| 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 _____________
. |
4.6 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) |
4.8 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). |
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
_______________________________) |
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) |
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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