t. DA.TI TIMI . NUMIII Ofl OIJICTI S. LINOTM OP 6. 'TY~I OP 7. COUtlll t. ~HYIICAL IVIDINCI I. LOCATION fCircle ORal '") He _ .... IF ,.-111awara .. YES, tl2111 o. De r lhltlll r c (Circle 0.1 .,.... weul4 r-eathta? IF re YEI, 41. PI tiYe the f.llewln1 PIHN lndlc .,., apaclel educetl trolnl"l 1lc1t you hve ..... U. L All POICI TICHMICAL IMPORMATIOM SHIIT (SUMMY DATA) In ., ., tt.t r .._ fll.4 ...., clllalll eccun~telr poaal~le, '' v the fole.wlftt te .,. .. evt ahert lilt._ of the went that '"' oHIF'fM Yw ... , , .. '''' tt.t r ...... ,. , ti9M Itt the ttVIatlannaiN, an4 oM 111 furthar that r Mllwe I Trr te ,.. ..... the cletella of the -.." .. ht whllh "'-r ,. Adllll ,. ... of the ,.,., "''' M ottochacl (0. Hot Wrl,. lit Tltl SpoeeJ U. S. Alii FOIICI TICHMICA\. IMPORMATIOM SHI!IT Thft questfoMOire hot bHn prepored so that you can give the U. S. Air Force aa Much lnfcrNtlon 01 poulltle concerning the unld.ntlfletl aerial phenomenon that you have oltseretl. Please try to answer 01 many questions os you poetlbly con. The InforMation that you gle will lte uaed for reseatch pwposes, and wllr b. regorde4 os confidetttlal Materiel. Your no,.,. will nof Ito use4 In connectiOft with any stoteMOnts, conclusions, or publications without your Pntitalon. We requeet this persanal information 10 that, if it it dHnted necetsary, we may contact you fot furtft Htoilt. 2. Time of ct.y: 1. When did you tee the oltject? (Circle Orte}: 3. Time zone: a.. Central (Circle OneJ: Oo Daylight 5cwf"' I It, Stondonl . (Circle OneJ: c. Mountain d. Pacific 4. Wh~re were you whett you sow the object? Stete ., CeufttfJ 5, fsthltOtO haw IGng you lOW the oltiect, 5.1 Circle one of the followiftt to indicate how certoltt you are of your answer to Quettien 5 6. Whot wea the conditi_. of the alcy? (Circle One}: a. Bright daylight ... Dull daylight Co Bright twilight c. Not very sure d. Justo .,en d. Just a tree of clay I ight e. No-ii-oce ofCiaylighf:, 7. IF you saw the oltiect during DAYLIGHT, TWILIGHT, or DAWN, where wos the SUN located os you loolaed ot the obiect? (Circle One}: o. In front of you it. In ltoclc of you c. T 0 your right d. To your left e. Overheat~ IF you saw the obfect at NIGHT, TWILIGHT, or DAWN, what dhl you notlee eoneernlng the STARS and MOON? STA~ (Cirde O~teh 8.2 MOON (Circle O~teJ: a. None a Bright moonlight Dull moonlight No moonlight -pitch clar~ . ...- d. Don't re1Mn4:r Was the oltfect lwtghter t'-' the lae,._und of the aky? (Circle ON): IF it waa BRIGHTER THAN the sky Mck .. und, was the lwightnen lllce that of on outontoltile headlight?: (Circle One) a. A mile ar """ away (a dlatent cCII')? 1.. S.vol b lack away? 'c. A block away?., d. S.vol yarda away? e . Other_ Dlcl the ob;.cH (Circle One lw eoclt qwtlon) -.--.-to atend still at any time? No Don't Know a. t'Y.a~ ... Suddenly speed up and rush away at any tl te? No Don't Know Br .. k up Into parta or ex,lode? Yea Don't Know Give oH aiiiOice? Vel Don't Know e. Cho111 lwlghtn1 ? Don't Know DOft't Know I Flick, throlt, or puiHte? Don't Know Did the oltiect IIIOft Nhlftll at anytime, ,..tlcultWiy a cloud? ( C lrcle O~te): No Don't Know. IF you answered YES, then tell what It mDVed Nhlftll: Did the oltiect ... .,. In Lent of so111ethit11at anytiiM, particularly a cloull? (Circle O~te): it mowd In front of: DM't Know. IF you anawered YES, than tell what 1t. DW the oltiect (Circle o,..J: a. Solid?-.) 1.. Transparent? c. Don't Know 15. Did you oltserve the olttect through any of the following? Ey .. laaaes . ...- Binoculars ... Sun glaaa.s v f. Telesco, Yes No WinclshleW v No Theodolite Wlnllewgless Yes No h. 16. Tell In a few word~ the following things about the oblect 17. Draw a picture thot will .how the aho, of the oblect or oblecta. Lobel and Include In your alcetch any details of the oJ.iect lh.t you aaw tuch at wlnga, lfOtruslona, etc., and especially eJChauat tralla or vapor trails. PltJce on arrow heslcle the drawing to ahow the direction the Htect wos moving. 18. The edgea of the oliect were: (Circle Orte): o. Fuzzy or ltlurred 1. Lllce a bright ,.., Co Sharply outlined_..} tl. Don't relllelll.., IF there waa MORE THAN ONE obiect, then how many were there? -:-~-t=--- -'- -'~'.J-- d7!J.o~--:-- Draw a picture of how they were arranged, and put an arrow to ahow the direction that they were traveling. 20. Draw picture that will ahow the MOtion thet the ollect or eltfect liNda. Place em A at the '-tinning ef the ,..e., 1 et the enl of the path, end ahow enr ch1ft1a1 In lrectlon uri,. the eourte 21. IF POSSIBLE, trr te 1~ ~ eatl,..te wft1t the rael alae, of the ~iecto woa In Ita longest ~-nalon. 22. Haw lore wtt. oltiect oltiect 4. Nrcilitl IPAIIII with .. , of the followl,. oliectt lteltl In tlte ltontl I SUvar 11 I S.aketk1ll 22.1 (Circl 0111 of the follewlftl to l,.,lcata how earleln you of your an1war to Queatlon 22. Certain lt. Felrlr c~rtal~ Uncertain Whre were )'0\1 locat.cl wh.n you sow the c.bject? (Circle 0...): lnalcle a bvlldi"' Ia. In a cor c. Ovtd~ 26. Were you (Circle OrteJ a. In the b"siMss sectiOft of a cltr? b. In the resld..,tlol section of o city? c. In open countryside? .. d. Flylnt near em alrftelcl? e. Flying ewer a city? f. Flying ov., open countfr? 21. What were yev clolne at the tl,.. you saw the obiec:t, and how dlcl you happ.n to flotice It? 21. IF yew ware MOVING IN AN ~u ILE or other vehicle at the time, then complete the followl"l quettlont: 21.1 Whet direction were you wine? (Circle One) North c. Eoat lt. Nortl:eeat d. Southeest f. Southwest h. Northwest 28.2 I low faat were you lfiOYint? 28.3 Did you atop at any tim. while you wet'e loolclng at the ol.jec:t? (Circle CM.J Yes No 29. Wt.t cllrectton were yow looldftl wheft you first MW the o~t? (Circle One) 'h. 'Northweat f. Southw .. t ... Nottheatt d. Southecut 30. .._, 4Wectl were yew loolclftl wheft you loat tew the olttect? (Circle Qae) f. Southwest d. Sovlh..at 31. If yow ore fa.allor with lteoriftt tar"" (oneulor direction), try to eatirnate the numMr of degrM the olalect wae fro true tiOfth and olao the""'"'* of d ..... It wa1 upwar4 from the horizon (IYetion). 31.1 Wheft it flrat oppeere4: lt. Fr0111 horlzOft -----degr .. a. 31.2 When It dlaappeare4: Fro true North ------detrH lt. FrOM haria c1 ...... 34. Whet w1re the weather condition at the time pu sa the ol,fect? CLOli)S (Circle OrteJ Scott~red ciMt Thiel& or hr cleullt 34.~ W!ATH!R (Circle 0111} ~. F .. , tltt, or llthf rot" c. Mod1rate or hr roftt 34.2 WIND (Circle OrteJ No wln4 i. Slftht l.reeae .. c ; Stro"' wtfl4' 4. Den't reman,., 34 TEMPERATURE (Circle Orte} 35. Whett fiW r ,.,_, te 101111 oHiclal thot ,au hod n the oltfect? 36. Wa1 eiH with you .at the tl e yov taw the oltject? (Circle Ortel Yea .J No 36.1 IF rv on1Ware4 YES, fiW ther '"the ol.iect too? (C lrcle Orte} Y .) No 37. W01 thl1 the flret tlllie thet y1u he4 11111.,. -"feet oltiectt IIIlo thlt? (Circle OJ. Yet) Ne 37.1 IF rv neware4 No;thM whett, where, nl UMIF clrc.,.t. c 4W r other onet? 38. l11 row ., ... ,.,. what flo you thlnlc the ol.fect wet and whet ltht have cauaefl It?