34. What were the weather condition :at the time you aaw the obfect? CLOUDS(Circle One) /a: Clear alcy c. Scottered:clouda d. Thiele or .. .,ovy clouda WEATHER (Circle One) b._ Fog,.mlat, or.light~raln c. Moderate or :heavy .rain Don!t remember 35. When.andto whom.did you report th'at,you:hod.ae~.the obiect? 36. Was anyone else with you.at thetime you. aawthe obiec:t? (Circle One) 36.1 !F you answered YES, did they '" the obiect toq? (Circle One j 36.2 P;eose list their :1omes .and ocidre1sea: 37. Was. ti1is the first time that you hod seen an object or obiects lilce_.this? (Circle One) 37.1 IF you answered NO, then when, where, and under what clrcum~tances.dld you .... other ones? 38. In your opinion what do you thinlc the obfec:t was and what might.have caused it? 39. Do you thlnlc you can estintate the speed of the obiect? (Circle One) IF you answered YES, then what speed would you estimote? . ~0. Do you thlnlc you.can estimate how far away from you the obiect was? (Circle One) IF you answered YES, then how far away woul~ you say It was? . _ ~1. Please give the following inforn1atlon.about.yourself: TELEPHONE NLj .. indicate any odditionai information about youneH, including ony education, which might .be pertinent 42. De1te you completed this questionnaire: U.S. AIR . FORCE TECHNICAL INPOR~TION 'SHEET (SUMMARY DATA) In .order that your Information may be flied and coded.as accurately as po11lble, pleaae .. us the .following space .to .write out a short desc1lptlon of the event that you obaerved. You may,.. peat 1lnfor :that you :havealready given In the queatlonnolre, :and odd any further .comment, or slcetches: that you.belleve are Important. Try to preaent the detalla of the obaerva- tlon1ln the order In whlch.they occurred. Additional page of.the:aan:e alze ~per.n:oy.be attached If :they. are need eel (Do Not Write In This Space} (P.I P.rtnt) Please complete the attached form and return to me for an anlyeia or your sighting. HIIJJ:AM J. WOJr.ADOO Lt. Colonel, USAF Public Intot!ltation Division Office of Information U.S. AIR FORCE TECHNICAL INFORMATION SHEET Thla queatlonnalre haa been prepored :ao that you can give the U.S. Air Force aa much lnfOtmatlon .aa poaalble .concerning the unidentified ;aerial phenomenon that you have obaerved. Pleaae try to anawer.aa many queatlons.oa you poaalbly.can. The Information that you give will be uaed for reaearch purpoaea, :and will be regarded.aa confidential material. Your name willnot be uaed In connectlon.wlth any atatements, :conclualons, .or publications without your permf1slon. We request .thl per1onal Information :10 that, If. It 1 deemed necessary, we may contact you for further detaili. 1. When did you'" the object? 3. Tin Zone: (Circle One):(ci: c. Mountain d. Pacific 4. Where were you when you saw the oblect? Additional remarks: S. I low long was obiect in sight? 5.1 How was time in sight determined? a. Certain . Fairly certain 6. What wqa the condition of the .slcy? (Circle One}: (Circle One}: ~ Daylight Saving City or Town State or Country c. Not very sure d. Just o guess Gi:; Bright "t; Cloudy 7. IF you aaw the obiect during DAYLIGHT,.where was the SUN located as you loolced at the obiect? (Circle One}: a. In front of you b. In baclc of you d. To your left e. Overhead c. To your right f. Don't remember FTC JUL 61 164 Thleform upereed ... ATJC 164, Feb 60, whleh ta obeolete. 8. IF you aaw.the object.at NIGHT, what did you notice.concernlng the STARS and MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle One): Don !t re~t~ember a. Bright moon I ight b. Dull. light ~ No moonlight.-pitch dark :d. Don!t renaember 9. The obiect.appearecl: (a: Aaa light :I Circle. One): 10. lf.lt appeared aa a light,waa It brighterthan the brighteat:atara? d. Don't remember 11. Did the object: (Circle One for each question) a. Appear .to stand stlll.at any time? Don't Know b. Suddenly speed up and ruah.away at any time? Don't Know c. Break up into ports or explode? Don't Know d. Give off smoke? Don't Know Change brightness? Don't Know Change shape? Don't Know g. Flash or flicker? Don't Know h. Disappear and reappear ? Don't Know 12. Did the object .nteve behind .something at :any time, particularly a cloud? (Citcle One): Don't Know. IF you answered YES, tnen tell what 13. Did the object move in front of something at any time, particulorly.a cloud? (Circle One): (Y;a No Don't Know. IF you answered YES, then tell what (Circle Ontt): b. Transparent 14. Did the object appear: Did you observe the object through any of the following? Eyeglasses e. Binoculars Sun glasses c. Windshield g Theodolite Window glass 16. Tell In a few words the followlng.thlngs.alout.the ohlect. 17. Draw a picture that wllhahow.the,ahapeof :the obtec:t. .oblecta. Label.and lnclucle:ln your:alcetch.any details .of.the obfect:that yO,.:aaw:<~uch.aa wings, protrualona, ;etc:.,:ancJ especlally.exhaust trails or vapor tralla. .Piac an. beslcle.the: lng:to show.the dlrectlon:the obiect:waa.movlng l8. The edges of the obiec:t. were: (Circle One}: a. Fuzzy or .blurred b. L ilce .a . bright a tar c:. Sharply outlined Dont remember 19. IF there was MORE'THAN ONE oblec:t, then how many were there? '-1~----------- Draw a picture of how they.were arranged, and put an arrow to 'lhow.the dfr,.~tion.that.they were traveling 20. Draw a picture that will show.the motion that the obfect or oblec:ts.mode. Place.an .. A .. at the beginning of .the path,:a "B" at rhe end of the path, and.ahow any changes ln .dlrection during the course. 21. How large cfldthe obfec:t.appear.to you as compared to an obiec:t.wlth which you are familiar? 22. We wish to lcnow theangular size. Hold a match stick.at arm's length in line with a kn~wn object .and note how.much of the obiect:is covered by. the head af the match. If you had performed:this experiment.at the-time of the sighting, how much of the obiect would have been covered by the match head? 23. Did the object disappear while you were watching it? If so, how? U. In order that you can give as clear a picture as possible of what you.saw, .describe in your own words a COIYhllon object or obiects which, when placed.up in the sky, would give the same appearance as the obiect . which you saw. . 25. Where were you located when you aaw the obiec:t? 26. Were you (Circle One) (Cirele One): a. lnaide a building a. In the buaineas.section of.a city? b. In the residential :section of.a city? b. In a car c. In open.countryside? c--:. Outdoors cl. Neor .an airfield? t: In a~ airplane (type) Flying over a city? At aeo f. Flying over open.country? ~7. What were you doing at the tin:e youaaw.the object,.and how did you happen to noticeit? 28. IF you. were MOVING IN AN AUTOMOBILE .or other vehicle.at the time,then complete. the following question: What direction were you moving? (Circle One) Northeast. d. Southeast 28.2 How fQs! were you moving? mi lea per hour. 28.3 Did you stop at any tim while you were looking at the ob;ect? (Circle One) Yea Nu What direction were you looking when you first saw the ob;ect? (Circle One} h. Northeast . f. Southwest 30. What direction were you loolci~ when you last saw Jhe object? (Circle One} c . East b. Northeast cl. Southeaat f. Southwest i. Overhead 31. If you are familiar with bearing terms (angufar.direction), try to estimate the number of degrees the object wcs from true North (thru east) and also the number of dettn'es' it waa upward from the horizo..-(elevotion) 31.1 When it first appeared: a. From true North . degrees. b. From horizon ' degrees 31.2 When it disappeared: a. From true North------degrees. b. From horizon degrees. 32. In the following sketch, imagine that you are at the point shown. Place an A on the c"rveclline to show how the obiect was above the horizon (alcyline) when yo~ lirst saw it. Place a a on the same curved line to ahow how high the obiect was above the horizon (skyline) when you last saw it. !n the fo!iowing i~r;er s~<ercn place an A" at t~e ?Os;tior. ~he objec~ wos when you first sow it, ancl a a at its positio~ when yov ic~ !O'I. r. Refer to smeller si<e~cn c;c en example of how ~o complete the large~ slcetch.