NU~AIIIt 0' OIJICTS S. LIHG rJ-4 01' OISI .. ~A TIOM 6. TYP! OF 08SlRVA Tlf)" t. ~HYSICAL IYIDIMCI 2. LOCATION 10. CO..CLUitOM Insu! oat& 25. Where wr you 1\)cated when )Ou sow tt' e o~ject? (Circle One): a, lnttde a building b. In a C4t., c('OutdoOr-~----') d. In an airplane 26. Were you (Circle One) .. b:-In the residential sectioa..of-o-etty?--- c. Tn ope;~c,_;ntry-;ide? d. Flying near an airflld? Flying over a c ity? Flying over open country? 2;'. W~ot were you d:>ing at the time you .110W the object, and how di d you happen to notice it? I I A I J" ~S. IF y o u were ~VING IN /'.N ; ,Ill G,,,(l~ILE or other vehid at the time, then complt the following questions: b. Northeast f , ,,,ut heas t f. Southwest h. Northwest How fast were yCMI rttO\> 28.3 Did you stop at any ti.,tt o hile you were loolcing at the object? (Circle One) 1'~tl No ::'i. '/r'hot J.rect1on were you loolctr:u ., ,,.," 'f?tJ firsr saw the object? (Circle One) d. Southeast f. Southw .. t Whet d irection were you loolcing when )OU lost sow the oDiect? (Circle Crt.) Southeast f. h. Northwest 31. If yo u are familiar ith bearing'-'"'' (ong~;lar clirec:tiOft), try ta estimote the nu111ber of degr"' the oltject was r:"m true Nonh and also the number of degr"s it was upward from the horizon (ele,ation). n i t ctbuppecr "C. I show how high the object was abu" tne ~(irtton (skyline) wh.n you last sow it. In th. foll owing larger al..tch t~l1 ., "' "A" at the position the object wos wt.en you first jOW it, and a "B at its poaition when you lost aaw it. r.., fr to smaller sketch as an example of how to complete the larger ale etch. .OS (Circf .. One) ~. Sc:.ltt!'!r d clouds i . Ti-11ck or h~-,vy chu<h ,.,f:~ ThER yo r po. c.u -.~w tne O:JI~ct. .,u hJd sc. .:l t~e 3tt.2 WIND ( C icb One) c . N..:.wrnd b. Sl :~!,t hreez~ c. Stro,g ftand d. l) .'t rene ."1her Don't rem rJ."'r (Circle Oll<t) (Cirele Or:e) (f5J !~r;se lis their nam.!" :? ... Wos t;, is ~n f;rst t ime that ~ou fh.~ti sHn nn ob1eet 01 ob jects l ilce this? t C cle One) i,.) yov ons-.ered NO, tr:e n w._en, whete, ana undet what c~rcumttances did you sH or~er ones., 39. Do you thinlc you c:an eatimote t he -;p..,O 'Jf t~e obiect? (Circle One) Yes IF you answered YES, then whot spee<f would you eatimote? 40. Do you thlnlc you can estimate how far away from you the object was? (Circ:le One) ~ No IF you a nswered YES, then how for 'lwuy would you say it wos? 41. Please give the following information about yourself: TELEPHONE NlJ~BEP. _ M tddle N ame '.VI,at is your present io'-? Please tndic:ate any special eJw tr .. mol training thot you have had. 12. O.te you c:ompleNct thie queationnoire: e. e. Technical s c hool 1. Oth special troini"t --------------- U. S. A I R F 0 R C E TECH HI CAL I H f 0 R MAT I 0 H SHEET Th1s questionnaire has been prepared so that you can give the U. S. A ir Force 01 rn1.1ch information as pouible concerning rhe unidentified aerial phenomenon that you hove observed. Please try to answer 01 many questions as you pouibly can. The information that you g ive will be uaed for r esearch purpotet, and will be regarded a1 confidential material. Your name will not be used in c onnection w1th any statements, conclusions, or publications without your permiuion. We re<;uest thi s personal inforrno t on so that, if it is d~emed necessary, we may contact you f, furth"' ~. tn il s . OCJy !Jo'l!"' Yeor 1 ( CtrcloJUtotl: 1 t.un ... n J . J ctltc (Crrcle One}: a. U1yltght Saving b. 5 rand.Jrd Nooroet Poetol AJdru City or Tow" Stofo or Co"""' 5. Estimate how long you saw Ji,e .,n ~oure Mnuto1 S.co"4 , S.l Crde one of the followtr~g ro indicate how certain you are of your answer to Question S. I tj; Cwta in c. Not very 1 ure I I b. Fairly certain d. Just a gueu . 1 6. What w~s t~e c:onditiCift of ftote slcy? fC~rde One): a. Bright daylight d. Justo t race of day I ight r-e obj~:? To your lef c. 8. IF you s aw the object at NIGHT, !''IILIG~T, or DAWN, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One): d. Don't reme ... ef 8.2 MOON (Circ:le One): a. Bright moon I ight b. Dull moonlight (9 No moonlight -pitch dark d. Don't remember Was the object brightef than the buckground of the sky? IF it wa s BP tGIITER THAN th~ !'>!,y hnckground, was the br ightneu I ike that of c.:n outomob i le heod' ght?: (Circle One),~ A mile; ~ore awa y (a dista nt car)? b. 5.tveral blocks away? A block away? Se '"'a I yards away? 11. 0 id the ob ftte:t : o. App.tar to stancl stiiiJt ,.,., tr ""'? b. Suddenly speed up and .~. 1 "''f .,t any time? c. Breck up into porta 01 .. ~I 1., ? d. Give oH amolce? C hange brightneaa? f. Change shape? g. Flick,, throb, M puls11r-.? (Circle One for eoch question) Don't Know Don't Know Don't Know Don't Know Don't Know Don't Know Don't Know 12. Diet r+te object nHWe Mhind ,.,,...:!-. rg :~t anyti:ne, particularly a cloud? ( C irde One): Yes <f~ Don't Know. IF you answer.ct YES, then tell what 13. DW the object move ift frent of somethi"' at anytiiM, pcwticularly a cloucl? (Cirde Orte}: Yea ,~ Don't Knew. IF you answefecl YES. than tell what S .. n ghsses lr'lids'ti ... l ~, a . Solid? b. Tronsparent? c. Don't Kr.ow.-.,. No c . 9 rnocu1Jrs f. T clas::ope T 1--e ocJ o l1 ~a 16. Tell in a few words the fol !owing t r-;s .. bJUt the object. The eclget of tM otject were: (C~rde One): a, Fuzzy or !-..,,.,d 19. IF theN was MORE THAN ONf "'.ct, then how many wete thete? Draw a picture of how they weN :1rronte4ll, oncl put an arrow to thow the direction that they were traveling. 20. Draw o picture that will sho t~e 110 .. ~1"1 :t the obiect or obiects mode. Place an A at the beginning of the path, o a at the end of t.,e ~,~ ":. . -.d show any chong in direction during the cowse. 21. fF P05SiSl E, tr 1 h quess or :uti""-''" what the real size of the obrect was in iu l"nge.-t dimension. 1 22. How larg~J d : I r::lt .:bject 01 .,bll'!c~ l .1,1pear as compard w ith one of the followtn'j obiac:ts held in tf1a hnr:d 1 c.and a t ablut l.lrm'~ length? Si fver do liar Grapefruit Boslcetboll k. Other 22.1 (Circle One of the followi"l 1 how certain you ate of yo~ answer to Question 22. a. Cew , n c. Not v.,y sure d. Uncertain 24. In 4 thctt yeu cen ''" e1 cle a p ttture es ,.asiltle ef whet yeu sew, we wewl4 1111 f yew te imetifte thctt yeu eeuld cena,.uct the eltiect th reu aew. ; ., ... ,,. lei weul4 ,.., melle it? How lore .... ui4 it b., on4 whet she,. weul4 it hewe? De .. llte lA , ..... ,. .,~, h" teet., eltiecta which wheft pice ... "' i" the ally weul4 tw the 32. In the following sketch, imagine th a t / CJ 'Jre at the point shown. Place on A" on the curved I ine to show how high the object .vas above the hori z ;-n ! c, ne) when you first saw it. Place a a on the some curvecl line to show how high the object was above ,,. or zon (skyline) when you lost sow it. 33. In the followint lor.., elr.lch ,, A at the poaition the object was when you lint sow it, and a a at its position when you lott aow it. ~ ~., to smaller sketdt as on example of how to complete the larger slcetch 25. Where were you luc:oted when you .~""' r oject? (Circle One): Inside a building b. In a car Out~O~..L :J In an airplane 26. Were you (Circle One} a. In the bus ineu section of a c: ity? ~ b. Jfillii iaiiJntial iiclion' of! clryt;' c. In open countryside? d. Flying near an airfield? e. F lyi ne over a c ity? f. Flying over open country? 27. What were you doing at the tine you saw the object, and how did you happen to notice it? 1'' E or ot"'er vehicle at the t ime, then :.:?mplate the following questions: 2a. t What ~irection <..,ere , ;or ''' ''" ,g J (Circle One) a. f~.;,rth b. NOf'rheast f. Southwest h. Northwest f ;S .. rhecnt 28.2 How fast were you ,, .. I 28.3 Oicl you atop at ant ti~e ""~'tie you were loolcing at the object? 29. What direction wer you leo~'' " yv firet saw the ob;.ct? (Circle One) b. Nottheott f. Southweat h. Narthweat 30. Whet clir.ctien were you loolcinca nen yeu lett sow the olti.ct? (Circle One) Go Nerfh I d. Southeast f. Southwest 31. If you are familiar with bHring terfM (antular direction), try to estimate the number of degrMI the oltject was I j from true North and also the number of degrMI it was upward from the horizon ~elvoton). .\F FOIM 112 PART I \PP"'VID I J\j.MI: 19411 .: NCLASS f FJ EO ' L E. I "'F. IJL.LVK'l AIR INTELLIGENCE INFORMATION REPORT