1, When 41.4 JOU the objeota Dq Month, Year !!M of dqa (Circle One) 1.3 !me Zone I (Circle One) I . b. c-entral o. Mountain d. Pacific (C 1role One) t a. Daylight Saving b. Standard 1.4 OU'QJ.I on@ ot the following to indicate how certain you are ot 7our an~ver to the above question 1.21 a. ~ertain' b. Fahijr certain o. l{ot very sure d. Just a guess Cit, or Town 3. Where were JOU located vhen you saw the object: (Cirole One) a a. Inside a building b. In a oar d. In an airplane o. ~tdooriV 3.1 llere JOUI (Circle One) 1 a. In the business section of a city? b. In the residential section of a city? ( a; -In Open. co\intrya!de? ~4;-rl7ins near an a lrfield? e. F171ng over a c1 ty? t. Fqing over open count1'7'1 5. When dl4 JCN report to a offioial that J'CN had eeen the object? i What were J'OU doiftg at the time fOU saw the object? 6.1 What had rou been doing for the 30 minutes be tore y-ou saw the object! Tr,r to list the activi~ or activities, and the appraxiate amount or time spent on each. 7. Were you mov1ng at M7 ti!H whUe you saw the ob ect? (Circle One) 1 D rou answered xm,, then ccmplete the following questions. 7.1 What direction vere y-ou moving? (Circle One) 1 a. North b. Northeast 4. Southeast t. Soutlnofest h. Northwest 7.2 How fast vere you moving? miles per hour. 7.3 Did you otop at a117 time while you were looking at the object? (Circle One) a 1!1. or Hs a. What 41reotion "'" fO'l fao1ns vhen 7 first aav the obJect? (Oirole ODe) I b. lartbeaet f. Soutbveai' 4. Southeaat h. Northwest 8.1 What 4ireotion vere JOU faoiftl vhen the object disappeared? (Circle One) 1 Kerth b. lortheaat 4. Swtbeaat t. 1 Southwest h. Northveat 8.2 0Q1 ot the following to 1Jd1cate heM. certain 7'0\1 are ot .,~ anaver to the above tvo questions. (8 and 8.1). a. Certain c. Hot ve:ey sure b. Fairly certain d. Just a guess 9. Were rou vearJ.na eye glasses vhen JOU sav the obJect? (Circle One) 1 10. How vaa the object seen? (Circle One) a a. Thr ougb w Wow glass e. Through theodolite t. Through sun glaaaes , I Through open apace b. Throup vindshield o. Through binoculara 4. Through teleacope 11. What do 7ou remember about the weather condi tiona at the time you aav tbe object? , 11.1 CLCIJIB (Circle One) a. ,Clear sq .. 0. Soattere4 olouda 4. Thick or heavy clouds ll.2 WD!D (Circle One) a. (P.o vind~ b. Slight breese c. Strong vind 11.) \lEATHFR (Circle One) b. Yog, Mist, ar light rain c. Moderate or heavr rain e. Don t t remember 11.4 TEMPERATURE (Circle One) c. rlTarm) e. t?n't remember 14inutee Seoeb!a 12,1 of tbe tollowq to ildioate bC* certain 70u are of rour anawer to Que atiOD 12 a. <Certalli"l riir~ ur o. Not vef7 sure a. Just peal 13. DS4 tbe ob~eot 1oolu (Cirole OM) . 14. Df4 the objeot at aa, t!Ma Change direction? Change a peed? Cha"l aise? Cbup oolar? Break up into parte ar Give off amoke? brightDeaa? , throb, or R-illaoticmleaa? (Circle One fOr each question) ppn't knqw [>pn't Jsn9H Don't 1cnQW Doo'1; knOW ~qn't len~ Pon't knpw Qoo't knmt 15. D14 the object pve oft a 11gbt! (Circle One) 1 ~b!! Pon't knCM 15.1 JF JOU aDSwere4 tm, what waa the color af' the light? ..... _......_... .. 16. !ell in a ffN warda the following tbinp about the object? ~ . 16,1 Sound 16.2 Color 17. "11 there was !-!mE THAN (JIB obj.ot, then how maey \Jere there? Drav a pioture at how th17 were arranged, an4 put an arrow to abow the direction tbq were trawling 18. Did the object at ~ tme a 18.1 Moft bebird emeth1fta? (Circle One) D' JCN aDI"'ered DS, then tell vhat it moved behiDl. 18.2 in front ot ecnethina? (Circle One) I!! J!!l Dsm't 1sncM Jr JOQ anavered tm then tell what 1 t moved in front of 18.) Blem with the bacqroond? (Circle One) Xes Which ot the following objects is about the same object JOU saw? (Circle One) t b. Baseball. o. ( Basket~!_l '.i d. Bicycle vheel e. Office desk t. Autanobile I Small airplane h. Large airplane 1. Dirigible size as the 19.1 Cira:W ot the following to imicate hov certain you are of 7our answer to Queetion 19. a. Certain_ b. (J'a~rq certaili.' c. Not very sure 4. Uncertain 20. T17 to tell the following tbinga about the object: 20.1 How high above the earth was it? .Si:/J ~ teet. 20.2 How tar was it from J'OU'l - : ... ,_ : feet ar miles . 20.) How fast was it going? _ .?' 2 t(; Vr7 miles per hour. 20.4 Qtrcle one of the following to indicate how certain you are ot your answer to the above questions& a. Certain b. Fairl7 ccrtnin c. ~" ot very sure d. Juat a guess 21. How did the object disappear fran view? (Circle One) 1 a. c~uddenly) b. Graduiilq c. Other--~-- d. Don t remember In the tollad.aa eatoh Jr:Nr er at the point ahown. Place an A Oil the liM to 1haw how hlp the objeot waa above the horizon vhea JG.a eav it, Plaoe a "B" to ahow where it vaa when when yw u. Ill the tollowq aketoh plaoe an "A" at the position the objeot \lae vhea JOU tirat eav it, and a "B" at ito poaition when J'OU last saw it H~iz~n HQriz~n 24. Draw a pioture that vUl show tbe motion that the object made. Place u "A" at the beg1naq ot ita path and a "B at the end of ita path elH vltb rou at tbe U.. rw aav the ob3ect7 (Obole 0.)1 JlP aJIIVeN4 1IS, 4!4 iber the ob3eot toot (Oirole Oal) I 29.2 n. lilt their ancl a44re VIe a441v~" D7 f\lrtber vbicb 7ou believe are importan~. eheeta or the eame eise paper lt neoeseaey.