I. LOCATION 12. COMCLUIIOHI a Was lolloon 2 Ju 1 58 Ohio a Proltoltl, Balloon Lenl ...... ~I.Wo:::.lil~.... a O..un4-Yl suel a Oreun4Ro4or g ~:.!r;'t.~craft a AI~VIel D Air-Intercept Ro4or D PossiW, Aircraft D Yea ~xProiMW, Aatronomicol II:Jio ivilian a Poaailtl, Astronomical 7. LINOTH OP OlllltYATION I. NUMI!It OP OIJ!CTS 9. COURI! D Other-------- D Insufficient Data for Evaluation IRIIP OP liGHTING Bright white light' blinking very fast, no distinct shape . 11. COMM!NTI Very little info to go on, but probably astronomical. Altair was at 35 deg elev 110 dng azi- muth & DENEB 45 deg elcv 60 deg azimuth these are 1st mag stars exact position not givor1 other than east. No pl~nets in East. Case listed as Astro U. I. A I R P 0 R C I TIC H MICA L I M P 0 R MAT I 0 tl S H I! E T (SUIMWIY DATAl In.,., that your lnfor lon a,. flied ond coded o1 accurntoly o1 possible, please us the following poe to write out o short deacrlptlon of the event thot you obs&rved. 'Y'C'u 111ay re- peat lon thot you have alreody given in the questionnaire, oncJ acJcJ .Jny further c"mments, or 1lcetche1 that you believe are important. Try to J~relert the cJeta ils of the observa tlon In the order In which they occwrecJ. AcJcJitionol poge1 of the 1ome 1i1e paper moy IN attached If they e needed. (Do Not W.lte ;,, This Space) d l~lt l.AI~ ~--A.A'-i U. L All PORCI TICHMICAL IMPORMATIOM Thle ttueetlonnolre hoe M.n prepered 10 that you can tlve the U. S. Air Force ae Much . \ lnftlon poeelble concernlnt the unidentified aerial phenOMenon that you hove obeervect. I I , 'PI try to anewer a1 many queetlone you poeelbly can. The lnfor tlon that yo" elve will ~ uee4 f reeHrch purpoeee, and will be reeardect ae confidential material. Your name will ttof ~ ueecl In conne~tlon with any atatennte, conclueiona, or publication without your perMilelon. We requeet thla penonal lnformotion 10 that, If It 11 deemed necey, we may contact you for I 2. Time of clay: Heur Minute 1 / j, .<J r 3. Time aonea c. Mountain d. Pacific (Circle OneJ: A.M. (Circle OneJ: a. Daylight Saving e. Other------ 4, Where were you when you 1ow the ob;ect? 5, EatiMote how long you 1ow the obiect. 5.1 Circle one of the following to Indicate how certain you ore of your on1wer to Que1tlon 5. (0. )Certain I. Foirly certain 6. What wae the conditicn of the alcy? (Circle One): a. Bright daylight b. Dull daylight c. Bright twilight c. Not very 1 ure cl. Just 0 guell Just a trace of daylight e. No trac:e of daylight f. Don't remecnber 7 . IF you sow the obiect during DAYLIGHT, TWILIGHT, or DAWN, where was the SUN located a1 you looked at the obiect? (Circle One}: o. In front of you b. In bac:lc of you c. T.o your right ATIC FORM NO. IN ( 1.1 OCT 14) cl. To your left Overhead f. Don't remember I. IP ,_ eaw the oufec\ at NICHT, TWILIGHT, or DAWN, what 4lcl you notice concerning the STARS ancl 1.1 STARS (Circle One}r . 1.2 MOON (Circle Ottel: fl. Don't remomlter 9. Waa the olfect lwlghter tha.n the ltaclcpouncl af the alcy? (Circle One}: Bright light ~ Dull moonlight c. No light pitch 41c fl. Don't reet~ember 10, lfllt 1 BRIGHTER THAN the alcy ltaclcgrouncl, waa the lwlghtneaa like that of an automobile heaclllght?a (Circle One} a. A mile or more away (a 41atant car)? 1.. Several ltloclca away? c. A ltloclc away? 4. Several yar4a away? 11. Dlcl the oltiect: a. Appear to atancl atlll at any time? 1.. Suddenly apeed up and ruah away at any tl ? c. Break up Into parts or explode? d. Give off smoke? e. Change brlghtneaa? f. Change shape? I Fllclcer, tlvob, or pulsate? (Circle One lor eaclt quetlonJ Don't Know Don't Know Don't -Know Don't Know Don't Know Don't Know Don't Know 12. Did the object move behind lng at anytime, particularly a cloud? (Circle One}: Yea ~ . Don't Know. IF you answered YES, then tell what 13. Did the object move In front of aonaethlng at anytime, particularly a cloud? Don't Knaw. IF you answered YES, than tell what (Circle OneJ: Yea @ 1~. Dkl the obiect appear: (Circle Onel: lt. Tranaparent? (!;) Don't Know. 15. 014 you observe the object through any of the following? a. Eyeglassea Sun glasses c. Windshield d. Window glasa e. Blnoculara f. Teleacope I Theodolite '' Tell In few wor4a the following thln11 Nut the o._fect. 17. Drow picture that will the shape of the olttect or olttecta. Lol.l and lnclucle In your aketch any cfetolla ef the ol.fect thclt you aow auch o1 wl,ga, protrualona, etc., cmcleapeclolly ehouat trella or vapor trolla, Place new .. alcle the owing to ahow the 41rectlon the ot.tect waa naovlng. . 18. The e<gea of the obtect were: (Circle OneJ: Fuzzy or blurrecl Lllce a bright star c. Sharply outlined d. Don't remember 19. IF there waa MORE THAN ONE obtect, then how mony were there? Draw a picture of how they were orrongecl, ancl put on arrow to show the direction thot they were traveling 20. picture ,_t wLII ahew the tlen thet the tee~ w. eltfecta ....... Piece ett A et the l.tlnnl,. ef the path, a t the end of the ;.th, n4 nr chaneea In cllrectlen 4urlft1 the courae IF PO~LE, try to gue11 eathnate what the real alae of the oltfect 1 In Ita longeat dhnenal~. 22. I low cUd the oltfect " oltfecta compore4 with one of the following oltlocJ. hlfl Itt tlte ltollfl ancl at altout ~ length? (Circle 0}: a. Head of a pin d. Nlclcet e . Quarter f. 'Half dollar Jlt Sliver dollar \hJ Daaelall I Baalcetltall lc, Other-------- 22.1 (Circle One of the following to Indicate how certain you e of yow anawar to Queatlon 22. Certain {j> Fairly certain c. Not very awe d. Uncertain 2~. In .,.,., that rev c elvo aa clo a ,lcturo ,.aalltlo of whet you aow, we woul4 IIIlo f you to hw .. lne thet you could the oltfoct thot you aaw. Of whet t"a Material weultl you ..... a It? How lareo wovltl It Ita, anti wh.at ahape would It hava? O.acrlk In your own wortlt a low~n ol.loct or oltfactt which when placed up In tha ally would tlvo tha me appearance a1 tho oltloct which rou aaw. 25. Whete ,ou I the oltiect? 26. We rou (Circle OneJ (Circle O...J: In I a ltullcllftl ct>ln a cor cl. In an air In the ltuslneaa aectlon of a c lty? it. In the realdentlal aection of a city? (i) In countryalcle? cl. Flyln1 an airfield? e. Flying over a city? f. Flylnt over open country? IF you we MOVING 'IN AN AUTOMOBILE or other vehicle at the tiN, then coe~tplete the followln1 queatlona: What direction were you moving? (Circle One} it. Northeaat I low Ia at were you miles per hour. 28.3 Did you stop at any time while you were looking at the oltiect? (Circle One} No 29. What direction were you looking when you first saw the oltiect? (Circle One} f. Southwest h. Northwest 30. What direction were you looking when you laat saw the oltiect? (Circle One} h. Northwest it. Northeast d. Southeast Southwest 31. If you are familiar with bearing terms (angular direction), try to estimate the number of degrees the obiect waa from true North and also the number of degrees it was upward from the horizon (elevation) 31.1 When It first appeared: a. From true North -----...... it. From horizon deer 31.2 When It disappeared: a. From true North -----d ...... it. From hori-zon degrees. 32. In the following a Ieetch, I glne that you are at the point 1hown. Place an A on the curved line to ahow how hlth the obiect waa al.ve the horizon (1lcyllne) when you lirst 1aw it. Place a a on the aome curved line to ahow how high the obiect 1 above the horizon (slcyllne) when you loaf 1aw lt 33. In the following larger 1ketch place an A" at the poaition the obiect wa1 when you lirst sa~ it, ancl a a at its poaltlon when you laat saw It, Refer to sn~aller sketch aa an example of h~w to complete the larger sketch. 34. What were the conclltlona at the time you aow the oblect? 34.1 CLOLOS (Circle One} . ce. .. alcy c. ScoHerecl c loucla fl. 'Thiele or heavy clouds e. Don't re 34.3 WEATHER (Circle One) Fog, mist, or light rain c, or heavy rain 34.2 WIND (C lrcle One} No wlncl C)) Slight breeae c. Strong wlncl fl. Don't remer 34.4 TEMPERATURE (C lrcle One) 35. When dlcl you report to some official that you hocl seen the object? 36. Was anyone else with you at the time you saw the object? (Circle One) Yea No 36.1 IF you answered YES, did they see the obiect too? (Circle One) Yea No Please list the 37. Wai this the first ti that you had '""an object or objects like this? (Circle One) Yea No 37.1 IF you answered NO, then when, where, ancl under what circumstances did you see other ones? In yow opinion what do you think the obiect was and what might have caused it? 3P. bo rou thin ,ou can eatiNte the (Circle Yea IF rou YES, then what apeecl would you eatl 40. Do you think you can how far away from you the obiect waa? (Circle O...J Yea YES, then how far away would you aay It 41. Pleaae tlv the followlnt oltout youraelf: Ml441e Name TELEPHONE NUMBER-------- Pleoae lncllcote any apeclal educational training that you haw hocl. Grode achool --------- b. High school --------- 4. Poat graduate --------- Technical achool _ f. Other special training ---------- 42. Dote you co,..pleted thia queatlonnalre: