CENTER
FOR UFO STUDIES
P.O. Box 31335
Chicago, IL 60631
Please use this form as a guide, and feel free to add
narrative comments or information on the last page.
Names and other personal information included on this
form will be kept confidential. Mail form to above address.
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DURATION OF SIGHTING
Seconds
Minutes
WHAT WERE THE WEATHER
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u
55
H
CONDITIONS?
Clear _______ Partly cloudy _____ Full cloud cover
Fog
Rain
Sleet _____ Snow ______ Smog ______
Hazy
55
O
Hours
Windy
Temperature
Wind direction
H
H
X
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O
o
H
-1
DESCRIBE THE AREA OF THE SIGHTING
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55
O
H
City
Suburban
Rural
Commercial
Industrial
Residential
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Q
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X
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WHERE WERE YOU WHEN YOUR
Outdoors
EXPERIENCE OCCURRED?
Indoors
In a car
Were you looking through:
A
screen
Double glass
Glass
WHAT WERE YOU DOING WHEN YOU
Lying down _______
Driving _____
Flying
FIRST OBSERVED THE UFO?
Sitting _______
Standing _______
Riding as a passenger
Riding as a passenger in an airplane
w
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CO
HOW DID THE UFO COME TO YOUR
ATTENTION?
Someone else called it to your attention
o
X
Heard a sound ________
Heard animals react
Saw the object move _____
Electrical interference
Don't really know ______
Other
H
W
W
W
JM
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as
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55
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Saw a light
WHAT DID YOU
SEE?
A light
An object
How many of either
Were there any other witnesses _______
How many _____
Do you know them _______
Please list their names and addresses below:
WHERE WAS THE LIGHT OR OBJECT WHEN FIRST SEEN?
High in the sky
Tree top level
On the ground
How high was it ______________________________________________
How far away was it ____
How fast was it moving
WHAT WAS THE APPEARANCE OF THE LIGHT OR OBJECT?
How large was it ______________________________________
Shape
Was it clearly outlined
Color
_____________________________________________________________
Did you notice:
Appendages
How many lights
Seams
Windows
Lights
Pulsating
Steady
Did it separate into parts
How many
WHAT DID IT DO?
Moved across sky
Hovered in sky
Hovered near ground
Rotated
Vibrated
Wobbled ______ Exploded ______
Fell like a leaf (fluttered)
Changed speed
Changed color
Changed direction suddenly
Moved in straight line ______
In what direction did it move ^^__________________________________________
Did it pass in front of, or behind any object ______
What
How far away was that object ____________________________
Did it land
How close:
feet
yards
How did you lose sight of the object _____________
Please describe your experience below, adding any pictures or maps
you feel would be helpful:
174
DID YOU SEE ANY IDENTIFIABLE OBJECTS IN THE SKY?
Airplane
Balloon _______ Birds
Searchlight
Was the moon visible _______ Were the stars visible
Other
HOW DID YOU OBSERVE THE LIGHT OR OBJECT?
Naked eye
Binoculars
Telescope
Other
DID YOU NOTICE ANY EFFECT ON THE FOLLOWING:
Radio
Television ______ Engines _______ Lights
Clocks ______ Animals
Did you have any physical sensations
Please explain any of the above:
DID ANY EVIDENCE OF THE UFO'S PRESENCE REMAIN?
Imprints
Residue _______
Damage to vegetation
Other __________________________________________________________
Is there any photographic or other evidence ________
Has any of the above been preserved
GENERAL
Was this sighting reported in the press
What paper
What day did the account appear ______________________________
Have you ever seen anything like this before
Technical experience ______________________________________
Educational background _____________________________________
Occupation __________________________________________
Age
YOU MAY/MAY NOT USE MY NAME. SIGNATURE WITNESS:_____________________________