ALSACAT:

Your observation

We will ask you to provide as much information as possible about your observation. The most important thing is to leave nothing out: it is often the details that make it possible to solve the investigations. Do not hesitate to give the maximum of information, even if your memories are incomplete or that certain elements seem unimportant to you. If you are not sure about this or that detail, tell us your doubts, but, again, do not omit anything. We need to be able to visualize everything you've seen, like re-runing the movie of your observation.

Use the end of this page to tell the story of your observation and continue on free paper as much as you want:

Your free account of the observation:

Tonight, October 22, 2013, at 10:40 p.m., observing the moon in the direction of the east, I saw an object that passed between the moon and me, in the south-north direction, approximately vertical to the hills located at the east from the city of Colmar. I first thought of a cloud, but its shape was not a cloud. The object had a rounded shape on the upper part, flat in its lower part, with parts directed downwards, a little like enormous legs of an insect hanging under its body. I wanted to take a picture of it using my cellphone, but it came out of the moonlight before I could do it.

CNES / GEIPAN Standard Questionnaire GEIPAN V3.5-June-2013 - page: 3

Conditions of observation of the phenomenon

What were your occupations just before your observation?

I was in my daughter's apartment on the ground floor of our house. After turning off the lights, I closed the front door. It was at this moment that I observed the sky, which was almost clear, and the moon partially hidden by what I first thought to be a cloud.

Specific address of the place of observation (street, city ...):

The observation was made from my home on the parking lot in front of the house, looking east.

Where exactly were you? (Please indicate if you were in a building and on which floor, if you were looking through a window, and how fast you were driving if you were in a vehicle.)

On the parking lot of the house, outdoors.

Date of observation:

10/21/2013

Precise start time (in local time):

10:40 p.m.

Duration of the observation or end time (in hours, minutes, seconds):

less than 10 seconds

Did other witnesses see the same phenomenon as you? If yes how many?

I do not know.

If so, please ask them to contact us using the contact details on the last page of this document.

How do you relate to these people (parents, friends, colleagues, neighbors)?

The observation was made in a way:

continuous

(delete or par the useless words)

If the observation was done intermittently, specify why it was interrupted and resumed:

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How did this observation end?

Disappearance of the object.

Have you seen the phenomenon directly with your eyes?

YES

(delete or par the useless words)

Has the phenomenon been observed through an instrument (eyeglasses or sunglasses, binoculars, camera, video camera, telescope...)? If so, please specify the model:

No

Weather conditions (clear skies, clouds, wind, storm, mist, fog, rain, snow, changing conditions during observation):

Clear sky, some clouds. No wind at ground level, but there seemed to be altitude.

Astronomical conditions (remember the position of the Moon, the Sun, the presence or not of stars or planets, etc.):

Moon to the east, few stars.

Equipment on or active during the observation (lights, radio, TV, lights ...):

None, I had just tunred off the lights.

Noise during observation (TV or radio on, passing vehicles, airplane engine, thunder ...):

No.

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Description of the phenomenon

Number of phenomena (single, multiple or single and then divides ...):

Single.

Shape:

Hemispheric with outgrowths below. The shape looks like a hot air balloon seen through a telescope that would flatten the shapes.

Color:

Black, night-time observation against the moon.

Brightness (in comparison with known stars like Venus and the Moon, or the lighting of a lamppost, car lights, house lights, etc.):

Black, clear moon.

Presence of a drag or a halo? If so, what color?

No.

Apparent size (express the dimensions of the phenomenon in relation to a familiar object and / or in millimeters counted on a graduated scale carried at arm's length):

Hard to estimate. By the time I saw it, its position was roughly centered on the moon. Its extremities protruded from the imperfect circle of the moon, horizontally, but not vertically.

Noise coming from the phenomenon (hissing, buzzing, detonation, comparison with a known noise ...):

No.

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Distance between you and the UAP (the observed phenomenon), estimated roughly (specify if the object passed in front of or behind an element of the landscape):

10kms.

Direction of appearance of UAP (north, south, southwest, etc., or specify a local visual or geographic landmark, direction of a place, etc.):

South

Direction of disappearance of UAP (north, south, southwest, etc., or specify a local visual or geographic landmark, direction of a place, etc.):

North

Height of appearance of the UAP with respect to the horizon (the horizon = 0 °, the zenith = 90 °):

30

UAP disappearance height from horizon:

30

Trajectory of the phenomenon (straight line, rising, descending, with or without change of direction, curve, etc.):

Right

Portion of the sky covered by the UAP during the observation (eg a quarter of the sky or 30 ° to 40 ° with respect to the horizon, etc.):

<5°

Effect (s) on the environment (trace (s) on the ground, effect (s) on living beings or equipment):

none

CNES / GEIPAN Standard Questionnaire GEIPAN V3.5-June-2013 page: 7

Reconstitution of your observation

In order for us to reconstitute the "movie" of your observaAon, we must have the maximum amount of informaAon. Concretely this implies that we understand everything from the beginning to the end of your observation, and that we know the direction of movement of the phenomenon as well as its altitude. This step is crucial.

We offer three complementary methods:

• (1) Take a picture of the environment as it was during the phenomenon, as if the camera was your eyes during the observation. Feel free to draw what you have observed directly in the photos.
• (2) Make one or more sketches of your observation (see next page) from your point of view, including the environment. Give as many elements as possible to give us a good understanding of the scene.
• You are entirely free from the sketches you send us. But color accuracy is important, especially if the level of contrast between the observed phenomenon and the environment is low. Try to be as precise as possible, even if you write on the sketch.
• No talent in drawing is necessary. The key is to make us understand what you have seen schematically. You can use the following page for this purpose.
• (3) Make a reconstruction of your observation on one or more planes. If you can, it's about presenting your observation with a view from above. For this you can print a map of your place of observation on Google Map (http://maps.google.fr) or Geoportail (http://www.geoportail.gouv.fr/accueil) and report your different positions and directions of observations.

How to "caption" a photo or a map with your comments?

If you are used to image editing software (Photoshop, GIMP, Illustrator, ...), we advise you to use these tools, then send us a file in the jpg png or pdf format.

If you can not access this type of material, print a map of the place and / or a photo, draw over it and attach it to the paper file; or scan or photograph the result and send it to us in jpg, png or pdf format.

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Sketch of your observation

Use this page to draw your observation.
You are entirely free as of the development of this sketch.

NB: the shape of the moon is not exact because it is not a full moon. It showed a small crescent to the south.

Moon

Direction

Hills

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And now?

Describe the emotions you felt during and after the observation:

At first none because I thought it was a cloud, then I was intrigued. I especially regretted not having had the time to take a photograph.

What did you do after your observation? Have you spoken about it? How did your interlocutors react? Have you done any research to understand what you saw?

I have not spoken to anyone yet.

I searched via the net, without result so far.

What interpretation do you give to what you have observed? Have you thought of a known phenomenon? What are the elements that justify your interpretation? If you do not know, did you give up understanding? If so, when and why?

I do not like giving up, so I will continue to search.

Before your observation, what interest did you have in strange aerospace phenomena? Did you have a clear opinion on the subject? Which one? What is the base of your opinion?

These phenomena intrigue me. In the absence of an official proclamation of those who would have the greatest possibilities of observation, it is difficult to get an idea on the matter. I have 2 opinions whose conclusions are diametrically opposed. On the one hand, I think it is unlikely that we are alone in the universe. On the other hand, I believe that distances make any contact with other civilizations impossible.

CNES / GEIPAN Standard Questionnaire GEIPAN V3.5-June-2013 page: 10

Did this observation change your vopinion on unidentified aerospace phenomena? If yes, explain what you think now:

No

Do you think that science will give an explanation to your observation?

Certainly

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Summary

If you have already reported about this UAP, please tell us to what authority, organization or person by removing or blocking the useless mentions in the list below, and completing the requested information (several possible contacts):

- Gendarmerie (mention brigade and date): no ...

- Police (mention the police station and the date): no ...

- GEIPAN (mention contact name and date): no ...

- Private Investigator (mention name of contact and date): no ...

- Ufologist (mention the name of the contact and the date): no ...

- Journalist (mention contact name and date): no ...

- Internet (mention site and date): no ...

Please indicate in the list below the documents you have attached or filled.
(Tick or delete the words that are not applicable)

( ) Form
( ) Sketch of observed phenomenon (number: ......)
( ) Map(s) or map (number: ......)
( ) Photograph(s) of observation (number: ....)
( ) Video(s) of observation (number: ......)
( ) Photograph(s) of the environment (number: ......)

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You still have to fill the authorization of publication below, which will enable us to oublish your anonymized testimony on our Internet site.

Authorization to publish your information

(In case of refusal, bar or delete one or both of the following formulas.)

• I authorize GEIPAN to publish this testimony on its own website, after deleting the information that could be used to identify the witnesses (name, address ...).
• I authorize GEIPAN to publish in the media (press, television, Internet) parts of this testimony (texts, photos possibly retouched, drawings, maps, videos).

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I, the undersigned [-], certify the sincerity of the information provided above.

Made in Munster

October 22, 2013

Signature

If you fill out this form by computer, insert your scanned signature or simply type your name.

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This questionnaire is to be sent to:

• By e-mail with all digitized parts to geipan@cnes.fr

or

• By mail to the following postal address, after having made a copy that you will keep:

GEIPAN
National Center for Space Studies
DCT / DA / GEIPAN
18 avenue Edouard Belin,
31401 TOULOUSE CEDEX 9

We thank you for taking the time to testify.

CNES / GEIPAN Standard Questionnaire GEIPAN V3.5-June-2013 page: 13