(Fields preceding of " > " are necessary to the information treatment)

> Date of the observation :

> Place :

> Latitude - Longitude :

> Surroundings descriptions (trees, buildings, plain, etc...) :

Proximity of a military base ? :

Proximité of an industrial center ? :

> How many witnesses :

> Duration of the event :

> Description of the event :

> Have-you : Photo Drawing Film Sound recording

Name :

First Name :

Activity :

Age :

> Town of residence (or nearest town) :

> Email adress :

> Do you accept the publication of these informations Yes No

> Date of the redaction for this document :