4. NUM8e R OF J .S.JcCTS 5. L eNGTH 0? O~ScRV.\TlOH TYPE OF 09S VATION -~. LOCATIO~ 10. CONCLUSIO .. 1 t. a~t!i' SUMMA~Y ANO ANALYSIS 9 . PHYSit:AL EVIOi:HC! Fr o sEP .)3 o-329 (TOE) --llo \,o I' Tni ~ c;u~stionnair., hcs been prepar~d 50 thot yo~.~ C!Jn g i V t) th~ u.~. ,:._;,. ;:-:or~e IH r;'! ;:.:. info rmcti o n c 3 p os:>ibl., c nncerning ~he! unid~ntlfiad t'idriol p han:>lnttnon thot r )ll :,~.n>~ ob:;cJrv_,J. P I )O.S'I!t tt'/ to .::n s-..,er o:; many qJe'3t ions (.1'3 you r :.>ssibly c an. T ho in~onnnt:~}/1 ,!mr 'J()ll Jhl wil~ b~ I,Jj~d :~ r':1S~:~arch purpose.;. Your r.om~ will uur sd u.o.:d i:~ C(.t'l>edit)il I i:;) o: .... "l1:':1~ "''" .. (1l., co:mc .. J s:onS c r puo iCO ll)ns w1t out your p e rm t i':>i~P. "'~ (~;;ue.H ~ I S ~-'"$r;;nr.u l ric rmcr .. , n o 1n:1t ;,: t s d')om~d n~c&ssory, w~ may c ontact Y'J fM :=urr h'='' der Jils. V/h,-t,, diJ y )l; Htt t h e obj~ct? Tim~ Z r.m.;: (Circle One): b,. c~nr:l Dcv! 1 ghi Scv 1: 1;7 Stond..,(cl I N19ar~.,p ?ostol Addre:ss C lty or To.,. .. , 5. Ho w long was object in sight? {Totol Duration) o. L t:Htarn b. Fairly certain d. Just a guu3 5.2 Was obj~cr 11 .sisn~ continuously ? 6 . 'Hho t wo!S th~ condrtion o f the s!<y ? o . Bright a . Brigh r IF you saw fhe object during D.L\YLIGH i, Nhdr:J wn:; rh~ S0N loc ;t.,ri ,1s y.;u (Circlo Oo~}: o . j ;, front o f you a. In b .Jc'< of you c . To your ;ighr 8. IF y o u saw the oLjact ot NIGHT, wh ot d id y ou notice c onr;&rning iho STAHS cm.-1 MOC.r? 8.1 STAI~S (Circl~ One): d. D on't ; -,member OON ( Circle One): a . Brioht m\)oolight b. Dull moonlight c. ~to moontight . pitch dark d . Dco't remembotr 9. What wers the w~otfur conditions ar me tim~ yoo saw 1h~ obj~ct? C L OUDS ( C ird a Onft): WEATHER ( Cirde On~): a. C !<.lo r sicy h. Fag, mis?, or light rain c . Scotter~d d ouds c. Modarote o r heavy rain d. Thick or h~avy clouds 10. T},, cbj ~ct ;zQ~ored: (Circl e Onft): o. S.;:,lid b. T ronlpar~nt (jJ A1 J I igh't o, Dcn' t romemO.r 11. If ir op~ear-td os a light, wa~ it brighhr than thb bright~s? stors? (Cirde On~:t): l tl~utr. C, 1"\ OUt tne Sllme b. Dimm.r d. Don't know 12. Th~ ~ges of tne object were: (Circle Omt): a, Fu:ny or blurrttd b. Lik~ a bright stOf c, Sharply out I ined .:J. Do'n't rememo.,, 13. Did the obj!!c~: a . A p!)ear to .:;tand ::otiU o' orry ti rM? b . Sudd~nly ~p.,ed 'JP nnd ru3h away o t any t i m.,? c . Br~olc up inr~ parts or explode? d. Giv~ off smol<~? ~. Chan ge br i Jh tnll!f!U? f. Chong e .>hoJ)('t? g . Fla3h or flickar? to. D isap pe\Jr cmd r e a ppear? (Cii'clo One for ~cch queltion) Don't know Don't Xt! OW Don'~ know C>vn' ~ l<n ot'lf :show how h igh ~h~ obi~ct WO$ above th~ horiz on {;;l<y! 1n~} .,.,.n<rfl 'JC'J l.t .. : .:r.u" i1 P! lC") ~ ~ IJ v' :.:t c:.):""f'O.lli 28 . Dr o,.y ~ i'ic~r., that will show th e m~+:;n that the obj::t(:? or ob j.-,cts mod~. P.i.ac9 -:n !,:V' '.JJ t', , luglnn: ng ~i :ilf1 path , :~ ' ':3., -a: zh~ i:1nd of ~he path, c:id show any chc:nacu In dir~ction during ;:v:; cc~T"h). 29. IF ~h~r~ wos MORE THAN ONE object, ~hlln how many W:!r~ the r,? _ Draw a pictuto$ o f how they, w~re a rra nged, a nd put on -:ur ow t o $how th& direction hat ih~)' Wrtra ho'J"'Jir.g. b .. for't. or t:ot 31. Was onyonct else with you at t he tim.., you :>'J.v th-l obj~:~ct? (Circ.f-. ... OJ. ::) IF yo u cnsw~red YES, did.th<'~y so;., tha objec t too? (Circle Or~.-,) 31.2 Pf.;,:~s.., Ls; thctl r nomc.s and oddrttS!i".:S; 32. Pb.:::;e give ..... ~ followin g informot i::Jn ~::;,out yours-:t!r: L ast Name TELEPHONE NUMBER-------- ~ndicat~ a n y additional infor ma t ion about your:s.,lf, incl1.1ding any sp~ciol ~xp..,rit)nc~, 't'<nkh mi~}ct ~ r;l r s .ittt:t ',Yh.::t~ and to whorn did you r"poO tho~ you hod seen the obj.,ct? 35. Information which you fe :tl partin"nt and which is not odl!tquot~ly cov~rdd in tha .spacific: point.l CJf !h., quutioonaira c r o norrativ.s explanation of your :::igl-rting