Emergency Letter

Emergency Processing to Address the AARO Website's Paperwork Reduction Requirements OSD007948-23 RES FINAL.pdf

AARO Contact Form for Authorized Reporting

Emergency Letter

OMB: 0704-0674

Document [pdf]
Download: pdf | pdf
DEPUTY SECRETARY OF DEFENSE
1010 DEFENSE PENTAGON
WASHINGTON , DC 20301 - 1010

SEP 2 8 2023
The Honorable Richard L. Revesz
Administrator
Office of Information and Regulatory Affairs
Office of Management and Budget
Washington, DC 20503
Dear Mr. Revesz:
Pursuant to Office of Management and Budget (0MB) procedures established at 5 C.F.R.
Part 1320, Controlling Paperwork Burdens on the Public, I request that 0MB process the
proposed Department of Defense (DoD) information collection covered, "AARO Contact Form
for Authorized Reporting" for the All-domain Anomaly Resolution Office (AARO), as an
emergency clearance request in accordance with 5 C.F.R. § 1320.13, "Emergency Processing."
The collection of contact information from members of the public is an essential step in
providing a mechanism for AARO to receive authorized reporting as required by section 1673 of
the James M. lnhofe ational Defense Authorization Act for Fiscal Year 2023 (FY23 NDAA).
Section 1673 of the FY23 NDAA, "Un identified Anomalous Phenomena Reporting
Procedures" requires that the Secretary of Defense "issue clear public guidance for how to
securely access the mechanism for authorized reporting," no later than 180 days from enactment,
which was June 2023. Furthermore, section 1683 of the FY23 NDAA requires AARO to
produce a Historical Record Report detailing the historical record of the United States
government relating to unidentified anomalous phenomena (UAP); to meet this requirement,
AARO relies on the "AARO Contact Form" to receive reports from individuals with knowledge
of potential UAP programs.
In light of the overdue statutory requirement, congressional and public interest in
AARO' s reporting mechanism, and the criticality of the collected information to AARO's
mission, I have determined that AARO must begin collecting this information no later than
October 31 , 2023. It is, therefore, impracticable for DoD to consult in advance with interested
agencies and members of the public in order to minimize the burden of the collection of
information pursuant to 5 C.F .R. § 1320. 13(c). Therefore, DoD requests a 180-day emergency
clearance to obtain the infom1ation required. During the 180-day emergency clearance period,
DoD will work to establish a regular clearance submission. DoD is also seeking 0MB 's
approval to waive the need for the Federal Register Notices otherwise required by 5 C.F.R.
1320.S(a)(l )(iv) and 1320.8(d)( I) prior to publication and implementation of this disclosure.
We request your approval/disapproval determination ofthis request to collect information
under an emergency clearance by close of business on September 29, 2023.
Sincerely,

Enclosures:
1. Supporting Statement, Part A
2. AARO Self-Reporting Google Form

2

ENCLOSURE
1

SUPPORTING STATEMENT- PART A
AARO Contact Form for Authorized Reporting
1.
Need for the Information Collection
The AARO Contact Form for Authorized Reporting information collection will be used to
gather contact information, to include Personally Identifiable Information (PII) from
members of the public. The collection is necessary to enable the All-domain Anomaly
Resolution Office (AARO), Office of the Secretary of Defense, Department of Defense, to
meet its statutory requirements.
The proposed information collection, AARO Contact Form for Authorized Reporting, enables
AARO to comply with Section 1673 of the James M. Inhofe National Defense Authorization
Act for Fiscal Year 2023 (FY23 NDAA), which directs AARO to establish a secure
mechanism for authorized reporting of U.S. Government programs and activities related
unidentified anomalous phenomena (UAP). The form will collect contact information from
current and former U.S. Government employees, service members, and contractors who
wish to make an authorized report to AARO. The collection is necessary to enable persons
wanting to make a report to contact AARO directly.
The AARO Contact Form for Authorized Reporting also supports Section 1683 of the FY23
NDAA, which directs AARO to produce a Historical Record Report (HRR) on U.S.
Government activities and events related to UAP from 1945 to present. Oral history
interviews, records of the National Archive, open source research, and all records and
documents from U.S. Government agencies are the foundational pillars of information
supporting the HRR. The AARO Contact Form for Authorized Reporting enables AARO to
contact individuals to schedule oral history interviews.
2.

Use of the Information

The respondents are current and former U.S. Government employees, service members,
and contractors who want to contact AARO in furtherance of providing authorized
reporting regarding potential U.S. Governments activities and events related to UAP. The
respondents will be asked to voluntarily provide their contact information by completing
fields and using drop down menus on a page within AARO's website (www.aaro.mil). This
form is the only collection instrument, is 100 percent electronic, and is accessible by any
web browser, via both desktop and mobile device. The collection is sent to AARO once the
respondent clicks the "Submit" button on the website. No other communications are sent
to the respondents that solicit responses. The Office of the Secretary of Defense Public
Affairs will notify the public when AARO's contact form is available for use.
Information, including PII, collected from the public will be processed and stored in an
electronic environment accred ited to handle and secure PII. AARO will then review
1

submitted information to prioritize potential oral history interviews of persons so that they
might make an authorized report. The end result of the information collection is the
successful ability of individuals to contact AARO, provide a report, and contribute to the
HRR, and for AARO to meet its statutory requirements.
3.

Use of Information Technology

Responses will be collected entirely by electronic means via AARO's website at
www.aaro.mil. Information will be entered into text fields and with the use of drop-down
menus prior to being submitted to AARO electronically. A screenshot of the proposed form
is included, although the visual depictions of the information collection fields may differ
upon publication, dependent upon the backend computer application used to appropriately
collect PII. Regardless of the backend application and secure environment, the information
collected will not change and the drop-down menus will remain for ease of use by the
public.
4.

Non-duplication

The information obtained through this collection is unique and is not already available for
use or adaptation from another cleared source.
5.

Burden on Small Businesses

This information collection does not impose a significant economic impact on a substantial
number of small businesses or entities.
6.

Less Frequent Collection

This is a one-time information collection per respondent, and thereby, infrequent.
7.

Paperwork Reduction Act Guidelines

This collection of information does not require collection to be conducted in a manner
inconsistent with the guidelines delineated in 5 CFR 1320.S (d)(Z).

8.

Consultation and Public Comments

AARO is seeking an emergency approval. A 60- and 30-Day Federal Register Notice will be
published subsequent to emergency approval.
Part B: CONSULTATION
No additional consultation apart from soliciting public comments through the Federal
Register was conducted for this submission.

2

9.

Gifts or Payment

No payments or gifts are being offered to respondents as an incentive to participate in the
collection.

10.

Confidentiality

PII will be collected, and a Privacy Act Statement is required. The Privacy Act Statement
will be prominently displayed on AARO's website and accessible to the public prior to any
contact information collection.
The SORN (Privacy and Civil Liberties Complaints and General Correspondence Records,"
DoD-0017, will be used to support this information collection.

11.

Sensitive Questions

No questions considered sensitive are being asked in this collection.
12.

Respondent Burden and its Labor Costs

Part A: ESTIMATION OF RESPONDENT BURDEN

1) AARO
a)
b)
c)
d)
e)

Contact Form for Authorized Reporting
Number of Respondents:2500
Number of Responses Per Respondent: 1
Number of Total Annual Responses: 2500
Response Time: 5 minutes
Respondent Burden Hours: 208 hours

2) Total Submission Burden (Summation or average based on collection)
a) Total Number of Respondents: 2500
b) Total Number of Annual Responses: 2500
c) Total Respondent Burden Hours: 208
Part B: LABOR COST OF RESPONDENT BURDEN

1) AARO
a)
b)
c)
d)
e)

Contact Form for Authorized Reporting
Number of Total Annual Responses: 2500
Response Time: 5 minutes
Respondent Hourly Wage: $22.26
Labor Burden per Response: $1.86
Total Labor Burden: $4650.00

2) Overall Labor Burden
a) Total Number of Annual Responses: 2500
b) Total Labor Burden: $4650.00
3

The Respondent hourly wage was determined by using the [Bureau of Labor Statistics
Wage Estimate Website] ([https://www.bls.gov/oes/current/oes_nat.htm]). Respondents
are anticipated to be employed in a variety of sectors and the hourly mean wage for May
2022 was used to estimate the burdens.
13.

Respondent Costs Other Than Burden Hour Costs

There are no annualized costs to respondents other than the labor burden costs addressed
in Section 12 of this document to complete this collection.
14.

Cost to the Federal Government

Part A: LABOR COST TO THE FEDERAL GOVERNMENT
1) AARO Contact Form for Authorized Reporting
a) Number of Total Annual Responses: 2500
b) Processing Time per Response: 5 minutes
c) Hourly Wage of Worker(s) Processing Responses: $37.08
d) Cost to Process Each Response: $3.09
e) Total Cost to Process Responses: $7725.00
2) Overall Labor Burden to the Federal Government
a) Total Number of Annual Responses: 2500
b) Total Labor Burden: $7725.00
Hourly wage was determined by using the [Bureau of Labor Statistics Wage Estimate
Website] ([https://www.bls.gov/oes/current/oes_nat.htm]). The mean hourly wage for
Federal Executive Branch was used for May 2022.
Part B: OPERATIONAL AND MAINTENANCE COSTS
1) Cost Categories
a) Equipment: $2000.00
b) Printing: $0.00
c) Postage: $0.00
d) Software Purchases: $0.00
e) Licensing Costs: $7200.00
f) Other: $1500.00
2) Total Operational and Maintenance Cost: $10,700
Part C: TOTAL COST TO THE FEDERAL GOVERNMENT
1) Total Labor Cost to the Federal Government: $7725.00
4

2) Total Operational and Maintenance Costs: $10,700
3) Total Cost to the Federal Government: $18,425.00
15.

Reasons for Change in Burden
This is a new collection with a new associated burden.

16.

Publication of Results

The results of this information collection will not be published.
17.
Non-Display of 0MB Expiration Date
We are not seeking approval to omit the display of the expiration date of the 0MB approval
on the collection instrument.
18.

Exceptions to "Certification for Paperwork Reduction Submissions"

We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.

5

ENCLOSURE
2

AARO Self-Reporting Google Form Images and Text
As of 09/19/2023

Table of Contents
Proof-of-concept Google Form lmage ....... ............. ....... ............ ......................... ... ................................................................. 2

Submission Qualification Criteria ............................................................................................................. 3
If submitter does NOT meet criteria ................................................................................................................................3
If submitter meets criteria ...............................................................................................................................................4
UAP Form Fields ....................................................................................................................................... 5
Current Contact Information ........................................................................................................................................... 5
U.S. Government UAP Program/ Activity Information ...................................................................................................9
Referral Information ..................................................................................................................................................... 12
Prohibition on Reprisal Information ............................................................................................................................. 13
Certification and Consent/ Submit .............................................................................................................................. 14
UAP Report Text and Dropdown Options .. .. ....... ................................................................................................................ 15

Submit a Report : U.S. Government Programs/Activities Related to Unidentified Anomalous Phenomena

15

Submission Qua lificat io n Criteria ........................................................................................................... 15
UAP Form Fields ..................................................................................................................................... 16
Current Contact Information ........................................................................................................................................ 16
U.S. Government UAP Program/ Activity Information ................................................................................................ 18
Referral Information ..................................................................................................................................................... 19
Prohibition on Reprisal Information ............................................................................................................................. 19
Certification and Consent/ Submit ........................................................................................................... ................... 21
Privacy Act Statement .............................................................. .............................................................. 21
Appendix: List of data field s to be collected from submitters ........................................................................................... 22

1

Proof-of-concept Google Form Image
The images below reflect a proof-of-concept with using Google Forms to collect reports associated with UAP-related
programs / activities. When AARO has a Google Enterprise Plus accounts established, this form can be imported into
AARO' s secure environment and adjustments can be made based on the Google Form capabilities available in their
account. Since the proof-of-concept form was built using a basic Google account, all references to AARO and UAP
have temporarily been replaced with placeholders (e.g., , , etc.). The exact wording that will appear on
the finalized Google Form is included in this package on pages 15-21.

All-domain Anomaly
Resolution Office
U.S. Government  P rogram / Activity R eport
Form
DoD Is currently accepting reports from current or former U.S. government employees,
service members, or contractors wnh firsthand knowledge of U.S Government programs
or activrhes related to  dating back to 1945. 

Do no1 en1er class,fled ,nformat1on.

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Submission Qualification Criteria
If submitter does NOT meet criteria
If an individual clicks on "No" for the combined response to the first two questions, that individua l will not be able to
proceed with filling out the Google Form to submit a UAP Report to AARO.

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All-domain Anomaly
Resolution Office

,

U.S. Government  Program / Activity Report
Form
• Indicates requ,red question

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  ?*

Q

Yes

@ No

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All-domain Anomaly
Resolution Office

U.S. Government  Program / Activity Report
Form
 1s currently ~ accepting reports from current or former U S Government
employees, service members, or contractors with firsthand knowledge of U S Government
programs or activities related to  dating back to 1945 In the future. the abilily to
submit
 reports will be available to the general pubhc

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Th s:onr \',as crea~ea outside of yoor aoma n & ~--e:rms o' Sf:V'CI? - =:nvacv~

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If submitter meets criteria
If an individual clicks on "Yes" for the combined response to the first two questions, that individual will see the multiple
form segments in the Google Form, as shown in the following screenshots, to submit a UAP Report to AARO.

U.S. Government  Program / Activity R eport
Form
* Indicates required question

Former or Current U.S. Government employee, service member, or contractor?

,t

AND
Do you have firsthand knowledge of a U.S. Government program/ activity related
to ?*

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Q

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Th s rorm ,•,as c•<:ated outsKle of your doma n Beoo Program / Acci viry Report
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CURRENT CONTACT INFORMATION
Pro·,od,ng :he n'onnat on below will ass,st  with poten11a follo,';-up

U S Go·1emm~nt employee service member. or contractor status

Q

Cu rent

Your CJrreni e11p10ymen contract affiliation v11tn the US Government

Your current employmen contract role w,th tne US Government

Unt I ec " lease prov  Program / \ cc iviC)' R.eport
Form

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U.S. GOVERNMENT  PROGRAM / ACTIVITY INFORMATION
Please ens~re rl:.i, ;ne prowdea ,nfcrmar,on ,s NOTc1ass1fi~

Approxirrate start date of  -rerated programs/act v1t1es
(" le<1!e si:bm,: a ne,v iorm w,rh re:e,an: mforma:,on for ano:ner dare r11nge)

mm dd

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Approx1rrate end date o'  -rela ea proorams/act1v1t es:
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mm dd fYYY

Your errploymen contract affiliation with the U.S Government dunng re.ated programstactrv I es

Your errploymen contract role w th the U S. Government -related
progra'Tls/ act,vrt es.

Are yoJ a,•,are of any SJppo rng photos. riles. or other phys ca ev dence?

Q

Yes

Q

No

10

•

Your US security clearance status during the  prO(Jram l ac1•v1ty : •

COOOs.e

Non-Oise osure Agreell'e1t ( OA)t s.gned for security clearance during
 program/ activity?
-Per ,he  t:1:, individi.als ma;• report to  w, hout fear of vI0 a ing tl'e terms of
currert or previous non-disclosure agreemen s Howe ,er, once an authon: ed oisclosure is
made to , ndivtduals are expected to continue pro:ec11ng n' ormat on in accordance
w 1 !'l

l'e org nal non-01sclosure agreem er.

By la.v.  m ay rece \ e all -related ,nformauon 1ncl1.d,r 9 any c lass ' ed national
secunty n'ormauor, involving m1h,ary, ,melhgence. ano m elhgence-re,ated act ·r: .es at all
le, e s of class ficauon rega•d ess o' .any res ict, ,e access cor,.rols spec,al access
programs or compa'1rrtenteCI access p rograms Moreo,e', : t-ere Is no resrncuon o 
receiving any past or present -related inforT1a:1on, regarc ess o ' the organiza ona
af IatIon o' tne ong,na class1fica11on outhorny •,1irtl1in 

:I: An a.i:nor•:ud d,sc•osure shall no1 be sub1ecc co a nond•sctostJre agreement emered ,mo by
che 1r.dm duat who makes rhe d1sc/os!Jre; stia/1 oe deemed co comply 1•111h a.,y regu1a:1on or
order ,ssued tJnder che aurhomy of Execu;r,e Order 13526 (5/j U SC 3 16 1 no1e re/ac,ng co

class,fied na!'ona/ secunry information) or cl:ap ;,: r 18 of :he ..:.comic Energy Ac1 of 1954 142
USO. 2r 1 er seq .I. and 1s noi a ·,io /ar,on of sec11on 98 of r,r/e 11 18. Ur:11ed Srazes Code,
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Referra I Information

Li ..'. Government  Program / Acri,·icy Report
Form

REFERRAL INFORMATION
Were you referred to  Program / Accivicy Report
Form

Reference Alfi at on.
Youran~r

Na'l'le of Reference
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12

Prohibition on Reprisal Information

..'. Governmen t  Progra m / Ac ri,·iry Report
Form
PROHIBITION ON REPRISAL
nd ,,,dua s who ,nake authorized d sc,osures to  are e phc ly protected from reprisal
under law per the  - I ;-ou celie. e you have exper erced repnsal for making an
authonzed disclosure to  please subrr1t a report o the OoO Office of the tnsRector
General Hotline Office of the Intelligence Communi~pector General
Hotline. DeRanment of Energy: Offi ce of the Inspector General Hotline. DeRanment of
Homeland Secun~spector General Hotline. or the IG office o' your current or fo rmer
'ederal agency

t ,:.n emp101 ee of a depar:menr or agency of :ne federal Go.emmem. or of a concracior.
subcon raccor. gra'lree, sr.,o-gran:ee or persona. ser,,1ces conrrac:or of suer> a aepanmen: er
agenc1. Nno has au:non:y ro rake ctm:c. o:.l'lers :o ra e, recommercJ, or appro, e any
persor:net acr,on. shall no1, ,.,, n resper.r ro such aurhom:,,. ra e er a•I 10 ;ake, or threa:en :o
,a e or fails 10 take. a oersor.neJ acr,on. 1r c1ua1r9 rre revocar,on or suspension of secunr1
c earances. or ie•mma:,on oi emp,o,ment ·:, ,rt, respect :o any .nd1v1dual as a reprisal for any
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Certification and Consent / Submit

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All-domain Anomaly
Resolution Office

U. . Govern 1m:nc  Program / Accivi cy R.epo n
Form

CERTIFICATIOt-,, AND COt-,,SE~
Please check a statements below 1 order o suom,t you· report

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I cert fy, to the best o' my krow'ecge, :hat :he pro-11ded 1nformat10f'I ,s NO';'
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14

UAP Report Text and Dropdown Options
Submit a Report: U.S. Government Programs/Activities Related to Unidentified Anomalous Phenomena
AARO is currently accepting reports from current or former U.S. government employees, service members, or
contractors with firsthand 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. In the future, reporting
eligibility will be expanded to the general public and include reports of any event related to UAP. 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.

Please ensure that the provided information is NOT classified.

Submission Qualification Criteria
Your response to these two questions will be used to determine if you meet the criteria to complete and submit a
UAP Report at this time.

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?
(Appears when click on Information button ~ ) '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.
-- Yes/No··

V

If answer above is No, only display this text in red w ithout the form fields:

RO is current! ONLY acce tin re orts from current or former U.S. Government em lo ees, servic
members, or contractors with firsthand knowled e of U.S. Government ro rams or activities related to UAP
atin back to 1945. In the future, the abili to submit UAP reports will be available to the eneral ublic.
If answer above is Yes, display all of the UAP Reporting Form content that appears below:

15

UAP Form Fields

* indicates required fields.for submitting a UAP Report
Current Contact Information
Providing the information below will assist AARO with potential follow-up.
U.S. Government employee, service member, or contractor status:*
Dropdown List Options
• Current
• Former
Your current employment/contract with the U.S. Government?
Affiliation Dropdown List Options
• Department of Defense
• Department of Energy
• Department of Homeland Security
• Other Federal Agency
• Non-Federal Agency
• Prefer not to disclose on form
Role Dropdown List Options
• Employee
• Service member
• Contractor
Please provide your DoD ID number or Home Agency ID number, if applicable:
DoD ID Number:

(Appears when click on Information button 0 ) To find your DoD ID, look on the back of your CAC or login
to DoD ID Card Office Online> to view your profile

Agency ID Number:

(Appears when cl ick on Information button 0 ) To find your Agency ID number, open a web browser, navigate
to Certificates and under the Personal tab , select your certificate details tab ...

Military branch of service (for current/former service members):
Dropdown List Options
• N/A
• Air Force
• Army
• Coast Guard
• Marine Corps
• Navy
• Space Force

16

Your highest rank (military) or grade (civilian):
Droodown List Options
Military Ranks
• E-1
• E-2
• E-3
• E-4
• E-5
• E-6
• E-7
• E-8
• E-9
• 0 -1
• 0 -2
• 0-3
• 0 -4

• 0-5
• 0 -6
•
•
•
•
•
•
•
•
•

0-7
0 -8
0-9

0 -10

W-1
W-2
W-3
W-4
W-5

Civilian Grades
• GG/GS-1
• GG/GS-2
• GG/GS-3
• GG/GS-4
• GG/GS-5
• GG/GS-6
• GG/GS-7
• GG/GS-8
• GG/GS-9
• GG/GS-10
• GG/GS-11
• GG/GS-12
• GG/GS-13
• GG/GS-14
• GG/GS-15
• SES/DISES/DISL
Other Options
• Other
• N/A

17

Your preferred salutation:
Dropdown List Options
• Dr.
• Mr.
• Mrs.
• Ms.
• Miss
• (My military rank)
• NIA
Your full name: First Name*, Middle Name*, Last Name*, Suffix
Your current Zip Code:* Enter "00000" if you currently do not have an address with a zip code
Your Contact Details: Phone number:*
Current Email Address :*
Your current U.S. security clearance: *
Clearance Status Dropdown List Options
• Currently have
• Previously had
• Never had

U.S. Government UAP Program/ Activit y Information
Please ensure that the provided information is NOT classified.
Approximate dates of UAP-related programs/activities: From :* (datepicker) To:* (datepicker)
Your employment/contract with the U.S. Government during UAP-related programs/activities :
Affiliation Dropdown List Options
• Department of Defense
• Department of Energy
• Department of Homeland Security
• Other Federal Agency
• Non-Federal Agency
• Prefer not to disclose on for m
Role Dropdown List Options
• Employee
• Service member
• Contractor
Are you aware of any supporting photos, files, or other physical evidence? *
Dropdown List Options
• Yes
• No

18

Your U.S. security clearance during the UAP program/activity: *
Clearance Status Dropdown List Options
• Held a clearance during UAP program/activity
• Did not hold a clearance during UAP program/activity
• Unsure
Non-Disclosure Agreement (NDA)t signed for security clearance during UAP program/activity? *
Dropdown List Options
• Yes
•

No

•

Unsure

•

N/A

tPer the Fiscal Year 2023 National Defense Authorization Act:j:, individuals may report to AARO without fear of
violating the terms of current or previous non-disclosure agreements . However, once an authorized disclosure is
made to AARO, individuals are expected to continue protecting information in accordance with the original nondisclosure agreement.
By law, AARO may receive all UAP-related information, including any classified national security information
involving military, intelligence, and intelligence-related activities, at all levels of classification 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 UAP-related 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.

+

An authorized disclosure sha!! not be subject LO a nondisclosure agreement entered il'llo by the individual who makes the
disclosure; shall be deemed to comply with any regulation or order is ·ued under the authority ofExecutive Order 13526 (50
U.S. C. 31617 note; relating to classified national security information) or chapter 18 ofthe Atomic Energy Act of1954 (42
U.S.D. 2271 et seq.): and is not a 1·io/ation ofsection 798 oftitle 11 18, United Swtes Code. or other provision of/aw

Referral Information
Were you referred to AARO?*
Dropdown List Options
• Yes
• No
Reference Affiliation: (text input)
Name of Reference: (text input)

Prohibition on Reprisal Information
Individuals who make authorized disclosures to AARO are explicitly protected from reprisal under law, per the
FY23 National Defense Authorization Act.t 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.

19

t An employee of a department or agency of the Federal Government, or of a contractor, subcontractor, grantee,
sub-grantee, 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 fails 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.
2023 NOAA - National Defense Authorization Act

20

Certification and Consent / Subm it

p

I certify, to the best of my knowledge, that the provided information is NOT CLASSIFIED.*
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.*
Submit to AARO

Privacy Act Statement
PRIVACY ACT STATEMENT FOR UNlTED STATES GOVERNMENT UNIDE TIFIED ANOMALOUS PHENOMENO
(UAP) REPORTING
AUTHORITY: IO 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.
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 ofphenomena, 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-00 17, "Privacy and Civil Liberties Complaints and General Correspondence Records," accessible at
https ://wwvv.federalreg ister.gov/documents/202 3/02/23/2023-03 74 5/pri vacy-act-of- 1974-svstem-o [-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.

21

Appendix : List of data fields to be collected from submitters

User Input

>

-

n,
::::J

CJ

Meet criteria to
report for Phase 11
(yes/ no)
U.S. Gov. Status
(current/former)

Field Input
Type

Required

Dropdown
List

Yes

Dropdown
List

Yes

Dropdown
List

Yes

Dropdown
List

Yes

Text field

No

0

C

Current
Government
Affiliation
Current Gov. Role
(employee, service
member,
contractor)
DoD ID Number

+,I

Agency ID Number

Text field

No

E

M ilitary branch of
service

Dropdown
List

Yes

Highest rank
(military)/
grade(civilian)

Dropdown
List

Yes

·-ro
0

-

C

+,I

C

(1)

:::l

u

Preferred
salutation
First Name
M iddle Initial/
Name
Last Name

Dropdown
List
Text field

Yes

Text field

No

Text field

Yes

Suffix

Text field

No

Zip Code

Text field

Yes

Phone Number

Text field

Yes

Email address

Text field

Yes

22

Yes

Field Input
Type

Required

Current U.S.
security clearance
status (e.g., have,
never had)

Dropdown
List

Yes

UAP Program/
Activity Start Date

Date Picker

Yes

UAP Program/
Activity End Date

Date Picker

Yes

0

U.S. Government
Affiliation

Dropdown
List

Yes

-

U.S. Government
Role (employee,
service member,
contractor)

Dropdown
List

Yes

Knowledge of
supporting
materials (yes/no)

Dropdown
List

Yes

U.S. security
clearance status
(e.g., had, never
had)

Dropdown
List

Yes

NDA signed (yes,
no, unsure, N/A)

Dropdown
List

Yes

Referred to AARO
(yes/ no)

Dropdown
List

Yes

Reference
Affiliation

Text field

No

Name of Reference

Text field

No

User Input

C:

·-n:s
E
...
0

'+C:

"'C

a,

-n:sa,
0:::

C.
<(

::,

-...n:s
...a,

'+-

a,
0:::

23

Field Input
Type

Required

Information
provided not
classified

Checkbox

Yes

Contact by AARO
consent

Checkbox

Yes

Checkbox

Yes

Checkbox

Yes

Checkbox

Yes

User Input

..
C
CII

"'0C

..
u

C

0

ra
u

"f
CII
u

Information
provided true &
accurate
Voluntarily
providing PII to
AARO
Information
provided subject to
Privacy Act

24


File Typeapplication/pdf
File TitleDEPUTY SECRETARY OF DEFENSE LETTER
File Modified2023-09-28
File Created2023-09-28

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