DD3212 U.S. Government UAP Program/Activity Report Form

CUI (when filled in)

All-domain Anomaly Resolution Office (AARO)
U.S. Government UAP Program / Activity Report Form

OMB Control No. :
0704-0674
Exp. Date:
20240430

AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-0674, is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources,
gathering, and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the
Department of Defense, Washington Headquarters Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision
of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 113, Secretary of Defense; 44 U.S.C. 2107, Acceptance of Records for Historical Preservation; Section 1673 of the National
Defense Authorization Act for Fiscal Year 2023 (Pub. Law 117-263).
PRINCIPAL PURPOSE: To manage general correspondence and reporting relating to unidentified anomalous phenomena. Information provided may
be used to contact or seek additional information from individuals reporting information relating to such phenomena, including but not limited to any
event relating to unidentified anomalous phenomena and any activity or program by a department or agency of the Federal Government or a contractor
of such a department or agency relating to such phenomena.
ROUTINE USES: The information solicited may be made available as a “routine use” to appropriate Federal, State, local, territorial, tribal, foreign, or
international law enforcement authorities to assist the All-domain Anomaly Resolution Office with authorized reporting of phenomena, to appropriate
Federal, State, local, territorial, tribal, foreign, or international agencies for the purpose of authorized scientific study or counterintelligence activities, or
for the purpose of executing or enforcing laws designed to protect the national security or homeland security of the United States, including those
relating to the sharing of records or information concerning terrorism, homeland security, or law enforcement. A complete list and explanation of
applicable Routine Uses is included in SORN DoD-0017, "Privacy and Civil Liberties Complaints and General Correspondence Records,” accessible at
https://www.federalregister.gov/documents/2023/02/23/2023-03745/privacy-act-of-1974-system-of-records.
DISCLOSURE: Voluntary; however, failure to provide the information may result in the inability of the All-domain Anomaly Resolution Office to
evaluate the information and engage in follow-up communications in furtherance of the authorized reporting or assessment processes
AARO is currently accepting reports from current or former U.S. government employees, service members, or contractor personnel with direct
knowledge of U.S. Government programs or activities related to UAP dating back to 1945. These reports will be used to inform AARO’s
congressionally directed Historical Record Report. This form is intended as an initial point of contact with AARO; it is not intended for conveying
potentially sensitive or classified information. Following the submission of your report, AARO staff may reach out to request additional detail or arrange
for an informational interview.

NEEDS DD67

Unidentified Anomalous Phenomenon (UAP) means (A) airborne objects that are not immediately identifiable; (B) transmedium objects or devices;
(C) and submerged objects or devices that are not immediately identifiable and that display behavior or performance characteristics suggesting that the
objects or devices may be related to the objects or devices described in subparagraph (A) or (B). (Per the NDAA FY23 Section 1673(d)(8))
The DoD considers Unidentified Anomalous Phenomena (UAP) as sources of anomalous detections in one or more domains (i.e., airborne,
seaborne, spaceborne, and/or transmedium) that are not yet attributable to known actors and that demonstrate behaviors that are not readily
understood by sensors or observers.
“Anomalous detections” include but are not limited to phenomena that demonstrate apparent capabilities or material that exceed known performance
envelopes. A UAP may consist of one or more unidentified anomalous objects and may persist over an extended period of time.
Who is eligible to report:
AARO is currently accepting reports from current or former U.S. Government employees, service members, or contractor personnel with direct
knowledge of U.S. Government programs or activities related to UAP dating back to 1945. These reports will be used to inform AARO’s
congressionally directed Historical Record Report.
What NOT to report:
• Please do NOT submit any information that is potentially CLASSIFIED, or unclassified information that is not publicly releasable
(e.g. subject to export control regulations). If you are unsure whether the information you have is classified or CUI, please do not submit
it on this website.
• Please note that reporting is limited at this time to current or former U.S. Government employees, military personnel, or contractor personnel
with direct knowledge of U.S. Government programs or activities related to UAP dating back to 1945.AARO is NOT currently accepting
reports of UAP sightings/encounters from the general public. In the future, reporting eligibility will be expanded to the general public and
include reports of any event related to UAP.
• Please do NOT report secondhand information or hearsay regarding UAP programs or activities. Please encourage those with firsthand
knowledge to come forward and share their information and experiences with AARO.
• Please do NOT use this unclassified website to submit current operational reports of UAP sightings/encounters that have occurred in the
course of your official U.S. Government duties as a Service member, federal employee, or contractor personnel. Please follow the process
established by your service branch or federal agency to report the information to AARO.
What to expect after filing a report:
Following the submission of your report, an AARO staff member may reach out to request additional detail or arrange for an informational interview.
I signed a Non-Disclosure Agreement (NDA). Can I still report to AARO?
Yes. Per the James M. Inhofe National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2023[1], individuals may report to AARO without fear of
violating the terms of current or previous nondisclosure agreements (NDA). However, other than authorized disclosures made to AARO, individuals are
required to abide to their lifetime commitment to safeguard classified national security information and expected to continue protecting information in
accordance with their original NDA.

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Controlled by:
CUI Category:
LDC:
POC:

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By law, AARO may receive all UAP-related information, including any classified national security information, regardless of any restrictive access
controls, special access programs, or compartmented access programs. Moreover, there is no restriction to AARO receiving any past or present UAPrelated information, regardless of the organizational affiliation of the original classification authority within DoD, the Intelligence Community, or any
other U.S. Government department or agency. As a reminder, individuals cannot report classified national security information on this form.
[1] NDAA for FY2023, section 1673(b)(1): An authorized disclosure shall not be subject to a nondisclosure agreement entered into by the individual
who makes the disclosure; shall be deemed to comply with any regulation or order issued under the authority of Executive Order 13526 (50 U.S.C.
31617 note; relating to classified national security information) or chapter 18 of the Atomic Energy Act of 1954 (42 U.S.D. 2271 et seq.); and is not a
violation of section 798 of title 18, United States Code, or other provision of law relating to the disclosure of information.
Prohibition on Reprisal:
Individuals who make authorized disclosures to AARO are explicitly protected from reprisal under law, per the National Defense Authorization Act
(NDAA) for FY2023[2]. If you believe you have experienced reprisal for making an authorized disclosure to AARO, please submit a report to the DoD
Office of the Inspector General Hotline, Office of the Intelligence Community Inspector General Hotline, Department of Energy Office of the
Inspector General Hotline, Department of Homeland Security Inspector General Hotline, or the IG office of your current or former federal agency.
[2] NDAA for FY 2023, Section 1673(b)(2)(A): An employee of a department or agency of the federal government, or of a contractor, subcontractor,
grantee, subgrantee, or personal services contractor of such a department or agency, who has authority to take, direct others to take, recommend, or
approve any personnel action, shall not, with respect to such authority, take or fail to take, or threaten to take or fail to take, a personnel action,
including the revocation or suspension of security clearances, or termination of employment, with respect to any individual as a reprisal for any
authorized disclosure.
Do I meet the criteria for submitting a report?
I am a former or current U.S. Government employee, service member, or contractor personnel.
I have first-hand knowledge of a U.S. Government program or activity related to UAP.
If you answer YES to both of the statements above and you are interested in sharing your personal testimony for our historical investigation, please
complete the report form.
Instructions for filling out the form:
Do not submit classified or other non-public information through this form.

NEEDS DD67

UAP Program / Activity Involvement Section:

Are you U.S. Government Employee, Service Member, or Contractor AND do you have firsthand knowledge of a U.S. Government UAP-related
program or activity? YES/NO REQUIRED
“Firsthand knowledge” refers to an individual who participated in, was involved with, or was directly supporting a U.S. Government
program or activity related to UAPs.
Did you answer NO? This form is only for reports from current or former U.S. government employees, service members, or
contractors with direct knowledge of U.S. Government programs or activities related to UAP dating back to 1945. If you answered
NO, do not continue filling out this form.
Current Contact Information Section:
Current full name:
Provide your preferred salutation (derived if prefer military).

REQUIRED

Provide your full first name (no nicknames or aliases).

REQUIRED

Provide your middle name or initial (no nicknames).

OPTIONAL

Provide your current last name.

REQUIRED

Provide any suffix (e.g.: Jr., Sr.).

OPTIONAL

Contact details:
Provide your current phone number.

REQUIRED

Provide a current email address.

REQUIRED

Current location:
Provide the zip code in which you currently reside.

REQUIRED

Current employment and rank:
Provide the status of your government employment or service: Current or Former

REQUIRED

Provide your current employment/contract with the U.S. Government:
Affiliation: DoD, DoE, DHS, Other Federal Agency, Non-Federal Agency, Prefer not to disclose, N/A REQUIRED
Role: Employee, Service Member, Contractor

REQUIRED

Pay Grade:
Current military branch of service: (If you are a current or former service member):

REQUIRED

For uniformed employees, provide the branch of the military of service and rank: Enlisted 1 – 9; Warrant
Officer 1 – 5; Officer 1 – 10, (for GO/FO use O-7 through O-10); OR For civilian employees, provide the grade
(e.g. GS-14) AND/OR the desired salutation.

REQUIRED

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Current Clearance Information:
Provide the status of your clearance: Currently have, previously had, never had.

REQUIRED

DoD ID # or Agency ID # (DO NOT USE Social Security number if that was your ID #).

OPTIONAL

If you do not know your DoD ID #, look at the back of your CAC, or visit https://cac.mil/ to find out how to get your DoD ID #.

U.S. Government Program or Activity Related to UAP Section:
Provide the approximate years of the UAP-related programs or activities: Start and end years.

REQUIRED

If you have more than one program or activity, or breaks in service, please enter the most recent start year. The additional information can be
discussed in potential follow-up conversations with AARO.
Provide your response of having any firsthand knowledge of additional programs/activities or period of time: No/Yes

REQUIRED

Provide your employment/contract with the U.S. Government:
Affiliation during the UAP-related program or activity: DoD, DoE, DHS, Other Federal Agency, Non-Federal
Agency, Prefer not to disclose

REQUIRED

Role during the UAP-related program or activity: Employee, Service Member, Contractor

REQUIRED

Provide whether or not you are aware of any supporting photos, files, or other physical evidence: Yes/No

REQUIRED

Did you possess a U.S. security clearance at the time of the UAP program or activity?: Yes/No/Unsure

REQUIRED

Provide whether or not you signed an NDA for the UAP program/activity: Yes/ No/ Unsure

REQUIRED

Referral Information Section:
Provide whether or not you were referred to AARO: Yes/ No

REQUIRED

Provide the affiliation of the reference: Congress/ OIG/ Other

OPTIONAL

Provide the name of the reference

OPTIONAL

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Certification and Consent Section:

Check the box to certify that to the best of your knowledge, no CLASSIFIED information has been provided on the report
REQUIRED
form to be submitted to AARO.
Check the box to consent to being contacted by a representative of AARO, should additional information be required to
complete the report.

REQUIRED

Check the box to certify that to the best of your knowledge, the information has been provided on the report form to be
submitted to AARO is true and accurate.

REQUIRED

Check the box to indicate you understand that you are voluntarily providing person identifiable information (PII) to AARO. REQUIRED
Check the box to indicate you understand that the information you provide may be subject to the safeguards of the
Privacy Act of 1974.

REQUIRED

Submitting the form:
Ensure all of the REQUIRED fields are completed, and NO CLASSIFIED or unclassified information that is not cleared for public release has
been provided.
If you have completed the electronic form, save the form with the information. Confirm the information by opening it in another browser window or tab,
or in a PDF compatible viewer.
-- OR -If you have hand written the form, convert it to an electronic format by scanning the form, taking a picture, or using a similar electronic capture
mechanism.
Email the form to the following email address: _________________
Please include ‘UAP PROGRAM REPORT’ followed by today’s date in the subject line.
Following the submission of your report, an AARO staff member may reach out to request additional detail or arrange for an informational interview.
Interviews conducted in a U.S. Government office are subject to the security and health policies and procedures of that office.

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All-domain Anomaly Resolution Office (AARO)
U.S. Government UAP Program/ Activity Report Form
AARO is accepting reports from current or former U.S. Government employees, service members, or contractor personnel with direct knowledge
of U.S. Government programs or activities related to UAP dating back to 1945*. These reports will be used to inform AARO’s congressionally directed
Historical Record Report.
This form is intended as an initial point of contact with AARO; it is not intended for conveying potentially sensitive or classified information. Following
the submission of your report, AARO staff may reach out to request additional detail or arrange for an informational interview.
* Indicates REQUIRED fields.
Do not submit classified or other non-public information through this form.

U.S. Government UAP Program / Activity Involvement
Former or Current U.S. Government employee, service member, or contractor?
AND
Do you have firsthand knowledge of a U.S. Government program/activity related to UAP?*
Current Contact Information
Providing the information below will assist AARO with potential follow-up.
Preferred Salutation*:
First Name*:
Last Name*:

Middle Name:

NEEDS DD67
Suffix:

Current Phone Number*:
Current Email Address*:
Current Zip Code*:

U.S. Government employment, service member, or contractor Status*:
Affiliation*:

Role*:

If you are/were a service member, select your branch of service and highest rank. For non-service members, select your preferred salutation.
Branch of Service*:

Rank*:

Current U.S. security clearance status*:

DOD ID # :

or Agency ID #:

U.S. Government UAP Program / Activity Information
If you have more than one program or activity, or breaks in service, please provide most recent start year.
Approximate years of UAP-related programs/activities: Start year*:

End year*:

Do you have firsthand knowledge of additional programs/activities or periods of time?*:
Affiliation*:

Role*:

Are you aware of any supporting photos, files, or other physical evidence?*:
Your U.S. security clearance status during the UAP program/activity*:
NDA signed for security clearance during UAP program/activity?*:

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Referral Information
Where you referred to AARO*:

Reference Affiliation:

Name of person who referred you to AARO:

Certification and Consent
I certify, to the best of my knowledge, that the provided information is NOT CLASSIFIED, and is approved for public release.*
I consent to being contacted by AARO should additional information be required.*
I certify, to the best of my knowledge, that the provided information is true and accurate.*
I understand that I am voluntarily providing personal identifiable information to AARO.*
I understand that the information I provide may be subject to the safeguards of the Privacy Act of 1974.*
PENALTY: This form is to be used for official business with the Department of Defense. Knowing and willful false reporting can be punished by fine or
imprisonment, or both (see 18 U.S.C. 1001). Additionally, falsifying information may have a negative effect on your security clearance, employment
prospects, or job status, up to and including denial or revocation of your security clearance, or your removal and debarment from federal service, if
applicable.

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