IRAAP: Report HTM

1.	Date reported: _________________ Time: ___________________
2.	Date of occurrence:_____________ Time: ___________________
3.	Nature of report: __UFO __Apparition __Animal __Other:_____________
4.	Witnessed by: Name: ______________________________________________
	Address: __________________________________________________________
	City: ____________________________ State: _________ Zip: __________
	Home Phone: (____) ______________ Business Phone:(____)___________
5.	Additional Witnesses:
	a. Name:________________________ Address: _______________________
	Phone: (____) _______________ _______________________
	b. Name:________________________ Address: _______________________
	Phone: (____) _______________ _______________________
	c. Name:________________________ Address: _______________________
	Phone: (____) _______________ _______________________
6.	Geographic location of incident:
	Nation: _____________________ State/Province: ________________
	County: _____________________ Nearest City/Town: _____________
7.	Exact location (Road/Nearest landmark, etc.) [Example: Near mile marker #71 on I-35] ___________________________________________________________________
8.	Is there an Airport/Air Base/Military Base within a radius of 10 miles? __Yes __No. If “yes,” name of facility: _________________________
9.	Estimated distance from observer’s location to Subject being reported: ___________________________________________________________________
10.	How many Subjects were there? _________________________________________
11.	Describe the Subject(s) in detail (if more space is needed, continue at end of form): ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________
12.	Was/were the Subject/s moving? ___Yes ___No If moving, in what direction? __N __S __E __W __NE __NW __SE __SW Elevation: ________________________________ Azimuth: __________________________________
13.	How long did the incident last? ____Seconds ____Minutes ____Hours
14.	Were any sounds associated with the incident? ___Yes ___No Any odors? ___Yes ___No If “yes,” describe: _______________________________________________ ___________________________________________________________________ Were any other physical attributes associated with the event? _____ ___________________________________________________________________ ___________________________________________________________________
15.	Summary of what happened (continue at end of form if necessary): ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________
16.	Background of witness: ____________________________________________ ___________________________________________________________________
17.	Any other information you believe would be useful? ________________ ___________________________________________________________________
18.	Does witness wish name to be kept confidential? __Yes __No
19.	Signature of witness: _____________________________________________ Date: ____________________________
20.	Investigator’s name (print): ______________________________________ Investigator’s signature: _________________________________________ Date: ____________________________
	Use space below for additional information: