3. DATETIME Cf?OUP CC.lllili...'C t J c:~ TYi-E r,e: 0 !3SERVATICN ::0 ::Zr<Jvnd-Vl svcl Gc.und-Rod or Q Atr 'li ~uol D Was Asttono"~e~o! 1 D Probably A~:r::.oric_ D Possibly Astr~..,~micc:l !J .\If-Intercept Roder I 0 Insufficient Doo for Evoluction 15 minuees two 1 E t o W 10. BRIEF SUMMARY OF SIGHTING j 11. COMMENTs T : o objects lil~c a star, sizt' of pea, Se e color like R bright star , SOU!lcl deep th robing with vapor l.l"ai ls. Uhje c t se<-:med to colJ irlc and disapJ..e,r, 1~1cr one object. was !::.een. Brol"':: up ana E:.xploded. Thvugh t it was 1Jcss j bly a t;:Gteor(s) unt:i J c'q;loded. L:..se file. 39. Do you think you can estimate the speed of the object? (Circle One) IF you answered YES, then what speed would you estimate? 40. Do you think you can estimate how for away from you the object was? (Circle One) Yes IF you answered YES, then how far away would you say it was? 41. Please give the following information about yourself: Mlddl Nome TELEPHONE NUMBER Please i'1dicate any specia l educational training tha t you hove hod. Grode school e . e. T echnkol sehool b. High school (Type) College f. Other special training Pos~ ~roduote I 42. Dote you <omp letd this questi onnaire: U. S. A 1 R F 0 R C f. TECHNICAL I H F 0 R MAT I 0 H SHEET (SUMMARY DATA) In ordor that your information may be filed and coded as accurately as possible, plaose use tno following space to write out a short description of the event that you observed. You may re- peat information that you hovo already g iven In the questionnaire, and add any further comments, statements, ot sketches that you believe are important. Try to present the details of the o bserva- tion in the order in which they occurred. Additional pages of the same size paper may be attached If they are needed (Do. Not Write in This Space) SIGNATURE_ HartfGrd 7 C!i'I'ICIAL BUSI1\'ESS D:::? A:T!~S. ~ of the rti3. FOJ.CZ ." .. L~ rECH:.liC.i.L D:'.f':i:;LT .IGa;cE CENTER ':l.'tlGHT~PATTI .. !1SCN AIR F0:1GZ HA&: tlest Harttora J Connecticut Your let.te.r or .l"f JlUY 56, eddnaed t o United .:>cates A1r F1rce, Waahington D.C., baa been forva:"ded t~ the .u..r ~rechnical I7l te lligence Cent:er for reply. The unidentified ~lying ob ject sighting which you r~ported h33 ~1.)~ been de1"1nit.ely identU'ied t o date; however, the :L"lformation will ~e uaea in our cJntinu1ng analyaia. A more detailed report is .J.eeded ~:or fin&l noalyol. Inclosed i s :me (1) copy USAF Tec:micsl Iru:'or1a't1on 3h~t. Please _'J.ll out anci re-:;1:r~ to t he Air c:mical I:ltelligence t~erter, Wright Patterson Air 7 o:-ce .Base.~ Cb.io. Attacbed tor your i.nror:1atl:)n is t~1e USAF -:;.r:wery \>f Events .!nd I ... ~ )r:Q&tion Ccncer ning t !le U:;.:!.:ier.ufied F ~71.1~ .... ojec i; Fe-. ~am. Also., -~cl USAF Press R~lease. nSSi .1! ~JUl:c~ U. S. A I R f: 0 R C E T E C H N I C A L. I N F 0 R M A T I 0 N S H E E T Thi'l qvutionnolre h:ss b .. n prepared ao that you can give the U. S. Air Force aa much fQ'mclion as poulble concerning the unidentified aerial phenomenon thot you have observed. Plaase try to answer 01 many questions as you pouibly can. The Information that you give will be :~ud for res.atch purpos.,s, ond wHI be regarded 01 confidential material. Your nome will not bs used ln connection with any atoternenta, conclualons, ot publications without your p-mission. We requeat th la personal Information ao that, If It !1 deemed neceaaary, we may contact you for further dotolls. When c id you see the object? Time of day: :kt"t I j :l Month_) v , Doy (Circle One): b. 'centro I c. Mountain d. Pacific (Circle One): (Circle One}: a. Oayjlght Saving b. StandarcL: , :~c:rrut Pottcl A7ru-s ' City or Town Stet o r Country f Add I tiono. ~.mrka: 5.1 c:,,,o one of the follow!:~Q o :ndlcate how c:ertain you ate of your answer to Question 5. b. rairly c:erro ir c. Not very sure d. Juat a gueu . 6. What was the conditi0'1 of ~he ssy? {Circle On~): c. Bri;ht coy d. Justo-trace of day I ight b. Dull daylight e. <tio trace of daylight c. Bright twi I ight f. Don't remember 7. IF you sow thl! object during DAYLIGHT, the objec t? (Cir:"" O:~e : a. !n front o f yo ... b. In bock of you : . To your righ' TWILIGHT, or DAWN, whero wa s tlie SUN located o s you looked a t To your left ~. Ov-erhead f. Don't remember ATIC FORM l'!O. M ( U OCT S4) B. IF you saw the oujec:t, ot NIGHT, TWILIGHT, or DAWN, what did you notice concerning the STARS and MOON? 8.1. STARS (C irele One): 8.2 MOON (Circle O ne}: a. None a. Bright moonlight t,. Dull moonlight cf.~on't remomber c. No moonlight -pftch dark d. Don't remember 9. Was the obfect brighter than the boclcground of the 1ky? (Circle One): c. Don't ramemher 10, IF It was BRIGHTER THAN the slcy background, waa the brlghtneu like that of on automobfte headlight?: (Circle Onero.-A mile or more ~cry (a distant c:ar),t_...:: b. Sevefa I blocks away? c. A block owoy? d. Several yards away? 11, Old the objec:t: o. Appear to stand still at any time? ~. Suddenly speed up and rush oway at any time? c. Break up into parts or explode? d. G'iveotfsmoke? - C h.:mge brightness? f. Change shape? g. Flicker, throb, or pulsate? (Circle One lor each question) Don't Know Don't Know Don't Know Don't Know Don't Know Don't Know Don't Know 12. Old the object "'~ove behind something at anytime, particularly a cloud? C Ire!~ One) Yes 'No' Don't Know. IF you answered YES, then tell what 13. Old the object i':'l~>Ve In front of someth lng ot anytime, particularly o cloud? (Circ:fe One}: Yes No Don't Knnw. IF you answered YES, than tell what Did the obieet appear: (Circle One): b. T ransporent? Don't know. Did you observe '"~ ob jeet through any of the following? EyegloHc s No e. Binoculars Sun gloss~s Yes .No f. Telescope Yes No Windshi~lc! Yes N_g.:. g. Theodolite Window glo H 16. T II In o few words the following things about the obiect. 17. Drow o picture that will ahow the ahape of the oblect or obfectl. Lobel ond Include In your alcetch any detail of the object that you saw auch aa wings, protrvalona, etc., and eepeclally e)Chautt trOlfl or vopot trail Plae on arrow beside the drawing to thow the direction the obf.ct woe lng. 18. The ed~a ef the object were: (Cire/3 ')ne ): o. Fu::~ cr. blurred b. Wk4L.~-~Jght s tor ' c. Sharply outllnecf d. Oon~ remember Draw c p h::~:.ae O>f how they were crre"gecl, and put an arrow to show th dlrectiCft tnat they ~r tra\ellng 20. Draw c picture 1hnt wlll show the ntOtlott that the o&lect ot ol.lecta made. Place on A at the beglnnl"l of the path, a a at the end of the path, and ahow any, change In cllrectlan clurfrtt the cowae IF POSSIBLE, try to guea1 01 estimate whot the real alze of the oDfect waa In Its longeat dfmenalon. How large did the. obJect fit obJecta oppear 01 comporecl with one of the following obJect belilln the ham/ ond at ohout arm' length? (Circle One}: a. He~d of a pin Sliver dol far h. Baaeball Grapefruit d. Niclcet Baa IeetH II f Half dollar 22.1 (Cirels One of the following to Indicate how certain you ore of your answer to Queat.lon 22. c. Not very sure b. Fairly certoln d. Uncertob' 24. In order th:tf you can give cu c l or o plctur os poulltle of whot you 1ow, wovlcf lll&o fot you to lmotlno thot you eoulcf =onatfuct tne object that you s ow, Of whot type motetlof would you rna" It? How fargo wovl.l It be, oncf whot shope wouJ.t lt hov? Deactl'-o '" yolK ow" wOfd a 6om~tton olttect or oltlocte wh lch whott plocetl up In the a1c, woufcf gin tho 1orno OJtpearance 01 tho object whfch yo~ 1ow 25. Whore ,..,~re you located when yo u saw the object? (Circle .On~}: 26. Were you (Cirde One) a. Ins ide c bui I ding b. Jn a cor c.( Outd~ors d. rn an a irplane e. At seo o. In the business section of a city? b. In the residential section of a ci ty? d. Ffying near an airfield? e. Flying over a city? f. Flying ovr open country? were you doing at the time you saw the object, and how did you happen to notice it? 28. IF you werta MOVING IN AN AUTOMOBILE or other vehicle at the t ime, then complete the following questions: What direction were you moving? (Circle One) d. Southeast f. h. Northwest How fast were you mQving? les per hour. 28.3 Di d you stop at a ny time while you were looking at the object? ( C i rcle On e ) Yes No 29. Wha t direct:on were you looking when you f irst sow t he object? ( Circle One) South g. West o. Northeast d. Southeast. f. Southwest h. Northwest What direct icn '"'ere you looking when you lost saw the object? (Circle One) d. Southeast h. Northwest' 31. If you are fami I io r wi th bearing te rms (angular d irection), try to estimate the number of degrees the obiect was from true North and also t he n umber of degrees it was upward from the horizon (elevation). 31.1 When it first appeared: o. From t ru e North - >:~: b. From horizon ------degrees. 31.2 When 1! disappeared : c. From tru e North ... _ ,_ , degrees. om hor izon degrees. In the ffJIIowing sketch imoginn tluJt high the o bject was obo~e the lhr I L,t show liow high the object was In t!-te follow ing larger sketch place on ~ pOSI ivn wrf'n you last sow it. Refer TC 34. Who were the weather conditions at the time you saw the object? 34. t CLOUDS (Circle One) a. C le.ar _sky; c , Scattered clouds d. Thick or heavy clouds e . Don't remember WEATHER (Circ:le One) b. Fog, mist, or light rain Moderate or heavy rain Don't remember 34.2 WIND (Circle One) a., No wind b. Slight breeze c. Strong w lnd d. Don't remember 34.4 TEMPERATURE (C#rde One) e. Don't remember 35. When did you report to some official that you had seen the object? 36. Was anyone else with you at the time you saw the object? (Circle One) .:ies"' No 36. t IF you answered YES, did they see the object too? (Circle One) ,Yes/ No 36.2 P lease li.st 37. Was this the f irst time that you had seen o:-t object :>r objects lik e this? rc ircle One) Yes No 37.1 IF you o:1swered NO, th en when, wh~re, and under what circumstances did you see other ones? 38. In your opinion wl,C!t do y~u think the object was and what might have caused it?