with subsequent degradation of flight control laws to alternate law and direct law. The aircraft lifted off at 113 kts and immediately after lift off a stall warning activation occurred for about 5 seconds. The aircraft continued the takeoff and climb until the activation of the master warning related to pressurization system fault occurred, at this time the crew decided to return to Verona where the aircraft landed with no further problems. Inspections on ground revealed extensive structural damages to the lower part of the tail fuselage compromising the pressurized compartment. CAUSES (translated from Italian): The cause of the accident is due to human factors. In particular, the incident was triggered by an uneven aircraft loading from the approved Load and Trim Sheet, relative to the position of the passengers on board, which resulted in a position of the center of gravity outside the rear limit of certification for the take-off for a mass of 56 t, the condition in which the A320 LZ-BHC was found. The following factors contributed to the event: – the absence of specific procedures for the aircraft operator, related to the loading of aircraft (passengers, baggage and cargo) in the case of flights with multiple destinations; – the absence of pre-established and recognized mechanisms of notice to the captain that the allocation of seats on board between the original flight (Hurghada-Verona) and the final destination (Verona-Rome) had to be significantly modified to maintain the position of the center of gravity within the limits allowed for take-off; – the absence of a verification of the actual correspondence between the aircraft loading condition indicated in the Load and Trim Sheet approved with respect to the actual configuration on board. Furthermore, it is believed that the failure to timely stop the take-off procedure at the start of the anomaly in the aircraft’s controllability contributed to a greater exposure to the criticality triggered by the loading of the aircraft different from the approved Load and Trim Sheet.