D\TT.UT:;, 4 . TYI-'f ;)F O~S;:RVATWI'l '"'h~ :rve-r ::.:lc; t.rriC!'ir'l;--; ba : i :1 t:1c ~"7l ::l,1r.h he observ nd f er t:;o ~l'i~utcn. cr.Pt1d :1nt locate t~e - .iun t.: ~ :-t hetvkli tc to ('h.icc t was o" br:i:"'ht ;--;s-.. o:y uuLoan 29, Un:l anyone else ,.,ith you at the time you saw the object? (Circle One): Yes 29.1 IF' you answered YES did they soe the object too? (Circl e One): Yes o::r. 29 . 2 Pl ea5e list their nomes nnd oddresses: 30. Please add here any further comments which you believa aro inportant. Use additional sheets of the s ame size paper if neces~ary. AF FORM 11Z PAP.T II APPROVED I J UNE 194 AIR INTELL!GENCE INFORMATION REPORT llf.I\>~T ItO, J'iLC ... OI'\ 'T ft,F FORM 112-PAHT I 1'1 'HOVFO 1 Jllt;r I J l'l (LJ.ll'!; IJL. \ .VJ-1 AIR INTELLIGENCE INFORMATION REPORT OA lt:. OF(INfn!~:AA fiON llA tF. 0~ I POR r I IIH''kU OV ( fJ 'lt'rr ) ~li:IIM.\HY: (/'I r Cltrltt ttiiiiiiiOT/1 o( ffpotl. (llt li']llljicorut f11 filial Ollt!tflltriU 1iiJfU)fiiJIII. ).i 'IIHitoltlft< Ul l ?rl tt lf'. l:cg 'fl l u i Of tt{'Or/ 1 11 .I/o' J"<JTI'\ I I !-]',rt II.) or-. rPIBUTIO~ OV OHIGIN.\ TOR 1. 1-lhen did you see the object: 1.2 Time of day: r> c. cr-t;)J> A-;1-t. or ti1) (Circle One) 1.3 Time Zone: (Circle One): a. Eastern b. ~ntral) c. ~fountain d. P3cific (Circle One): n. Daylight Saving b. Standard 1.4 Circle one of the following to indicate hou certnin you are of your ans~er to the above question 1.21 a. cg;;tai~ c. Not very sure b. Fairly certain d. Just a guess 2. Hhere did you see the object? Postal Address City or Town 3. \Ihere uere you located lJhen you saw the object: (Circle One) 1 a. Inside a building b. In a e~ 3.1 Here you: State Country d, In an airplane (Circle One): a. In the business section of a city? In the residential section of n city? e. In open countryside? d. Flying near an airfield? o. Flying over a city? f. Fly lng ovar open country? , H~.., did you happen t o notice the obj ect? 5. \lhen did you report to some official that y ou had neen the object~ ~. ~Thnt Here you d oing at tha time you sv.'-J t he object~ ,l't"-\IJ'r 6.1. Hhat had you been doing for the 30 minutes before you sa'"' tha object? Try to list the activity or activities, and the approximate amount of time spent on each. 7. \>Jere you moving at any time \Jhile you sn\.1 the objoct? (Circle One): IF you answered YLS, the n complete the following questions. 7.1 \~hat direction uere you moving? (Circle One) : a. north o. South b. Nort!1east r. southwest c. East g. Hest d. Southeast h. Northwest 7.2 Ho~ fast wero you moving? --------miles par hour. 7 .) Did you stop at nny tin:e \rhile you Yer e looking at the object? (Circle One): e:! or 8. \lhat direction \Jere you facing \lhen you firs t saw tho object? (Circle One): a. North e. South b, Northeast r. Southwest c, East _ g. llest d. CiC!~"i~as i) h. lT orthw ~s t L 8.1 "lhat direction 'were you racing when the objeot disappeared? (Circle One): a. North e. South b. Northea3t t. South\.les t c. En:.1t g. \-lest d. <foutheast h. Northwest ~ c-.J ~ r 8.2 ~irole on~ or the following to indicate he~ certain you are or your answer to the above wo questions. (S nnd 8.1). a, (Ccrtai~ c. trot very sure b. Fairly certain d. Just a guess 9. \Jere you wearing eye glas3es when you s a,., the object? (Circle One) 1 (i~;) or No 10. Ho" \Jas the object seen? (Circle One): a. Through windO\I glass b, Through windshield c. Through binoculars d. Through telescope ~ Thro~g~ theodol e--) t:--Through sun glttsses g. Through open space 11. Hhttt do you remember about the Yeather conditions nt the time you aaw 11.1 CLOUDS (Circle One) 11.3 HEATHER (Circle One) a. Cloar sky c'O~ ....Scattered clouds / d. Thick or hea.V'J clouds b. Fog, J.Iist, or light rain c. Hcderate or heavy rain e. Don't remecber e. Don't r emember HDID (Circle One) TEMPERATURE (C irclo One) a. No wind Slight breeze Strong wind d. Don't recernber '?n't remember 12. E3timate h eM long you saw the object? 0 Minutes Seconds 12.1 girole one or the following to indicate how certain you are of your ans,,er to Que otion 12: a. (C;i.ta~ o. tTot vory sure b. Fairly sure d. Just a gue3s 13. Did the qbject 1oqk: (C.ircle One) Solid or 7'ran~p:1rent? C o--1.'.-.'t:. t~,/ Tt. 14. Did the object at any time: 14.1 Change direction? 14.2 Change speed? 14.3 Change size? 14.4 Change color? 1~.5 Break up into parts or 14.6 Give off smoke? 14.7 Change brightness? 11.,.8 Flicker, throb, or 14.9 Remain motionless? (Circle One for each question) Don't knot.~ ~on' t knm1 Don' t kno\l Don't knC\ol Don't kno,., Don't knc..., Don't kncr..1 Did the object give off a light? (Circle One): jc"i' llo 15.1 IF you answered YES, \Jhat ~as 'the color of the light? Tell in a few words the following things about the object? 16.1 Sound 16.2 Color lF there \.las HeRE THPJJ ONE object, then ho"' many uere there? _ o_ D:.c"a\1 a picture of h0'.-1 they were Arranged, and put an arrcr.-1 to show tho direction they ~ere traveling. Did the object at any time: 18.1 Move behind something? (Circle One ) Yfl S IF you an~mered YES then t ell uhat it moved behind. 18.2 Hove in front of something? (Circle One) Ye3 @) Don't kncrJ IF you answered YES, then tell what it moved in front of. 13,) Blend ,.Jith the background? (Circle One) Yes 19, Hhich of the following objects is about tha same actual size os tha object you saw? (Circle One): a, Pea f. Automobile b. Baseball g. Small airplane o. Basketball h. Large airplane d. Bicycle l 7heel 1, Dirigible Ci ia of 'the rroilo,,lng t~ irxif t~ .. hotJ certain you n.re J ~ or your answer to Question 19. b. Fa~rly cert.lin Not very sut"e 20. Try to tell the follo~Jing things about the objeot: 20.2 Hou far to~as it from you? (!o ,;; ... c. feet or miles 20.3 How fast \Jas it going'? dT itt'"\. miles par hour. 20.4 Circle one of the follolling to indicate ho'.ll certain you are or your ansuer to the above questions: a. C~rtain" b. Fairly certain e. l!ot very sure d, Just a guess 21. How did the object disappear fl:om view'? (Circle On9) : a. Suddenly o. Other------ d. Don't rer.:ernber b. Grnduallf 22. In the following sketch, imagine your eye at the point shown. Place nn on the curved line to show how high the object l-Ias above the horizon l-Jhen you first s aw it. Place a "D" to ohow where it Ya:J l-Jhen "'hen you lc.st saw it. 23. In the follo~.Jing sketch place an "An at the posit ion the obj oot was ~hen you first saw it, and n at its ponition uhen