3. ii= you, ;1nw th., o~jdct, at NIGHT, TWJLICHT, or DANN, what did you notic!! conc~rning , ;,., STARS and MOON? B.l STARS (Circle One)= 3 .2 MOON (C irc/e One): d, Don' t rerr.omber 9. Wes the oojec: brighter than the baclcground of the sky? (Cirel One): tJ'f' Yes ., "' b. No o. Bright moolllight b. Dull moonlight c; No moonlight-pitch dor~ d. Don't r3member e. Don't remember iO. JF it was BRIGHTER THAN the sky "adcgrouncl, was th brightness like that of an automobile headlight?: (Circle One) a. A mile or mete away (a distant cor)? b. Several lloclcs away? A bloclc away? t.-"' " d. Several yards away? ll. 0 Jd the ob ;ect: ( C ire /e Orte /o, each question) a. Appear to stancf still at any time? h. Suddenly soeed up and rush away at any time? c, 8raaic up into part1 or explode? d. Give off smol<e? ' C!-!onge brightness? f. Chong shape? ~ Flicker, throb, or pulsate? D !d :he ~biect move behind somtthlng at anytin:e, partlcuiOf'ly o cloud? Don't Know Don't Know Don't know Don't Know Don't Know Don't Know Don't Know (Circle One): Yea~ . " No ., Don't Know. IF you onawered YES, then tell what 1 . u id rhe obiect move in front of somefh ing at onytftfte, particularly a cloud? 'C irele One): Yes No Don't J<nnw. IF you answered YES, than tell what b. T ransoarent? c. Don't Know. ) .d 10u observe the object through any of the Foll owing? 3i"oculcrs Y~s No = y'!giQSS<!I Sun glalSI!S f afe1c:ope '.J asrns ld No g . 7 neodol i te y -'l d. H.~oow g csl ~. r .Jd '" 0 few word, the following tnlngl about the o~tect;-_ ., ... "},_ \. ~ ~7, Orow " ,)lch~ that will ahow th enop. of the ooJct 0t o\tJectt. loO.I oncl lnclud In your s~ttch orty cletollt o~ :~ ooject '"t you aow auch at wlngt, protrutiont, tc., oncl etpecJoUy haust tr~lla or vapor trolla. Place \.:n "now b.alcfe the dra~in9 to anow lM direction the oltf.ct WCII nrovlng, a. The~ ... ef the oltfct were: (C!r-:le One): a!.. Fu:zy ltluned LJke a lwl;ht stat c. 5narply outllnecl :1. Oon't Mt ?; 1, Jhe,e MORE THAN ONE oltlect, then how""'"' were there? ------------------- Otaw ,lcture ' how they were arr"tecl, nd put an .,, show the alr.ctf'" thot they were trovelln, f :21. 'F ?OSSIBLE, try to gueaa 01 tlmate what t~e real size of the obJect was In lta .. Jongest cUn:enslon. :'22. How large clid the. obiect 01 objects appear aa con:par.cl with one of the followi"' objects belflltt tlte ltflftfl 4nG at alout '!'' 1 length? ( Circle Orte): a. Head of a pin I Silver dollar h. Baseball ... .J .-' Gropefrult .,... BaslcetMII f 'Ho If dollar 12.1 (Circle One of the following to indicate how cettain you are of yow ant,..., to Question 22. a. Certain c. Not vety s we d. Uncettairt . : _b,> Fairly certain L-... "' How did the ooj.ct 01 object dis appear from view? 24. ht .,~. thet yet~ cot' ea cl ,lcture ea ,..,1~1 ef whet yu aew, we weul4 lllae fer yeu te '"'tine th .. ,.u ceulci th ellject thet yeu Of whet ~ .. etwlel "'~ yu Mel.e It? Hew lt weul~ it M, end whet ehe,. ~o l~ It hee? DcrfiM ht yew " wer4a I"""" Ntect ., eltfech whtch when ....... .,_ In the sllr weul4 tle th 1a~ op,."" the eltlect which '"' aew, .Yh'! .. ~ w~re you lucated when you saw the object? 26. W!!r~ you (Circle One) (Circle One): a. In the business section of o city? o. Inside o building b. In th e resid!tntial ~ect ion of a city? b. In o car 1..- c. In open countryside? c . Outdoors ' d. Flying near an airfield? d. lnanairplone e. Flying over a c:ity? f. F I ying ovr open country? 27. What were you doing at the tin:e you saw the obiect, and how did you happen to notic:e it? 28. JF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the followins questions: What direction were you moving? (Circle One) a. North c. Eo s t b. Northeast d. Southeast ( f ) Southwest ... ~ - 28.2 How fast were you n10ving? 2S.3 Oi d you stop at :any time " (Circle One) ile ycu were loolcing ot the ~biect? 29. What direction were you loolcin9 when you first sow the object? (Cirde One) b. Northeast d. Southeast ._.,...- f. Southweat :o. Wr.at direction were you looking when you lost saw the ooiect? (Circle One) b. Nol1heast ( c~. Sou mea s t '-' f. Southwe$ t h. Northwest h. Northwest h. Northwest 3 i . d you are familiar with bearing terms {angular direction), try to estimate the number of degrees the object was (rom true North and also the number of degrHs it was upward from the horizon {elevaticn) .) 1. i 'Hhen it first appeared: ~. From true North------degrees. b . From horizon degrees. 3 . 2 .1/h~n it di soppeored: o . From true North------degrees. b. Fr'lm horizon degrees. J 2 . In h" f611owing s !<etch, irr.a gine that you are at the po int s hown. P la c e o n "A" on t he curv'!d line to show how hi an t ne object was above the hori:on (skyline) whe n you f i rs t saw it. Place a "B" on the .;ome c ur v., d l ine t o show how h igh the object wa s cbove the horizon (skyl int!) when you lost ~aw it. : J. In tne following larger alcetch place an A" at the position the obiect was when you lirst saw it, and a a at its position when you iast sow it. Refer to sn~aller slcetc:h os an example of now to complete the larger alcetc:h 'Nhot wer~ the weather conditions at the time you saw the object? CLOUDS ( Circle One} (C irt:.le One) Clear slcy \ No wind - Sl ignt br8e&e Scattered clouds SfTong wincl Thiele or heavy clouds Don't rm.meer Don't remember WEATHER (Circle One) 34.4 TEMPERATURE (Circle One} b. Fog, mist, Ot light rain c. Moderate or heavy rain e. Don't ren:ember e. Don't retnemD.r 35. When did you report to some oHicial that you had seen the object? Manth Yeor 36. Was a~yone else with you at the tinte ~owsaw the object? (Circle One)( Ye~:~ No 36.1 IF you answered YES, did they..He' the obiect too? (Circle One) ( Y'i>--" No Please I ist their names and addresses: 37. Was this the first time that you had sHn an object 01 objects lilce this? (Circle One) Yes ( No , c.. / 37.1 IF you answered NO, then when, where, and under what circumstances cUd you'" other onaa? 38. In yot~ opinion what do you thinlc the object was and what might hGYe caused it? 39. Do ou >hinl< o u con s s r imot' the s ,oc!ed o f th e objl!ct? (C ircfe 'Jn~) !F )OOU answ~red YES, ~hen what speed would you estimate? ! ~t). Do you t h inic you can estimate how for away from you the object was? ( Ci.rcfe One) l Yes ... IF you answered YES, then how far owoy would you say it was? 4 L ? J~ase give the follow;ng informat;on about yourself: TELEPHONE NUMBE P' cse ind icote any spec iol educational training rhat you have had. f. Other special training--------------- U~r~ 'IOU compll'ed this questionnaire: U. S. A'R F ORCE TECHHIC~l l~rOR~ATIOH SHE~T (SUMM~RY .DATA) In order that your information may be filed and coded os occurotel y as possible, please use ~he following space to write out a short description of the event thot you obterved. You n10y re- peat informot ion that you have already given in the questionnaire, a nd add any further comments, statements, or sketches that you believe ore important. Try to prsent the details of the observe tion in the ordet in which they occurred. Additional pages of the same size paper may be attached if they ore ""ded. (Do Not Write in This Space) 'J . $. ~ H< f 0 R C e TeCH HI CAL I M F 0 R MAT I 0 H ~ H E E T Thi\' qu.u, ionnoir has D4tn prepared so that you can give t he U. S. Air Fore at much i t1l-:ttrei jon Q S potsibl$ 'oncerning tne Unidentified aeriaJ phenomenon that you hovt obt ... ved. ? l.ecne try to antwer a a many question at you pos 1 i bly can. Th information that you giv wilt b ~.ned for res~rcn purposes, ond will b. regarded 01 confidential material. Your nam will not !J vted 4n conrection with any statements, conclusions, :w publications without your permission. We r.queJl thi1 p.rsonal information 10 that, H It it deemed neceasory, w rnay c:ontoct you for furth., derailt. When cUd you tee the obiect? (Cite/ One):(o. Eoater.n/ b. Central c. Mountain d. Pacific (Circle One): A.M. (Circle One): o. Daylight Saving 4. Wh wr you when you aaw the object? or Country C ity er Town Neoroet P utaJ Ad-'r 3 . Euimore how long you aow the object. 3.1 Circle one of the following to indicate how certain you ore of your answer to Question 5. c. C.,. tJllilla~in:&.. \..g. oar y cartat~ 6 . '.nat woe the conditi an of the aky? ( C ,'rde One): a. Bright daylight b. Dull daylight <:. aright twilight c. Not very aure d. Juat o gyeas d. Just a trace of da1l ighr f. Don't remember 7. !F 'lOu :aaw t._ obioc' ~uring L)~ YLIGHT, TWILIGHT, :Jr DAWN, where was the SUN loc~ted .-:s you looke-d at ((;: I:> On;JJ: J, f,, f r ont or 'fOU b. h cock o t you d. T oJ y our I eft e. Ove r heaJ f. Don' t rememb~r S,, !;: y"w' .Ht"" o~t ou/:Jct, ot NIGHT, T'rliLIGHT, or OAWN, what did you notic~ conc3rning 1h" STARS and MOON? ;>n ~ rerr.omcer ? , W:J tht . .,bjec~ br ightar ~nan the bacxground of the sky? 8 .2 MOON (Circle On,): Brio ht moon I lght DuU moonlight No moon I ight -pitch dark Don't remember ~ t; ire!-! One): b. No c. Don't remember lQ, JF it wos 8R IGHTER THAN the slcy baclcgrouncl, was the brightness like that of an automohlfe headlight?: (Circle One) o. A mile or more oway (a distant car)? b. S.Yeral bloclcs away? c. A bloclc away? d. ~!~I yards away? l1. Oid the cbjeet: (Circle One lor eodt question) a. Appear to stond still atony time? h. Suddenly speed up end rusn away at any time? e. Sreok up into parts or explod,? d. !Ji"~ oH .smoke? c. Charge brightness? f. Change shcpe? g . Flicker, throb, or pulsate? Oon't Know ~0 Don't Know Don't Know Don't Know Don't Know Don't Know No Don't Know J , IJ id rhe cb ject move In front of sameth ing at anytime, particularly a e loud? (C,;rde One }: Don't l<nnw. IF you anawwed YES, than tell what 1, Jd ,,...,, 'o[eer appear: (Cirele Onej: e. Oon't Know. ( o. Solid?) b. Transparent? ;. Di~ ' t ":Ju obsP.rv tne obj.,ct through any of the Following? a if'ocvlars "'::' T' le sc: :)J"