This form may be printed out for use.
NAME OF INVESTIGATOR: ___________________________________________
STREET ADDRESS: _________________________________________________
TOWN/CITY: ______________ STATE: ______ ZIP CODE: _______ COUNTRY:_______
Draw a simple sketch of the object (Label any lights, colors, protrusions) (On a separate piece of paper, please sketch a simple map of the area showing your position and the object's position. Include an arrow denoting the direction of North. Indicate direction that the object was moving.)
Please describe the incident as it happened. Be sure that your narrative includes the following:
- Where were you and what were you doing at the time?
- What made you first notice the object?
- What did you think the object was when you first noticed it?
- Describe your reactions and actions, during and after sighting the object
- Describe the object and its actions.
- How did you lose sight of the object? (Use additional pages as necessary)
Place of sighting
__________ PM( ) AM( ) Time Zone: _________
Durations: __________ Sec( ) Min( ) HRS( )
Date of Sighting
Day: ______ Month: ________ Year:_______
Environmental Situation (Check/Fill in as Applicable)Viewed From: Outdoors( ) Indoors( ) Car( ) Aircraft( ) Boat( ) Other _______ Viewed Through: Glasses( ) Window( ) Screen( ) Binoculars( ) Telescope( ) Still Camera( ) Movie Camera( ) Theodolite( ) Radar( ) Other _________________________ Area/Location: City( ) Suburban( ) Rural( ) Industrial( ) Commercial( ) Residential( ) Area/Terrain: Fields( ) Woods( ) Hills( ) Mountains( ) River( ) Pond( ) Lake( ) Area/Technical: Airport( ) Powerlines( ) Power Station( ) Railroad Tracks( ) Other ____________ Sky Condition: Clear( ) Partly Cloudy( ) Overcast( ) Foggy( ) Heavy( ) Medium( ) Light( ) Precipitation: None( ) Rain( ) Fog( ) Sleet( ) Snow( ) Heavy( ) Medium( ) Light( ) UFO Direction: First Seen in __________ Last Seen in ___________ It Moved from ______ to ________ UFO Elevation: First Seen - 1/4( ) 1/2( ) 3/4( ) of the way up horizon Overhead( ) Other______________ Last Seen - 1/4( ) 1/2( ) 3/4( ) of the way up horizon Overhead( ) Other______________ UFO Distance: When Closest to me ________ UFO Altitude when closest to the ground __________ UFO Passed: In-Front of ____________, which was ____________ in distance from the witness. Behind __________________, which was ____________ in distance from the witness. Also in Area: Airplane( ) Helicopter( ) Balloon( ) Searchlight( ) Other ____________ Before witness sighted UFO( ) During UFO sighting( ) After UFO sighting( )
Object Description(Check/Fill in as applicable)Observed: An Object( ) Number of _____ Shape of ______ Color(s)______ A Light( ) Number of _____ Shape of ______ Color(s) _______ Describe: Sound: _____________________________________________ Smell: _____________________________________________ Speed: _____________________________________________ Real Size: Larger( ) Smaller( ) Same Size( ) as the object listed below Basketball( ) Compact Car( ) Standard Car ( ) House( ) Other _____________ Apparent Size: Many times larger( ) Smaller( ) if put in the sky beside object below? __________ Times the size of a star _________ Times the size of a full moon Bright as: A Star( ) The Moon( ) Or a ______ Light if placed at the same distance away. Did the Object(s) or Light(s): (Please elaborate on items checked below by using a separate sheet.) Change Direction?( ) Hover?( ) Affect Radio/TV?( ) Flutter?( ) Turn Abruptly?( ) Descend?( ) Affect Electricity?( ) Spin?( ) Fall like a leaf?( ) Ascend?( ) Affect Magnetism?( ) Blink?( ) Absorb objects?( ) Over Powerlines?( ) Affect Timepiece?( ) Pulsate?( ) Eject objects?( ) Over a building?( ) Affect Engine?( ) Appear Solid?( ) Change Shape?( ) Land on ground?( ) Affect vehicle?( ) Have fuzzy edges?( ) Cast Shadow?( ) Land in water?( ) Affect animal?( ) Have outline?( ) Cast Light?( ) Carry occupants?( ) Affect human?( ) Wobble?( ) Reflect Light?( ) Communicate?( ) Affect water?( ) Vibrate?( ) Leave a trail?( ) Give off heat?( ) Affect ground?( ) Glow?( ) Disintegrate?( ) Leave Residue?( ) Affect Vegitation?( ) Appear Transparent?( )
How many other witnesses? ________________ Did any other Agency Contact You? ___________ Please provide the Names/Addresses/Phone Numbers of other witnesses and/or investigators or agencies on separate sheet if applicable and known. Signature of Observer ____________________________ You may( ) may not( ) use my name Date this form signed _______________________ Day Month Year