PROJECT 10073 RECORD CARD I. DATE 2. LOCATION CONCLUSIONS 0 Was Balloon 0 Probably Bnlloon 0 Po s si bl y Bol I oon TYPE OF OBSERVATION 3. DATETIME CROUP~ :O~Ground Vi suol s .. PHOTOS &. SOURCE 7. LENGTH OF.OSSERVATION C.i v llj_<.J n 8. NUMBER OF OBJECTS 0 Ground-Radar 0 Air-Intercept Radar c Was Aircroh 0 Probably Ai rcroh 0 Po ssi bl y Ai reroft 0 Was Astronomical .,,-.] i , )q t ' 0 Probably Astronomical o ;,:Possibly Astronomical 0 Insufficient Data for Evaluation to. BRIEF SUMMARY OF SIGHTING 01.10 luminous loug v1hi t~ s t t'v:tk rom ho1i~on to horizon .. 11. COMMENTS DC'scllrJt.Lort , fl it~ht pat.n h questionnaire as een 'prep re ao t at you can give the U. S. Air Force at much , lnfcrmotion as possible concerning the unidentified oerlol phenomenon that you have obaerved. Plecue try to answer 01 many questions as you possibly can. The Information that you give wUI be uted for rsearch purpoaea, and will b. regarded oa confidential material . Your name will not b~t used In connection with any stotementa, conclutions, or publications without your pef'mistion. Wt request this peraonal information ao that, If It It deemed neceasary, we may contact you for 1. When did you th object? Oo)' Month 3. Tim zone: (Circle One):@ Eastern b. Control c. Mountain d. Poci fie 4. Wher were you when you sew the obiect? / Neoreet Roetol Ad;r a ,. Additional remarks: L P' r\..,t 'JPI S. Es'timate how long you sow the obiect. 2. Time of day: (Circle One): A.M. City or Town a. Ooyl ight Saving b. Standard State or Covntry 5.1 Circle one of the following to indicate how certain you ore of your answer to Question 5. . ! o. ,,:Certo in t.,...f): Fairly certain 6. What wo~ the eondititn of the sky? {C ir: i , One): a. Bright doyl ight b. Dull daylight c, B r i gh t tw i I i gh t c. Not vt~ry sure d. Just o guess d. Just a trace of day I ight i'~ No trace of doylisht f. Don't remember 7. IF you saw the obioct during DAYLIGHT, TWILIGHT, or DAWN, where was the SUN located as you took~d at the obiact? (Citcle One): a. In front of you d. To your left b. In bock of you e. Overhood c. 1 o your right f. Don't utmerober ATIC JIORM N O . t64 ( IJ OCT b4) 8. IF you lt'IW the oufect, at NIGHT TWILIGHT, or DAWN, what d ld you notice conr.ornit1g th~ STARS tJnd MOON? 8.1 STARS (Circle One): 8.'2 MOON (Circ fo One): o. Bri~ht moonlight b. Dull rr~oonllght c. No moonlight -pitch dark d. Don't r(tmomber d. Don't rc9mamber 9. Was the object brighter than the background of the sky? (Circle Ont! ): c. Don't rem em her 10. IF It was BRIGH-rER THAN the sky background, was the brightness like that of an automobile h!tadllght?: (Circle One) @.t A mile or more away (adistoat euat7'u , ... b. Several blocks away? c. A block away? d. Severa I yard' away? e. Oth..-,r 11. Did the obiect: (Circ:l~ One lor each quastion) a. Appear to stand stlll at any time? b. Suddenly ~peed up and rush away at any time? c. Brook vp into ports or explod~? d. Give off smoke? e. Changa brightness? 1: Change shape? g. F Iicker, throb, or pulsate? 12. Did th' obiect move behind something at anytime, particularly o cloud? Don't Know Don't Know Don't Know Don't Know Don't Know Don't Know Don't Know ( C lrc/e One): . Yes C~o, Don't Know. IF you on.1wer"d YES, th!!n tall what 13. Did the ohjec' movs in front of something at anytime, particularly o cloud? (Circle One): Yes Don't Know. IF you answ~red YES,. than tt!ll what Did the obiect appear: (Circle OneJ: a. Solid? b. T ronsporent? c Don't Know. Did you observe the obiect through any of the following? Eyeglasses Yes e. Binoculars Yes No b. Sun glasses Tolsscopa Yes No No Theodollt" :-e ~ Windshield d. Window glass 16. Tell In a few words the following things about the obft~ct, 17. O;aw o plc:tur" t~ot will show th~ shope of th oblet or obiectt. Lobel and .lnelud., In yo~r aketeh any dtaiJ1 of th~ obfect that you aaw such at wings, protru31ont, ete., and ospeclolly e>ehauat tralla or vapor trails. Plat:tt arrow be a fd the drawing to show the direction the obiec:t wcu moving. 18. The edgea of the obiect were: (Cirdo One): o. Fuzzy or bfurr"d b. Like a bright ~tar c. Sharply out I ined d. Don't remember 19. IF thsro was MORE THAN ONE object, then how many were there? Draw a pictur~ of how th&y were arranged, and put an arrow to show the direction that they were traveling '10. Drow a picture Jhnt w~ll show the motion thot the obiec~ r>.r obJects mod. Ploce on A et the beginning of the pofn, a a at the end of the j.ath, and show anY, chongea In direction during th course. 21. IF POSSIBLE, try to guess cr eatlmat whot the real sl:z of the obiect woa In Ita longe1t dhn1n:tlon. 22. How lor~ did the obtect ~ objects oppear aa compared wl~h one of t,e following obiects. beiJ In th hand and at about arm's lngth? (Circl On.): Head of a pin g. Silver dollar Grapefruit d. Nie!cet Bo:skctthall f. 'Half doll or 22.1 (Circle o,. of th following to Indicate how certain you ore of your answer to Quest.lon 22. a. Certain c. Not very sure b. Fairly certain d. Unc~rtain 23. How did the obJect or obiects disappear from view? 24. In order that you can giYe oa cleor o plctur .oa po3aiM of what you ow, we would I lice fot you to Imagine that you could construct '" ooJct thot you aow. Of whot typ moterlol would you matce It? How large would It l,e, and .wh.at ahop. would It have? Oe2crlbe In your own w"'da o ~ommon o'-Jct or oblet which wnn placed up In tne t1cy woutd giY$ tn aame appearance os the oblect which you tCJW, 25. Where wero you located wlwn you s aw the oLject? (Circle One): a. lnsidtl a building b. In a cor c. Outdoors c..:~; In an a ifplone 26. Were y o u (Circle One) a. In the business s ection of a city? b. In the residential section of a city? c. In open co\Jntrys ide? d. Flying near an oirfi~ld? Flying over a city? "'"(. Flying over ope n country? 27. What were you doing at the time you saw the ohject, and how did you happen to notice it? 28. IF you were MOVING 'IN AN AUTOMOBILE or other vehicle at th e time, then complete the following questions: 28.1 What direction were you moving? (Circle One ) r!~.:>North / D c. Eas t {...-~._J':South \o.li. Northeast d. Southeast f. Southwest h. Northwest 28.2 How fast were you mov1ng? ...... , .. P . .! / -~ miles per hour. 28.3 Did you stop at any time while you were looking at the object? (Circle One ) Yes oY (Circle One) direction were you looking when you first saw the object? b. Northeast d. Southeast f. Southwest h. Northwest What direction were you looking whe n you last ~ow object? (Circi~One).., a. North lf'.'~ast e. South b. Northeast d. Southeast f. Southwest h. Northwest 31. If you cr~ fa mi li a r with bearing terms {angular direction), try to estimate t he number of degre~s the object was from tn : e North and als o the number of degrees it was upward fr o m the horizon {elevation). 31.1 When it first appeared: a. From true North------degrees. b. From ho ri7.on ------degrees. 31.2 When it disappeared: a. From tru~ No r ih ------d~gree3. h. From hori zon ----- degrees. 39. Do you think y o u con e stimate tha spead of the object? (Circle One) IF you answered YES, then what speed would you ostimote ? 40. Do you think you c a n estimate how far awa y fr&Jm you the object was? (Circle One ) IF you cn.swerc d YES, then how far away would you say it was? 41. Please give the following information about yourself: Middle Nom TELEPHONE NUMBER Please ind icote any spec ia 1 educational training that you have hod. o. Grade school e. e. Technical school High school Othe r special training d. Post graduate 42. Dote you completed this questionnaire: Yoor Month D ay