1. DATI TIMI NUIII 0' OaJICn t. LIMGTM 0' OIIIIYATIOM 6. TY'I 0, OIIIIYATIOM t . 'HYIICAL IYIDIMCI 2. LOCATION A .. AMALYIII fTD liP 61 U. I. All POICI TICHMICAL INfORMATION SH I! T Thlt .,ettfonnalre hot IMn thet you con give the U. S. Air Force at much lnf,.tlon potalltlo cancerftlnt tho vnldetttlfto4 aerial phenomenon that you have "'ve4. Preate tty to ontwer at 1n0ny t~vettlt at you pottlltly can. The Information that you give will .. used for ret larch purpatet,' ort4 will Ita ra .. rde4 at confidential material. Your name will ,., lte uted lft cnctl with aRy ttateiiiiRtt, conciV~Iont, or publicatlont wlthovt your pMittlon. We request thlt lnfar tatlen that, If It It dn,..c.f necary, we may contact you for further detei Ia. 1. When did you '" the oltiact? 2. Tim of day: 3. Time aon1: (Circle Onal: Co MaUfttelft 4. Pacific Whore ware when yau -the oltfiCt? , Cu, T " &tete Centrr Additional reiMrlct: 5. Eatlmote how lent you tho oltfact. 5.1 Circle one of the follewl"f to lft4inte hew certain you ore of yow antwor to Quettlon 5. 6. What wtlt tho cM41tian of the allr? (Circle Onel: Bright dayll,ht lt. Dull darlltht c. Bright twlllpt c. Nat vary ture d. Just a trace of doylltht (e:.'> No trace of daylight f. Don't re"''"'lter 7. IF you sow the object during DAYLIGHT, TWILIGHT, er DAWN, where wat the SUN located aa you loolcecl at the obiect? (Circle One): a. In front ol you lt. In baclc of you c. To your rltht d. To your left e. Overhead f. Don't reiNMiter I. IF r 10w the oillect at NIGHT, TWILIGHT, or DAWN, what cUd you notice concernlnt the STARS ond MOON? 1.1 STARS (C lrcle O~te}: 1.2 MOON (C ire I Otte}: Bright ntOOftlltht it. DulllftOOftllght c. No moonlftht -pitch darlr 9. Wat the. .. lect lwlthtr than the ......... of the tlry? 10. IF It wat BRIGHTER THAN the tlcy IMiclrpourMI, wat the lwlghtnets lllre that of an automol,lle headlight?: (Circle o,.J(;.1 A mile ....,, away (a cllttant car)? S.Y~rel ltloclrs away? c. A ltloclr away? 4. S1Yerol yerdt away? 11. ow .... olttect: (1 Arr te aton4 atlll at .., time? '-' Sudtlnly a,..l "'and ruth away at atty ti .. ? c. .. .L up lnte ,_,, Of plede? d. Gift oH kef r!'Y ct.,.. lwlthtn' , I;" Fllclrer, threlt, pvla ... ? (Circle One 'o' eodt queflonl ( YIJ No Don't Know Wa No' Don't Know Yea No Don't Know Yea No ~1)on'tKnow ~ No (_ D_on't Know-= f.Y.!J No Don't Know 12. OW the eltject ov Mhintl thl"l at anyti e, particularly a cloud? ( C lrcle 0}: Yet ~ / Ooft't Know. IF you answered YES, then tell whet 13. DW the eltfect In '"" of 101 i"l at nyti~M, portlculerly a c to? (Circle O~tel: Yea ('~\ O...'t Knww. IF you answered YE$, than tell what ov.d In ftont ol: \...:.: 1~. Dhl the oltject lt. T ronsporent? Did you oltserYe the oltject throuth ony of the foll.wi"lf No \ eJ Blnaculart lt. Sun glasaet f. Teleacope Yea Windshield Yea No 1. Theodolite Yea Window gla11 Yes No h. Other ( c. Don't Know. 16. Tel! 1ft f .. worcla the follewlftl thl"'' the oltlect. 17. Drew 'lctwe lhet will the of the Ol.f.ct oltlecte. Label and lnelu4e In 1fNI al&etch ... , det,.lla el the loct tt.t ,..; HW tvch wlftta, ''"rvalofta, etc., eapclellr xhauat troll., vopor troll1. Ploeo aftew ltnW. tho .......... ahow tho lroetl tho oltlect wet Movlftt. "' / 1L Tho o4te ol tho oltfect w1ro: (Circle Otto): fu11'., ltlurr (it./ Lluellrlfhtaw c . Shr,lr outllft_. 19. IF wet THAN ON! elttoct, 1le1R how ' w1re there? Or.w ,&cew. el hew ...., wro _. pvt oK .. ahw the cllrectlon that ther were trovllnl 25. Whor.-weN ,ou locot.cl wheft ,ou sow the oltfect? (Circle 0...): 26. Wer you (Circle One) In the ltualneaa aectten of o city? ~ In the realtlentlol section of a city? ~-;' In opn coulltrralde? ct. Flylnt naar Oft olrfleltl? e. Flyl,. ONr o city? f. Flying o.er Gflln country? 27. Whar;e yow ol"' ot the tl rou ~the o~ect: an4 hew .ct~ rou happeM te notice It? 21. IF rou MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the' followlnt queatlona: diNctt ,. you lng? (Circle One) 4. Sautheeat f. Southwest 21.7 lie feat were you lftlvlng? --------- tiles per hour. 21.3 Did yeu atep at any tl,... while rou wore loolcint at the oltfect? (Circle Ono} Yea No 29. What tllrectl were you loolcl"t wheft rou flrtt saw the object? (Circle Otto} f. Southweat clirectl were you loolcint when you lost aow the ol.fect? (Circle Ortel. l c_!,/ Eoat b. Nottheeat a. Soutlaaast f. Soutltweat h. Northwest h. Notthweat 31. If you are folllor with bearing terMS (antular direction), try to estimate tho """''* of degrHa the olioct was North and alao the nultor of degr"a It was upward frOift the horizon (elevation). When it first appeared: Fro"' true North Fro"' horizon When it disappiDred: Fro true North FroM horizon 32. In the following alcetch, imagine that you are at the point shown. Place on A" on the curvecl I lne to show h,w high the oltiect wos above the horizou (slcylfne) when you first saw lt. Plnce o "B" on the same curved line to ahow how high the obiect was obove the horizon (skyline) when you lost sow ft. 33. In the following larger alcetch place an A" at the poslticn the obiect was when you f;,., saw It, ancl a "B" ot its position wheft you last aaw lt. Refer to smaller alcetch as on example of how to compl,te the lar;er s'cetch. I I I I t I I 34. Wh.t .... ,. the weather conditfont Cit the tifM yov tow the ol.fect? 34,1 CLOtllS (C lrcle One I c. cleullt 4. Thick ., hea., cl_.t 34.3 WEATHER (CIIcle Ortel c. ., heoYr rein 34.2 WINO (C lrcle O~to} r.J Newlftd .. Slltht lweeao c, Strot'll wln4 4, Don't ra11 34.4 TEMPERATURE (Circle O el e. Don't re"'"'r 3S. WhN tlhl you re,Mt to efficl thet you hM '"" the oltfect? l6. Wet elM with ,_ .. the tl you lOW the oltfect? (Circle O,..l 36.1 Ill rou ewre4 YES, 414 th., '" the eltfect toe? ICircleO...I Ne 37. Wa thlt the flrtt ,._ tlwt ,_ h.l teet~ an Hied eltfecta IIIIo thia? (CircleO..J wt:e11, wh~re, .,., UA.tr wtt~ eire UlllllaiiCOI fiMf rou ... other Oftl I? 38. In your opinion what clo rou thinlt the ol.fect wat .ond w~ ~t haYe caused It? ~ .~ ~ ~ o cY'-L--cfr- ~ 39. Do yo. thlnlr you con estimate the speed of the object? (Circle On~t} Yes No IF you onswerecl YES, then what ,..d would you estimate? o. Do you think you con estimate how for owoy from you the obiect wo1? (Circle One} Yes <Yn.' IF you onwlred YES, then how for away would you soy It wo1? 41. P&.o .. etve the lnfer .. tlon olout yourself: Plea Indicate any 1peclol educotionol trolnl"' thot you ho.e h.l. Gre4e 1chool 1. High achool . f. Other ~ lelnl"l"t , d. Pnt orCMIte --------- 42. Dote you completed this questionnaire: U. S. All POICI TICHMICAL IHPORMATIOM SHIIT In cler r N fllecl aM ceded occurotelr po11lltle, pleaae use the follwl ,, ... te write M 1lwt tletcrlfltl of the went that pv oltaervecl. You moy , .. yo111 hiM elreedr tin In the tttlnnlre, and .W ony further comfNnta, thet ,_ ltellwe l .. ertMt. Try to prealftt the detolla of the Allf'Vct-............. a. whlclt ther ,. .. , ef the 1an11 alae pvper .. , N attached (Do Hot Write In Tltls SpeceJ