Approved For Release 2005/07/20 : CIA-RDP81R00560R000100060001-5
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SECTION E
26. Was this the first time that you have seen an object like this?
(Circle One): Yes or No
26.1 IF you answered NO, then when, where, and under what conditions did you see other ones?
27. In your opinion what do you think the object was and what might have caused it?
28. Give the following information about yourself:
NAME
Last Name | First Name | Middle Name
ADDRESS
Street | City | Zone | State
TELEPHONE NUMBER
What is your present job?
Age
Sex
29. Was anyone else with you at the time you saw the object?
(Circle One): Yes or No
29.1 IF you answered YES, did they see the object too?
(Circle One): Yes or No
29.2 Please list their names and addresses:
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Approved For Release 2005/07/20 : CIA-RDP81R00560R000100060001-5