A.R.C.
ANTUMBRA RESEARCH FACILITY
Advancing Scientific Understanding Through Empirical Research
WITNESS STATEMENT FORM - ANOMALOUS PHENOMENA
NAME:
DATE:
TIME:
LOCATION:
AGE:
PREVIOUS EXPERIENCE:
YES
NO
WITNESSES PRESENT:
YES
NO
PHOTOGRAPHIC EVIDENCE:
YES
NO
DETAILED ACCOUNT OF OBSERVED PHENOMENA:
Form AR-001
CONFIDENTIAL - INTERNAL USE ONLY
A.R.C. Research Division • Est. 1987
Page 1 of 2
A.R.C.
ANTUMBRA RESEARCH FACILITY
Advancing Scientific Understanding Through Empirical Research
SUPPLEMENTARY INFORMATION - CONTINUATION
CASE NUMBER:
RESEARCHER:
ENVIRONMENTAL CONDITIONS:
WEATHER:
CLEAR
CLOUDY
RAIN
FOG
TIME OF DAY:
DAWN
DAY
DUSK
NIGHT
ADDITIONAL OBSERVATIONS / RESEARCHER NOTES:
WITNESS SIGNATURE:
DATE SIGNED:
Form AR-001
CONFIDENTIAL - INTERNAL USE ONLY
A.R.C. Research Division • Est. 1987
Page 2 of 2