"To improve aviation safety and to enhance scientific knowledge"

 

Please print out this form, fill it in, then send it to the address provided below.

IDENTIFICATION STRIP: YOUR IDENTITY WILL BE SAFEGUARDED THROUGH ASSIGNMENT OF A UNIQUE CODE NUMBER BY A NARCAP DATA ANALYST. YOU WILL NOT BE IDENTIFIED PUBLICLY WITH THE INFORMATION YOU PROVIDE. ALL U.S. FEDERAL LAWS RELATED TO RIGHTS OF PRIVACY WILL BE MAINTAINED. THIS IDENTIFICATION STRIP WILL BE REMOVED AFTER NARCAP HAS DETERMINED IF IT
IS NECESSARY
TO CONTACT YOU FOR FURTHER INFORMATION.
PILOT OBSERVER INFORMATION

Print your name:_____________________________________________                                   First              M.I.                 Last

Mailing Address: ____________________________________________

_________________________________________________________

City____________________________ State _______ Zip __________

Telephone: (home) (     ) ______ - __________ Hours: ______________

Alternate phone: (      ) ______ - __________ Hours: _______________  :

Your Commercial License Number:

 _______________________________ : :

 

Leave Space below blank

NARCAP Date–Time Stamp








       

- - - - - - - - - - - - - - - - - - CUT HERE - - - - - - - - - - - - - - - - - - - - - - - - - CUT HERE - - - - - - - - - - - - - - - - - -

National Aviation Reporting Center on Anomalous Phenomena

Pilot Aerial Sighting Report

All names and personal information you provide
will be kept confidential unless you give specific
written permission to disclose it. This information
is for research purposes only.

When completed, please return this form to:
NARCAP
P.O. Box 1535
Vallejo, CA 94590

Rept. No. ______-________

leave blank for NARCAP analyst use

Local Time (24 hr. clock): __________
Date: m______d_____y_____

Receiving Site: __________

Set type: ________________

Rec'd. ___________________

De-identified by: ________________
       Date: ______________

.
Part I. DETAILS OF THE ANOMALOUS PHENOMENON:

Date of Event: _________________________       Local Time of Event: ____________________

1. Please describe what you witnessed. Be as complete as possible. (Use opposite side of page if necessary.)








2. Now draw a sketch of what you saw. If you were able to see it from two or more different angles, simply draw what you saw each time and label each sketch (A), (B), etc. to indicate the order in which you saw it. Also, draw an arrow pointing gravitationally upward and aircraft windshield struts/frames/etc.
   If the Earth's horizon was visible draw it in also.
   Finally, draw magnetic compass heading Tick marks across the bottom of the box and label several according to your heading--as related to your sketches.

3. Did the object (phenomenon) appear to move relative to your aircraft's window frame(s) during your sighting? (check one) . . . . . . . . .

 
.

..

.

..

.

.

.

.

No     Unsure     Yes


  If "yes" please use a dashed line to indicate this apparent motion in the box to the right. Mark an "a" at the location the object was first seen, a "b", "c" etc. for subsequent locations. Be sure to indicate aircraft window frame(s) if present to allow angular estimates to be made. For uneven, jerky motion, place "a", "b", "c" etc. at one-second intervals.

4. Did the object (phenomenon) appear to move relative to any stable background detail during your sighting? (check one) . . . . . . . . .

.

.

.

.

.

No     Unsure     Yes


4.1 If the object appeared to move, please estimate its apparent angular velocity.

Deg/
_________Sec.

Motion seen in relation to: ______________


4.2 Did the object move    behind    in front of    (circle)
anything?

4.3 Did the object (phenomenon) appear (check)

No


Solid

Unsure


Transparent

Yes


Couldn't tell


4.4 Did you observe the object through (check)

.

Binoculars     Telescope
Camera viewfinder     Other _____________
.

4.5 About how large did the object appear as compared with one of the following items held at arm's length? (Note: The equivalent visual angles are based upon an average arm-reach distance of 26").

(If object changed size during the sighting, just place a "1", "2", "3", etc. at the check marks to represent the order in which the size change occurred.)

.
Head of pin
Pea
Dime
Nickel
Quarter
Half-dollar
Baseball
Grapefruit
Basketball
Other: ______
Equiv. Visual Angle
(0º 4.1') (Assume .031")
(0º 8.2') (Assume .062")
(1º 31')
(1º 47')
(2º 3.9')
(2º 37')
(6º 17')
(10º 53') (Assume 5" diam)
(20º 10')

4.6 How certain are you of your answer to the previous question 4.5? (check one)

Very sure     Fairly certain
Not very sure     Uncertain (only a guess)

4.7 Did the object (phenomenon)? (check all that are appropriate)

(a) Change shape . . . . . . . . . . . . . . . . . . .
(b) Flicker, throb, pulse . . . . . . . . . . . . . .
(c) Break up into parts or explode . . . . . .
(d) Suddenly accelerate . . . . . . . . . . . . . .
(e) Give off smoke, vapor, trail . . . . . . . . .
(f) Appear to stand still whole time . . . . . .
(g) Change color(s) . . . . . . . . . . . . . . . . .
(h) Appear on your aircraft's radar . . . . . .
(i) Appear on any ground radar . . . . . . . .
.
.



No     Don't know     Yes
No     Don't know     Yes
No     Don't know     Yes
No     Don't know     Yes
No     Don't know     Yes
No     Don't know     Yes
No     Don't know     Yes
No     Don't know     Yes (If "yes" elaborate)
No     Don't know     Yes (If "yes" please
   elaborate here:_______________________________
____________________________________________


4.8 Did you experience any buffeting which you think was caused by the encounter?

No     Possibly     Yes (If "yes" elaborate)
__________________________________________

5. How did the object first become noticed?
(check all appropriate boxes)

It was already present and I happened to look at it.
Someone else saw it first: (Give name: ____________)
It suddenly appeared at or near where I was looking.
It gradually faded into sight where I was looking.
Other (specify): _____________________________
       _________________________________________

6. How did the object disappear? (check all appropriate boxes)

I looked away and when I looked back it was gone.
It suddenly disappeared from sight for no reason,
       i.e., it didn't pass behind a cloud, etc.
It gradually faded from sight without changing size.
It faded from sight by becoming smaller and smaller.
It faded from sight (apparently) by traveling away.
Other (specify): ______________________________
       __________________________________________

7. What distinguishable detail(s) did you see on or nearby the object? (check all appropriate boxes)

None
Sharply defined egde(s)
Fuzzy edge(s)
Darker porthole-like areas: (Shape was ___________)
Lighter intensity portholes: (Shape was ____________)
Seam(s), rivets, etc.
Markings
Atmospheric effect(s): (Describe _________________
       __________________________________________

8. Did you notice anything unusual happen in the cockpit just before, during, or just after the sighting? (check one)

If "yes" desribe as fully as you can.

 

No   Unsure   Yes


_____________________________________________
_____________________________________________


9. What do you think made the object visible? (check all appropriate boxes)

It reflected ambient light (sun; moon)   (circle)
It emitted its own light  (If checked elaborate on
       colors, brightnesses, etc. seen) __________________
_____________________________________________
_____________________________________________

10. Where was the   Sun   Moon  (circle)
during the sighting?

At ______ degrees elevation above the horizon, and
       at ______ degrees bearing relative to aircraft heading
       to   Right   Left   (circle one).

11. If you experienced any physiological sensations during the sighting, check all appropriate boxes to the right.

If you experienced any non-normal sensations within 24 hrs after the sighting please place an X at the right of the appropriate line(s) provided.


Eye strain due to very high brightness __
Eye strain for any other reasons: (Explain __________)
Tingling sensation(s): (Body location _____________)
Mild pain: (Body location _____________________)
Intense, acute pain: (Body location ______________)
Heat ___
Odor(s) (Describe __________________________)
Taste(s): (Describe __________________________)
Sound(s): (Describe _________________________)
Other (___________________________________)

12. What do you think the object (phenomenon) was? Be as precise as possible including whatever supporting facts you desire.

_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________

13. Have you ever seen anything while flying or on the ground that you thought was an unidentified flying object prior to this?

No   Unsure   Yes   (If "yes" please give details): _______________________________________
_____________________________________________


Part II. AIRCRAFT FLIGHT DETAILS: (Spatial)

14. Where did you take off from?
            Lat. ____º ____' ____" N  S;

Airport Name (Initials): ________
           Long. ____º ____' ____"  E  W  (if known)

15. What was your intended final destination?
            Lat. ____º ____' ____" N  S;

___________________________________________
 Long. ____º ____' ____"  E  W  (if known)

16. Sighting location. Where were you when you first sighted the object? Be as precise as possible.

(If appropriate, specify)
           Lat. ____º ____' ____"  N  S;
           Long. ____º ____' ____"  E  W


__________________________________________
__________________________________________

From _____ VOR ______ RADIAL _____ DME
Elaborate if necessary: ________________________
__________________________________________

17. Check box to indicate where you were during the sighting.

Taxi to takeoff
During takeoff
Climb to cruise altitude at (__________ ft/min)
At cruise altitude of (_________ ft)
Descending for approach to land at (________ ft/min)
Final approach (i.e., within outer marker)
Landing or rolllout
Other: (specify _______________________________)

18. Check all appropriate boxes to indicate what you did as a direct response of sighting the object (phenomenon).

 

(Please elaborate on all items on
the opposite side if necessary)


Nothing that was not already planned
Changed heading by turning   right   left   (circle)
Changed altitude by   climbing   descending   (circle)
Took immediate evasive action (Describe ___________
_____________________________________________
____________________________________________)

Turned my landing lights   on   off   (circle)
Used my radio to contact: (Specify whom __________
___________________________________________)
Changed my power setting
Pointed it out to (Specify name(s) ________________
___________________________________________)
Attempted to   follow   chase   (circle)   it for the following reason(s): (____________________________________
___________________________________________)
Other: _____________________________________
____________________________________________


19. Please use this space to add any other details/observations/facts that are related to the geographic/spatial location of your sighting.

____________________________________________
____________________________________________
____________________________________________
____________________________________________


Part III. AIRCRAFT FLIGHT DETAILS: (Temporal)

DATE OF EVENT:

20. When did you takeoff?
                       AM
___________ PM (local)
___________ Time zone

(GMT ________Z)
Daylight savings
Standard time

21. When did you plan to land (scheduled)?
                       AM
___________ PM (local)
___________ Time zone (if d

(GMT ________Z)
ifferent from above)

22. When did you first see the object (phenomenon)?
                       AM
___________ PM (local)

(GMT ________Z)

23. when did you last see the object (phenomenon)?

(Calculated total sighting duration)

                       AM
___________ PM (local)

(___________sec.) Commen
______________________


(GMT ________Z)

ts: _________________


24. What did you look at (or do) to determine the above times?

Looked at my wristwatch: (Est. accuracy to _______)
Looked at cockpit clock: (Est. accuracy to _______)
Radioed to crewmember for time
Radioed to ground for time: (Info. rec'd. from ________
____________________________________________)
I did not determine   initial   final   (circle)   times(s)
Other: ______________________________________

25. Did you have any indication (real or imaginary) of a loss of time, i.e., a period for which you cannot account?

Possibly yes
Definitely yes: (Elaborate _______________________
____________________________________________)
Unsure but probably no
Definitely no

26. Did you land at your pre-planned or scheduled time?

Yes (within normal tolerance limits)
No (Please explain why ________________________
____________________________________________)

27. Use this space to add any other details/
observations/facts that are related to the timing of your sighting.

____________________________________________
____________________________________________
____________________________________________


Part IV. SIGHTING AIRCRAFT DETAILS:

28. Type of aircraft (check)

Single engine
Multi engine (no. _____)
Propeller
Jet
Rocket
Glider
Balloon

29. Model name/number/airframe mfgr.

____________________________________________

30. Aircraft registration number.

____________________________________________

31. Airline name (if appropriate)

_____________________________________________

32. Scheduled flight number.

_____________________________________________

33. Object (phenomenon) was seen through the following window(s).

_____________________________________________
_____________________________________________

34. Describe as precisely as you can the apparent clarity/scratches/etc. of these windows.

_____________________________________________
_____________________________________________

35. About how familiar were you with this particular aircraft and its "peculiarities" of flight control?

Very familiar: (I had about _____ hrs. flt. time)
Reasonably familiar: (Comments __________________
_____________________________________________

36. Use this space to add any other pertinent details about the aircraft in which you were located during this sighting.

_____________________________________________
_____________________________________________
_____________________________________________

37. What was your indicated airspeed?

___________   mph   knots   (circle one)

38. What was your ground speed (if known)?

___________   mph   knots   (circle one)


Part V. WEATHER DETAILS:

39. I obtained the following weather information from: (check all that apply)

Flight service station
Terminal forecast
SIGMET or AIRMET
FD (winds-temp. aloft)
Other: ______________________________________

40. Visibility and clouds: (check)

Clear (visibility greater than 15 miles)
Clear (visibility 3 to 15 miles)
Broken clouds - sky cover in tenths was ____
         Cloud type(s): Cumulus
Stratus
Cirrus
Other: ______________________
Heavy overcast:   below   above   (circle)   my aircraft
Flying in clouds at the time
Other: _____________________________________

41. Did you file a flight plan? (check one)

No   Yes

42. Were you flying: (check one)

IFR   VFR

43. Sky condition was: (check one)

Bright daylight
Dull daylight (slight overcast, smog)
Twilight
Trace of daylight
Dark - no Moonlight
Dark - Moonlight present from: Full
3/4 visible
1/2 visible
Crescent
A few stars visible
All stars visible (very clear)
Don't remember

44. Outside air temperature was:

    ____________ TAT = ____________

45. What was the wind direction and velocity?

___________________________________________

46. Use this space to add any other details about the weather at the time and location of the sighting.

_____________________________________________
_____________________________________________
_____________________________________________


Part VI. EYEWITNESS DETAILS:
.
NOTE: This information will be kept confidential unless you indicate in the space below that it may be disclosed publicly.

47. Your full name: ____________________________________________________
                                     First                               Middle                              Last
48. Your mailing address: ___________________________________________________________
                                             Street                             City/Town                    State/Province      Zip
49. Your age at the time of sighting: _______ years
50. Your sex: (check)   Male   Female
51. Occupation: ___________________________
52. Marital status: (check one)   Single   Married   Divorced (widowed)
53. Telephone: area code (____) number (_________________)
54. Highest education level: ____________________________
55. Describe military aviation experience (if any): _________________________________________
      ___________________________________________________________________________
56. During the sighting were you wearing: (check)
      Prescription eyeglasses (no tint)
      Prescription eyeglasses (with tint)
      Contact lenses
      Polarizing sunglasses only
      Non-polarizing sunglasses
      No eyeglasses of any kind
.
PLEASE READ CAREFULLY (Sign one of the two statements that expresses your wishes.)

"I hereby permit my name to be publicly associated with the information I have free given on this form."
___________________________________________

"I do not permit my name to be publicly associated with the information I have freely given on this form."
___________________________________________

Copyright 1980, Richard F. Haines

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