1. 04TITIMI NUMI OP HJICTI 1. LINOTN Ofl OUihA t. ftHYIICAL IYIDINCI 1. LOCATION TICHHICAL IHFORMATIOH 5. AIR PORCI This questionnaire hot leen preparecl so that you con give th U. S. Air Force at much in,armJtion 01 poulltle concerning the unidentified aerial phenomenon that you have ob1erv.d. Pt Jse try to answer at mony quettlont 01 you pottlltly con. The information that you gie will h~ ;tH for retMfch purJtetea, ontl will be regerded 01 confidential material. Your name will nof It :.ued in connection with Oftl' tte ts, concluelons, or publication without your permlulon. Y.'19 ..quett thft pertonol inferiNtfon that, If it It ciNrMd ncuory, we may eontoct you for r~rh~tr detoflt. 1. When did you tee the o\iect? 2. Tim of day: (Circle One]: 3. Time 1one: (Circle One): o. Eost.,n b. Central (Circle One]: o. Doyllght Savlnt b. Standard c. MountoiR d. Pacific .C. Whre w.,e you when you aow the oltject? Neereet Peatel A44ren Additional remarlla: 5. Eati"'ate how lont you sow the oltlect&.~-~-- Cltr er Town 5.1 Circle 01te of the fellewl"f te ln41nte how certain you or of your anawer to Question 5. (;:) Cerl" c. Not ver, aure r Fairly c:... 4. Juat gueu 6. Whet we the con41tiM of the alar? (Circle O~tel: (ci) Bright doyltthf T. Du II d.,llpt c. Bright twilltltt d. Jutt o trace of cfGYIIght No trace of daylight f. Don't re,..ember 7. IF y~u saw the ol.iect durhlg DAYLIGHT, TWILIGHT, or DAWN, where was the SUN locoted aa you loolc.d ot the obiect? (Circle OneJ: o. In front of you In bocll of you c. To your right d. To your left e. Overhead f. Don't retNmber IF you aew the oi.fect at NIGHT, TWILIGHT, or DAWN, what did you notice concerning th STARS and MOON? STARS (C lrde Orrel: MOON (Circle One}: a Bright moonlight ... Dull moonlight No moonlight -pitch doric Don't re temher Was th. oltf.ct lwlghtar t'-' the Mclrpountl of the al&y? (Circle O~te}: c. Don't reMamltr 10. IF It woa BRIGHTER THAN the al&y Heir .. ~, wea the lwlghtness lllce that of on outoMOI.Ite heoclllght?: (Circle O~te} A Mile or mlfe away (a distant car)? ~ S.v~rlltloclla oway? c. A bloclr owoy? S.verel yardt awt~y? 1 I. Did the oltfect: (Circle One lor eaclt question} Ap:p to a tend atlll at atty tiM~? Yet Qjj) Don't Know ... Sudcf ... ly epeed up and ruth owoy ot any tlnte? Yet <!) Don't Know BrHir up Into .,...tl or .,lode? Don't Know d. GIYe off tmolce? Don't Know e. Change ltrlghtnaea? Don't Know f. Change 1 Don't Know Fllclc.r, throlt, or pul .... ? Don't Knew 0 id the oltfect ao~n~thlng at anytime, ,.tlcul.rly o cloud? ( C lrclo O~te}: Yea (No) Den't Know. IF you onawerecl YES, then tell What It IIUWid behln4: Did the oltfect Move 111 front of thing at onytiMI, ,_.lculorly o cloud? (Circle Onel: Don't K1111w. IF you answwecl YES, thon tell whet It moved In front of: Dlcl the object appear: (Circle O~tel: T ronaparnt? c. Don't Know. Did you MllfVe the oltlect through Oft1 of the foiiCNI"I? E~gtauet Yet C!} Blnoculara Sun ulan f. Telescope Yea No Windshield Yea g. Theodolite v Wirtdow glou Yet 16. Tell in few wortlt the follewln1 thlnp oltaut the oltfect. Sountl 1/!lu: 17, Drew 'lctwo that wlb h the "-111 of the _.teet or oltfects. Lot.l and Include In your alcetch on, detellt of the thet ,_ ewch wlnp, protrv1fen1, etc., anti pclally exheutt troll or vopor trolls, Placa en .,,. ....... the 1ftt to lh the tllrectiM tho ol.fect wet mavin,. 1L The ...... ef tho eltfoct were: (Circle O..e)l f1 ltlurretl lt. Lllco lwftht atw 19. IF there wee MORE THAN ONE Mioct, Draw ,..._. el l.w thor were ...4 ,., .. ., ... ahow the tlirectlon that the, ware trav.llng, Wner.-were ,...locotM when~ ... the oltiect? (Circle 0...): o. lnalde o INUdiftt lt. In a cer (c:)Ovtd 4. In an alrple a. In the business section of a city? @ In the roslllentlol section of a city? c. In open ceuntryallle? 4. Flying n11r Clft airfield? Flyl"' ower o city? f. Flyiftl o~er open c:ountry? 71. Whot we you delftl at the tiN yeu the o~.ct, anti hew did you happen to notice It? 21. IF Y" were MOVING IN AN AUTC*OIILE ather vehicle ot the ti'"' then complete the followl"l questiortt: WIN ye lflftlf (Circle ()fte) f. Southweat 23.2 How fast weN ,.., mniftt? 28.3 Did rev,,., at o~ty "'" whll, you were looldng at the olti.ct? (Cirola 0..) Yea No 29. Whet dlrectl were yeu loalcl"' whM JW first aow the oltject? (Circle O..e) North @Eoat f. Southweat 30. Whot cllrectl were r leal&l"' whM ru loat the oltiect? (Circle 0...) c. e e. South 4. S.UIIse f. Southw h. Northwest h. Northweat 31. If ru a. with l.eoriflt tw (on1ul tlirectiOft), try to eati ... te the"""''*' of degrMa the oltject was fro true Nerth aM alae the of da.-eea It wea upward froM the hwizon (elevation). a. frOM true tl~rth b. frOM hwlzM 32. In the followl,. slcetc:~ .... , .... that you :fre ot the point shown. Place an A on the curveclllne to show how high the oltiec:t woa oltove the horla (alryllne) when you lirst aow lt. Place o a on the some curveciiiM to ahow how high the oa.tec:t wet oltowe the herlzott (alcyllne) when you lost sow lt 33. In the followlnt larger al&etch ploce, eft .,. ... the pealtion the olaiect was when you lirtt ... It, an4 o a at Ita poaltiM when you lo1t lt. Re.fw te -ller alcetc:h oa on exOM,Ie of how to cOMplete the lger alcetch 3~. Whot were the weoth concUtlent ot the tiiM you aaw the obJect? 3~.1 CLOlllS (CI~I Otte) a. Clear alcy @ Scattered clo...te 4. Thiele or hee~ ciNe e. Don't rmLer 34.3 WEATHER (Circle 0.1 '( Fog, mist, or lltht ,.,,. C or heefJ Nlll 3~.2 WINO (Circle OneJ a. No wlncl (.9 Slight W.eae c. Strong wind 34.~ TEMPERATURE (Circle OtttJ 35. Whett dl4 )leV rpGft te 111111 offlclel that JOV hod. teen tho olafoct? Woa eftJOfll I with you lit tho tiMI yow aew the eltfect? (C lrcle 0110l e 36. 1 IF rov onawered YES, 414 th., '" tho oltfoct too? 37. Wctt thla tho flrat tiN that Je ._. ~n.,. elttoct or oltfecte lllce thlt? (CitcleO...I ..I uJtdar wttet CWcUIIIItaftCI did JOV s other Ofll 1? 31. In ~ opinion wh.t cle )fDU thillll tho oltject woa and 39. Do )'O thift you con estimate the speeJ of the obfect? (Cirde o,.J IF you Oftawere4 YES, then what speed would you esthnote? IF you onawered YES, theft how far away w 41. PINH give tt. follewl lnforiiMitlon aa.ut yourself: PINM Indicate any special eclucatlonol trofnl"9 that you heft hod. Gr.._ school T eclwtlcel acheel High school c. Colle,e f. Oth a,eclel trelnl"' d. Post poduete ~2. Dote you ca...,leted this questfoMeire: