1~ CONCLUSIONS I. DAT .. TIMI GIIOUP 4. I OP GelaiVA a PetiiWr Belleeft Lol 2:;. 10 .(QuauR .. YIIMI a Greun a w .. Alraraft :.\:-. -:: .,: a AI .. VIel a Air-Intercept R .. at:<-PoaaiWy Alrareft D We1 AllrenoMicel 7. LINOTM OP OIIIRVATION I. II Ofl OIJI!CTI t. COUIISI 0 Other _ C lnaufflclont Date t.r Eveluetlon D Unllnown U.S. AIR fORCE TECHNICAL INFORMATION SHEET This questionnaire has been prepared so that you .con give the U.S. Air Force as much information as possible .concerning the unidentified .aerial phenomenon that you have observed. Plea try to an1wer as many questlons.a you po1sibly can. The inforntatlon that you give will be used for research purpo1es, and will be regarded.a1 confidential material. Your nome willnot u1eclin connection with any 1totements, .conclu1ion1, .or publication without your permi1sion We request thl1 per1onal Information :so that, if .lt b deemed nece1sary, we ntay contact you for further details. 1. When did you see the obj~c:t? ' Bay Mo"th 3. Time Zone: I L (Circle One ): a,.......tostern b. Central c. Mountain d. Pacific: . 4. Where were yov when you saw the obiec:t? earest ost o 1 (Circle One): (Circle One): a. Daylight Saving b. Standard own State or Country Additional remarks: S. How long was object in sight? 5.1 How was time in sight ~etermined? a. Certain b. Fairly certain 6. What wqs the condition of the.sky? c:. Not very sure d. Just a uess { _g~ reg t 7. IF you sow the obiect during DAYLIGHT,.where was the SUN located as you looked at the obiect? (Circle One): a. In front of you In back of you d. To your left e. Overhead c. To your right FT 0 JU L 61 16 4 n,t form e up"rudn A TIC 164, Feb 60, whleh te obeolete 8. IF you sow the obiect.ot NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle One): 'ct.,.., Don!t remember 9. The obfect.oppored: eCircle.One): ~;As a light a. Bright moonlight b. Dull.moonlight c. No moon I ight.-pitch doric .d. Don't remember d. Don't remember 10. lf.it appeared as a light,-was it brighterthan the brighteststars? Did the obiec:t: (Circle One for eoc:h question) Appear to stand sti H at any time? Don't Know Suddeniy speed up and rush away at any time? Don't Know Break up into parts or explode? Don't Know Give off smoke? Don't Know e. Change br ightness? Don't Know f. Change shape? Don't Know Flash or flic:icer? Don't Know Oi sappear ond reappear ? Don't Know Did the obj.tet move behind something at any time, particularJy a doud? (Circle One}: Don't Know. IF you answered YES, then feil what it moved behind: Did the object move in front of something at any time, particularly.a cloud? (Circle One): Don't Know. IF you answered YES, then tell what in front of: Did the object appear: (Circle One): a. Solid b. T ronsparent c. i:>on't Kno~ Did you observe the object through any of the fotlowing? Eyeglasses e. Binoculars Sun glasses T elesc:ope e. Windshield Theodolite Window glass 16. Tell In a few words the followlng.thlngs.alout.the obfect. 17. Draw a picture that wlll:show.the:shope of :the oltect.or .obfects. Label.and lnclude:ln your slcetch.any details of the obfect:that y~:law:'luch.as wings, protrusions, .etc.,.ond especlolly.exhoust trails or vapor trolls. Ploct an arrow.beslde.the:drowlng:to show.the dlrec:tlon.the obtect:wos.movlng. The edges of the object were: (Circle One): a Fuzzy or .blurred b L ike.o bright tor c:. Sharply outlined Don't remember ;, 19. IF there was MORE THAN ONE obfect, then how many were there? .:.;..f,;; "------------ Drow a picture of how they were arranged, and put on arrow to 'Show.the di,. ... ~tion.thot they were traveling. 20. Draw a picture that will show the metion that the obiect or obiects.made. Place an 'A" at the beginnl"g of .the path, :a "B" at the end of th path, and .show any changes in direction during the course How large did the ob;ect.appear.to you as compared to an obiect.with which you are familiar? 22. We wish to know the angular size. Hold a match stick at arms length in line with a known ob!ect.and note how much af th object is covered by. the head of.the match. If you had performedthis experiment.at the-time of the sighting, how much of the object would have been covered by the match head? 23. Did the obtect disoppecr while you were watching it? If so, how? 24. In order that you can give as clear a picture as possible of what you saw, describe in your own words a object or objects which, when placed up in the sky, would give the same appearance as the obiecr which you saw. .Where were you locotecl.when you saw the obiect? (Circle One}: 26. Were you (Circle One} o. In the business.section of.o city? Inside a building b. In the residentialsection of a city? ln .o cor c. In open countryside? c Outdoors d. Near an airfield? Cl. In an airplane (type) . e. Flying over a city? e. At sea f. Flying over open.country? 27. What were you doing at the time you sow the obiect, .and how did you happen to notice it? 28. IF you were MOVING ~N AN AUTOMOBILE or other vehicle.ot the time, then complete.the following questions: 28.1 W~ot direction were you moving? (Citcle One) a. North c. East d. Southeast b. Northeast f. Southwest 28.3 Did you stop at any time while you were logking at the obiect? (Circ:!e One) Yes No 29 .What d!rection were you !ooking when you first sow the obiect? (Circle One) b. Northeast d. Southeast f. Southwest 30. What direction were you lookin~ when you lost saw the obiec:t? (Circle One) b. Northeast d. Southeast f. Southwest g . West h. Northwes~ h. Northwest i. . Overhead ~. Northwest i. Overhead 31. If you are familiar with bearing terms (angufor.direc:tion), try to estimate the nomber of degrees the obiect was from true North (thru east) and also the number of da,r"es it was upward from the horizon (elevation). 31.1 When it first appeared: a. From true North degrHs. b. From horizon degrees. 31.2 When it disappeared: a. From true North. degrees. 32. In the following sic etch, imagine that you are at the point shown. Place an A" on the curved line to show how high the obiect wa1 above the horizon (skyline) when you first sow it. Place a "B on the same curved line to thow how high the obiecf was above the horizon (sky I ine) when you lost saw it ln the fo!iowing iorge s.<:erch pioc~ ar.. lilA" a~ ~he pos;t;or. e ooject was when you first sow it, and a "B" at its positio:1 wha, ~Oll ict: ! :1 ' '-:t . fer ~o smel ler sir~ch oc: an axampie of how to complete the larger alcetch. 34. What were the weather conditions .at the time you saw the obiect? CLOUDS(Circle One) WEAtHER (Circle One} Clear slcy Scattered: Thiele or f.-,ovy.clouds b. Fog,.mist, or .light:raln c. Moderate or :heavy.rain e . Don!t remember Whenandto whom did yo~. report th'at,you:hacl1se..,.the obiect? ' Day Manth Year 36. Was anyone else with you at the time you saw.the obiect? (Circle One) 36.1 ~F you ar.swered YES, did they '"the object.too? (Circle One) 36.2 P~ease Jist their names.and addresses: 37. Was tnis the first t ime that you had seen an object or objects like. this? (Circie One) 37.1 IF yo~ answered NO, then when, where, and under what circumstances .did you see other ones? 38. In your opinion what do you think the obiect was and what might .have caus.ct it? 39. Do you think you can eatiniGte the apeed of the object? (Circle One) Yea (~ IF you answered YES, then what speed would you estimGte? 40. Do you thinlc you.can estimate how far away from you the object was? (C ire le One) IF you anawer,d YES, then how far away woul~ you.say it was? _ 41. Please give the following lnfarmation.about yourself: Madtllo Homo TELEPHONE NUMB Indicate any additional information about youneU, ~nclucHng any education, whieh might.be pertinent 42. Dote you.completed this questionnaire: lloy Month U.S. AIR FORCE TECHNICAL INFORMATION SHEET This questionnaire has been prepared to that you can give the U.S. Air Force as much fnfOtmatfon as possible concerning the unidentified :aerial phenomenon that you have observed. Pleaae try to answer as many questions .as you poaslbly .can. The Information that you give will be uaecl for research purposes, .and will be regarded.as confidential moterlal. Your name wi ll not be uaecl In connection with any statements, :conclusions, or publicatior,a. without your permfaslon. We request .this personal Information :so that, If. it 1s deemed necetsary, we enay contact you for further deta lis. When did you see the obiect? ~2. Time of day: (Circle One): 3. Time Zone: / fCirc:ie One):ray' Eastern (Circ:le One): a. Dayilght Saving b. Standard ' 1), Central c:. Moun tal n d. Pacific: aw the oblec:t? Additional remarks: State or Country City or Town 5. How long was obiec:t in sighr? 5.1 How was time in sight ~etermined? a. Certain . b. Fairly certain 6. What wqs the condition of the .sky? c:. Not very sure d. Just a guess 7. lF you saw the obiec:t during DAYLIGHT, where was the SUN located as you looked at the obiect? (Circle One): a. In front of you b. In back of you c:. To your right d. To your left e. Overhead f. Don't remember FT D JUL 61 164 ntl fonn e upereedn ATIC 164, Feb 60, which le obeolete 8. IF you saw.the obiect.at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle OnJ: 8.2 MOON (Circle One): d. Don!t remember 9. . The obiect. appeared: (Circle. One): a l As a light b. Dull.moonlight c. No moonlight.-pitch dark .d. Don't remember d. Don't remember 10. lf .it appeared as a light, was it brighterthan the brighteststars? 11. Did the obiect: (Circle One for each question) a. Appear to stanc:i stiil at any time? b. Suddeniy speed. up and rush away at any time? c. Break up into porrs or explode? d. Give off smoi<e? e. Change br;ghtness? f. Change shape? g. Flash or fl ic:ker? 1sappeor an Did the objact move behind something at any time, particufarJy a cloud? Don't Know Don't Know Don't Know Don't Know Don't Know Don'~ Know (Circle One): Don't Know. iF you answered YES, then tefl what it moved behind: Did the obiect move in front of something at any time, particularly.a cloud? (Circle One): Don't Know. IF you answered YES, then tell what in front of: Did the object appear: (Circle One): b. Transparent c. Did you observe the object through any of the fotlowing? Eyeglasses Binoculars Sun glasses Windshield Theodolite Window gloss Tell In a few words tne following thlngs.about.th oblect. ~7. Draw o picture that.wllbshow.the,ahapeof:the obfect.or .obJects. Label.and lnclude:ln your slc~tch.any details .of.the obfect:thot y~:aaw.,uch.as wlnga, protrualons, etc.,:and especlolly.exhaust trolls or vapor trails. Plac on.arrow bealcle.the:clrawlngrtoshow.the dlrectlon:the obtect:wos.movlng. 18. The edges of the obiec:t were: (Circ:le One): a. Fuzzy or .blurred . b. L ilce .a bright star c:. Sharply outlined d. Don't remember l 19. IF there was MORE THAN ONE oblec:t, then how many were there? _ Draw a pic:ture of how they were arranged, and put an arrow. to 'I how the dir t~tion. that they were traveling 20. Draw a picture that will show themotion that the obiect or obiecta made. Place on "A .. at the beginning of the path, .a "B" at the end of the path, and .show any changes in direction during the course. How IaMie dlcl the obiect .appear to you as compared to an obiect. witt'l which you are fanJiliar? We wish to know the ang-~lar size. Hold a m~tch stick af arm's 1/ngth in line with a known ob!ect .and nofe much of the obiect. ia covered by. the head of the match. If you hacl performed this experiment .at the. time the sighting, how much of the obiect would have been covered by the match head? Did the obiect disappear wh,le you were watching it? If so, how? 24. In order that you c:an give as clear.a picture as possible of what you.saw, describe in yout own words a obiect or obiects which, when placed. up in the sky, would give the same appearance as the object which you sow. 25. Where were you located when you aaw the oblect? 26. Were you (Circle One) (Circle. One): a. lnaide a building b. ln.a car a. In the business .section of.a city? b. In the residential :section of.a city? c. In open .countryside? (c.; Outdoors d. In a~ airplane (type) cl. Near an airfield?