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                                                         Range Fouler Reportin Form
Please complete this form to the best of your ability. If you do n~ot have the requested information,
please leave the field blank. If there was more than one "group " please report each on a separate
form for data collection purposes. You should receive a respons within 5 business days.               •

         Last Name, First Name                                   Rank            Squadron                       SfPR Email Address                      Crew Position
                                                             0-3           1172 ATKS                                                                 Other
             This information is for contact only. SPEAR sanitizes all r ports of identifying information.
             Absolutely no identifying information for aircrew or squadr, n will be recorded for analysis.

09/04/20                21 :09:00                   Night                                                     ISR
Date {mmlddlyy}         Time of detection           Day I Night              Side No.         Buno             Mi$$ion Description (CAS, BFM. etc)                   LFE?
                            (hh:mm:ss Z)


                                                                    N                                E        23819
  Contact Won,-ing Area                 Contact Latitute            N/S     Contact LongitrJ<Je   E,W        , ntact Altitllde     Altitude         W'incJ Dir at         Wind
  (Ex: W•721A)                          (DD:MM:SS)                          (DD:MM:SS)                   ~     : 22000}            Constant?        Contact Alt           Speed
                                                                                                                                                     (From)
Please attempt to determine a Lat I Long for the contact at initial cJete<;t;on. We recommend
using JMPS to reference the sensor-derived beating and range mtat/ve to the bullseye you had                                       Wes the contact moving?            Yes
in use. If that methocJ is not available, any reasonable derivation of location will won,-, but please
be as specific as possible and make a note in the comments section. These locations may be
                                                                                                                                          Direction/Speed
used to cue other means oftracking.
                                                                                                                                          (Ex. 090/15)                168/277

         Radar Equipped:                                                AIM-9x Self-Track:
                                                                                                     □                               Please check all that apply:
        Stable Trackfile?:                                           A TFLIR Autotrack:
                                                                                                     □                                     Round:   [l]             Moving Parts: D
                                                                                                                                          Square:    D                  Metallic: D
# of Contacts in "Group": 1                                               Tally Achieved:
                                                                                                     □                              Balloon-shapecJ: D                 Mar1<ings: D
       EA Indications (Check all that apply):
                                                                                                                                     Wings/Airframe: D               Translucent: D

      □               □                  □
                                         False
                                                             □                                                                          Other Shape: D                  Opeque:O
      ECM           . Letter                           Other/                                                                    Apparent Propulsion:□                RefTe<:tive: □
       An;          Identifier         Trackfiles    Ambiguous

     Please use the field below to describe the contact and any inte action in your own words with as much
     detail as possible. Please be sure to include any detail not incJJded in questions above.
 Contact at 21 :09z to 21 :17z 04SEP2020. MGRS location 38P L ?(~a<aoimJ(estimated lat/long              +
 I             (bJ(1 )1.4a       ~. While at 23,819 HAT over the ~ulf of Aden we tracked a round, cold object
 in IR traveling 168 degrees at 277 mph. It made a few abrupt dir~ctional changes during the 8 minute
 contact. Our sensor was aimed -39 degrees below our altitude w th a slant range of 6.1 ?NM and ground
 range of 8.81 KM. The IR sensor was set to black hot and the obj ct in question was a bright white.




 Don't use the purple "submit" button! Save this form with filenam "Date_Squadron_RF.pdf" and email
 it to I                  (blt61        3.5c. I(Also in the global). For troubleshooting, call I (bl(6l I                                                    3.5c,




 Thank you for your time. Please ensure all display tapes are rip ed for the entire time of interaction and
 saved as a .wmv (Example: 4 May VFA-106 HUD.wmv). Squa ron inte/ personnel shall upload those files
 to the repository located at this link.
 (            0     3::c,   c1:JJc61                 ,   I
                  USCENTCOM 26.0028                                Approved for Release to MRO - FOUO / PA applies                              03/16/26 000001


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1,1 · 5×5%
logoUS Department of War seal/logo
85,2 · 14×4%
stampClassification/release stamp - redacted

Vision Description (EN)

This is a Range Fouler Reporting Form, a standardized US military form used by aircrew to report UAP encounters. The form contains detailed fields for contact location, time, altitude, heading, speed, and sensor details. The document includes a structured table section for radar and tracking data, followed by checkbox options for contact characteristics (shape: round, moving parts, metallic, etc.) and a narrative text area. The narrative describes an eight-minute contact with a round, cold object tracked by IR sensor over the Gulf of Aden on 4 September 2020, moving at 277 mph on bearing 168 degrees at 23,819 feet altitude. Multiple fields are redacted for FOUO/Privacy Act compliance, including crew identification, contact information, and repository upload details. The form footer shows USCENTCOM classification and a release approval stamp dated 03/16/26.

Descrição Vision (PT-BR)

Este é um Formulário de Relatório Range Fouler, um formulário padronizado das Forças Armadas dos EUA usado pela tripulação aérea para relatar encontros com UAP. O formulário contém campos detalhados para localização de contato, hora, altitude, rumo, velocidade e detalhes do sensor. O documento inclui uma seção de tabela estruturada para dados de radar e rastreamento, seguida por opções de caixa de seleção para características de contato (forma: redonda, peças móveis, metálico, etc.) e uma área de texto narrativo. A narrativa descreve um contato de oito minutos com um objeto redondo e frio rastreado por sensor IR sobre o Golfo de Áden em 4 de setembro de 2020, movendo-se a 277 mph no rumo 168 graus em altitude de 23.819 pés. Múltiplos campos estão redigidos para conformidade FOUO/Lei de Privacidade, incluindo identificação da tripulação, informações de contato e detalhes de upload do repositório. O rodapé do formulário mostra classificação USCENTCOM e um carimbo de aprovação de liberação datado de 03/16/26.