Approved For Release 2005/07/20 : CIA-RDP81R00560R000100060001-5
TENTATIVE
OBSERVERS DATA SHEET
*Where Choice is Given, Circle Proper Answers, or Insert Answer*
1. Date of your observation:
Day _______ Month _______ Year _______
2. Date you reported the observation:
Day _______ Month _______ Year _______
3. What time was it when you sighted the object:
Hours _______ Minutes _______
A.M. P.M. Daylight Standard
Zone: Eastern, Central, Mountain, Pacific, _______ Other
4. Length of time object was observed. Estimate:
Hours _______ Minutes _______ Seconds _______
5. Where observed:
Postal Address _______ City or Town _______ State _______ Country _______
6. Where were you at time of observation:
Inside building, In Car, Outdoors, _______ Other
7. Were you moving at any time during this sighting:
Yes or No _______
8. Did you stop at any time during this sighting:
Yes or No _______
9. If you were moving - give _______ and _______ miles per hour.
Direction _______ Speed _______
10. How was object observed:
Naked eye
Eye glasses
Other glass (Window or Windshield)
Binoculars, Telescope, Theodolite
Other _______
11. How did you happen to notice the object:
___________________________________________________________
___________________________________________________________
___________________________________________________________
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Approved For Release 2005/07/20 : CIA-RDP81R00560R000100060001-5