MESSAGE SLIP

FI-4   PRELIMINARY REPORT TO UFORA

Electronic version. Copy and paste data bel;ow dotted line and paste into email
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Date of sighting
Time           AM  PM (Circle One)
City
State
Shape of UAP
Number of objects
Estimated size
Size at arm's length
Number of supporting witnesses
Sound
Duration
Distance
AltitudeObserved/recorded using NVG (night vision goggles) Yes   No
Or with polarized sun glasses (check for Faraday rings) Yes  No

PHYSICAL CHARACTERISTICS: (Check appropriate boxes)
(  ) Light form only                                 (  ) Vehicle/device
(  ) Animal reaction                                 (  ) Physical trace                           
(  ) Electromagnetic event                       (  ) Images or videos taken
(  ) Confirmed by radar                           (  ) Pilot report

FLIGHT CHARACTERISTICS:
(  ) Passed overhead                                (  ) Within 200' of ground
(  ) Under cloud ceiling                           (  ) Change in motion
(  ) Continuous flight                              (  ) Stationary target

REPORTING MADAR OP:

Name
Node #
Address
City/State/Zip
Home phone
Office phone

Created by Francis Ridge.