1. 0 A TZ T IWE G"OU~ <6. NUMI!R 0, OIJICTS 5. LEMGTH 0,. OISIRVATION 9 . PHY SIC.AL. !VIOINCI 10. CONCLUI'ON 34. ,Vhat were tne weather cond1tio,s :lf r"le me you sow the ob1ect? 3-l.l CLOUDS (Circle One) a. Clear sky\ c . Scattered clouds d . Theck or heavy clouds t!. Don ' t remember 34.3 N EA THER ( C irc/e One } m i s t , or l1 g h t r 'll n ... . ,,oder11te o r heavy r') en ! D ;m 't remember 34.2 WIND (CircleOne) o. No w ind b. Slight breeze c. Strong wind d . Don't remember 3 4.-l T EMPERATURE ( C trcle One) c. Don't remember 35. When did you report to some ollt.:eul thot you ha d seen the ob,ect ? 36. Was anyone else with you or ~ tn you saw the object? (Circle One) (f;} No 36.1 IF you answered YE~ d id they see the object too? ( C ircle One) ) No 36.2 Please list their names H d .1ddresses: 37. Was this the first time that you hod s .. n an object or objects like this? (Circle One) Yes 37.1 IF you answered NO, then when, where, and under what circumstances d id you s" other ones? . n yo ... r :;cn on Nnor oo 'f">IJ f, r'< '"e OOJect w o 5 U. S. AIR FORC! TECHNICAL I~FORMATIOH SHEET (SUAAIURY 0.4 T .4) In order that your 1nformation may be filed and coded as accurately as possible, pleose use th e followin9 space to wr~te out a short description of the event that you observed. You moy re pear information that you have already given in the questionnaire, and add any further comments, ' tote menrs, ot sketches that you believe are important. Try to present the dera.l s of the observa t ton ' " the order in which t hey occurred. Additional pages of the same size poper may be attached 1f h e y a,. needed. (PI1 Pttntl S IGNATURE_ (00 Not Wrttt! 1n Th1s Space) .iorp.n Caro'iina AIR TEO,N&CAL INTELLIGENCE CENTER NIUGHTP~TT!fUON AIR PORCE BASE Dear .Yr. Feltss ' Your recen ~ re~N, )Jr unidentified aerial. ohenomena h.as been receiv~ by the t i re cal Intelligenc e Center. Inclos~d is a questionnaire, wtt; :h, ~en anpleted by you and r~turned in the inclosed, selt-a~dre~sad envelQpe, will aid fn standardizing t h9 da~a and wi1l providB a complet cord o f the occurrence. Your intere.H. in reporting t he rrat ter and ymu public spirited desire to be of 9 !.'rice are greatly appreciated. Sine erely yours, llajor, USAF Air Adjutant General U. S. A I R F 0 R C E T! C H HI CAl I H F 0 R MAT I 0 H SHE E T This questionna ire has oe e n pr epared so t hat you con g ive th e U. S. Air F o rc e o s much Information a s p ossib le concernrng th e unident ifie d ae r ia l p he n omenon that you hove o bserved. P le a s e try to answer as ma n y qve~tans a s you possibly can. T h e information that y o u g ive w i ll sed fo r r esearch purp oses, a nd w d l be regarde d as conf iden t ia l materia l. Your nome will not b e used rn connection w ith any sta re menu, concl u s ions , or publ ications w ithout your pefmission. We re~uesf thi s personal rnfor mo t ron so that, if it i s deemed ne cessar y, we ma y con tact you f or fur rher derai l,. If "l e n d rd you ;C!e rh e o b 1ect' 2. T i ne of do y : 3. T ime zone: ( Crrcl e One): a . ... OVI fO 1n 4. Where were you when you s o w ~e o b ject? S. Estimate how long you sow the obect. ( Circle One): a. Oa ylght Savin g . b. Stand~ " Stote or Countr y 5.1 C i rcle one of the followtng to indicate how cert a in you ore of your answer t o Quest ionS. a. Certa i b. o ir lycertain 6. What was the conditien af the sky ? ( Circle One):~ Bright doyliqhj) c . DtJII do v li qht :J, rron r c . Not very s ure d. Just o guess d . Jus r a rroce -:>r jc-vlgnt e. ~lo 'Toce o f dovl g n r r. Oon ' r r~ll'enoer ~ rre m :le r 8. IF you sow the object at NIGHT, T'NiltGHT, or DAWN, what d id you notice concerning the STARS and MOON? STARS (C irele One): MOON (Circle One): None o . Bright moonlight Dull moonlight Don't remember No moon I ight -pitch doric Don't remember 9. Was the ob1ect brighter than th e bockqround of the sky? u . Y~s b. No c . Don't r~member 10. IF i t wos B~IGHTER THAN th 1 s ky bo ckground, was the br ightness l ilce that of on ouromobile heodltght?: ( ': ,rr:fe One) o . A ,.,; le or more away (a d tstont c o r}? ._b. Several blocks away? c . A block away? d. Severa I yards away? e. Other_ 11. Did the object: ( C ircle One for eoch question) o. Appear to stand still at any t1me? b. Suddenly speed up and r\1~" awa y at any t i me? c. Break up into parts or e-., I .::>lie? d. G ive off smoke? e. C hange brightness? f. Change shape? (!;(fl iclce!) throb, or pulsate? 12. Did the object move behind sorrthing at anytime, particularly a cloud? Don't Know Don't Know Don't Know Don't Know Don't Know No I No) Don't Know Don't Know (Circle One): Yes (0 Don't Know. IF you answered YES, then tell what 13. Did the object move in front of something at anytime, particularly a cloud? ( C ircle One): Yes Don' t Know. IF you answered YES, than tell what lJ. D id the ~b:ecf -Jopeor: ( C ircle One 1: a . Solid~ h. Tr::,..soorenr? ::. Dnn t (now. ~ ~eodol rs 16. T ctll in o few words the followmg ' hngs .:1 oout the object. 17. Draw o picture that w ill show the ,hope of the object or objects. label and include n your sketch any detr.~ils of the obtect that you sow such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on arrow beside the drawing to s how the direction the object was moving. 1 18. The edges of the object were ( Circle One):,:;.a -7 c. Sharply outltn.d d. Don't re r 19. IF there was MORE THAN ONE obtect, then how many were there? Draw a picture of how they were Ofranged, and put an arrow to show the direction that they were traveling. Draw a p ic ture that will shaw t n e 'llot on rnot the o b ject or objects mode. Place on A at the begtnnin~-Y of the porh, a "B at the end of rn e porn , .Jnd show any changes in d irection during the course. r-' POSSeBL E, u y t o guess o r '"SIItOOte what the real si:e o f the object was in tts longe s t dimen sion . 2 2. How lorq e J d rhe o b ject 01 ob1e ctJ lOpeor as compared w i th one o f the fo llowtng o b jects he ld in the hand and a t obo,t arm' , le09th? ( C ,rcle One): Hend o t o Silver dollar ~. 3 JBbod Gr cip e " u it) N I ( t..el Basketball Malt dollar 22.1 (Circle One of the following to i 'ldicote how certain you ore of yoiX answer to Question 22. c. Not very sure b. Fw. y certain d. Uncertain 24. In order that you con tiYe aa clear o ,.,,turo as pouiblo of whot you saw, we would l ike fot you to imotino that you could construct tho object that you saw. Of whot typo motoriol would you make it? How large would it be, and what shape would it have? Describe In yow own words a common object or objects which when placed up in the sky would give the some appearance oa tho object whtch you sow, 25. Where were you 1\lcoted when you S J w ,.,f! ob ject? ( C ircle One): a. In s id e a building b. In a car c. OutdoorS) d . hJnoirplone . . At s e a 26. Were you ( Circle One) a. In the business section of a city? b. In the residential section of o city? ~ In opc.rt untrysid~! d. Flying near on airfie ld? e. Flyng ove r .1 c ity? f. Flyi ng over o pen country? 27. Wha t 'Ner" you )oing at the t1me vo u s o w t he object, and ho w did you hoppen to n ottce i t? 2~. IF you wf'tre MOVING IN AN ~ J 1" JMOB1LE or o t her vehicle a t th e ttme, then complate the fo llowing questions: 28.1 What d irection were 1 } U ICJIIng? (Circle One) c cast e. South b. Northeast d. Southeast f. Southwest h. Nort hwest 28.2 How fast were you mov,'i> 28.3 Did you stop at any Tl r: (Circle One) ., t d e vou were looking at the object? 29. What d irection were you looking w hen you first sow the object? (Circle One) f $:J'-:W:.,o.f..:t-~ a. North c. East e. South g. West b. Northeast d. Southeast f. Southwest h. Northwest 30. What direction were you looking w hen you last saw the object? (Circle One) b. North.-t h. Northwest f. Southwest 31. I f :'o u or~ fa mi l iar with bearinq terms (angular d irection}, tr y to esrimote troe nu.,OI!r v r o " grees the ob ject was t,:>m rJe !'lo rth ana also n ., n u mb.,, of d e grees i t was upward from th e ort::..,n ~lem1 n ) b . rrom ncrizon ---------degrees. 32. In the followeng ~ketch, imagine rnur u .He ot the point shown. Ploce a n A" o n the curved line to show how high the ob ect was above the hor ten $<yl ene) when you first saw i t . Place a "B o n the some c urved line to show how hegh the object was above tl"le ho r i z on (skyline ) when you l o s t saw it. 33. In the follo w ing larger sketch ~lo,.<e ,n A" at the po s it ion the object was when you first sow it, and a "8" a t its posit ion when you last sow i t. ' r ro smaller sketch as on example o f how to complete the larger sketch. 39. Do you th ink you con estimate th-. spe-.tJ o r the object? (Crcle One) Yes No IF you answered YES, then what soeed would you estimate? 40. Do you th1nk you con estimate how fnr uwoy from you the object was? ( C ire/ I! One) IF you an~wered YES, then how for ::Jwoy would you say it was? ~ 1. Please '.Jive the following information about yourself: rrrst Nome City Zone S t ate TELEPHONE NUMBER -- . Please indicate any special edl,r. :r o"ul training that you have hod. Grode school e. e. Technical school High school Other special training Post graduate 42. Date you completed this questionnaire: