Approved For Release 2005/07/20 : CIA-RDP81R00560R000100060001-5
4. How did you happen to notice the object?
__________________________________________________________
__________________________________________________________
__________________________________________________________
5. When did you report to some official that you had seen the object?
______ Day ______ Month ______ Year
__________________________________________________________
__________________________________________________________
SECTION B
6. What were you doing at the time you saw the object?
__________________________________________________________
__________________________________________________________
6.1 What had you been doing for the 30 minutes before you saw the object?
Try to list the activity or activities and the approximate amount
of time spent on each.
__________________________________________________________
__________________________________________________________
__________________________________________________________
7. Were you moving at any time while you saw the object? (Circle One):
Yes or No
IF you answered YES, then complete the following questions:
7.1 What direction were you moving?
(Circle One):
a. North e. South
b. Northeast f. Southwest
c. East g. West
d. Southeast h. Northwest
7.2 How fast were you moving? __________ miles per hour.
7.3 Did you stop at any time while you were looking at the object?
(Circle One): Yes or No
8. What direction were you looking when you first saw the object?
(Circle One):
a. North e. South
b. Northeast f. Southwest
c. East g. West
d. Southeast h. Northwest
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Approved For Release 2005/07/20 : CIA-RDP81R00560R000100060001-5