The NASA C³RS Report Form is provided here as an Adobe® Acrobat® single-sided, letter-size (8 1/2 x 11) document, thus you will have to print two pages for the form. An extra page has been added to permit additional narrative, if desired.

Click on the report form link above - your browser should start the free Adobe® Acrobat Reader®. (If not, download the form and start Adobe® Acrobat Reader® manually.) You have two choices for submitting a C³RS incident report:

1. Fill out the form on your computer, print the completed form, enclose all pages together in an envelope, seal, affix sufficient postage, and mail to C³RS at the address below, or
   
   
2. Print the uncompleted form, fill it out by hand, enclose all pages together in an envelope, seal, add sufficient postage, and mail to C³RS at the address below.

Mail your completed form to:
NASA Confidential Close Call Reporting System
Post Office Box 177
Moffett Field, California 94035-0177