1. DATI TIMI GIOU' NUMIII OP OIJICTI 5. LINOTH OP 5 ::L,u.t es '1:rou rl-Vi.3~al I. ltHOTOI 9. PHYSICAL IYIDIMCI FTD Sill' 6J 0321 (TDI) 2. LOCATION 10. CONCLUSION 11. 1111, IUMMAIY AND ANALYSIS fl~. :3haC., rou c ... lete41 thia lonna ire: 35. lnfenlatlon which rou fMI inent oncl which i1 not adequately ccwerecl in the specific point of the queatlonnalre or a exp lon of your alghting. OFFICI,~l FILE COPY unident1t1e4 ObJect, U.S. AIR fORCE TECHNICAL IHFORMATIOIII Thla queatlonnaire has been prepared so that you can give the U.S. Air Force as much Information as posaible concerning the unidentified aer iol pheno.nenon that you hove olsei'Yeci. Please try to anawar as many. question as yau possibly con. The information that Y"" gie will be used for purposes. 'your name will not be used in connection with any statementaa, . - -- ---concluaioni;--.;ulillcatlona"wtthout -y.,;,e;miiaion . we ..aquest" this penonol lnf~i~tion-10 _,. _ _ that If It Ia cleeMM necesaGry, ww contact you for furlloer details. :~ ' . -;-1 '"-''"' : : " " 1. When ctl~ you'" the oliect? a(!, ftJiE~ 3. Time Zone: (C lrcla One Eo stem (Circle One): ~. Whet. ware you when you saw the ohfect? b. Fairly ceo lai" c. Not v"'' sura cl. Just a guess 5.2 Was oliect In alght continuously? 6. What was ,.,e condition of the slcy? a. Bright a. Bright b. CIOU<Iy -Cloudy .. 7. IF you aaw the oliect durit1g DAYLIGHT, where was the SUN locat'ld os you looked at the obiect? (Cirei Q,..): a. In front of you In boclc of \'au c. To your ri_.t d. To t oor l.,ft o. Overnoa f. Don-'t remmber TMa fa UJn PTD Jull, -"ieh &a oboleto. L IF you the olaiect at NIGHT, what cli4 you notice concecnint the STARS on4 STARS (Circle OneJ: 8.2 MOON (Circle O,.J: BriFt ,....litht moonll~t -pitch ------WEATHER (Circle .OMJ: b. Fog, Milt, light rain 4. Thiel. hea.Y ciCMia 10. The Mfect app1aretl: (Circle O.J: lltltt, 1 It lwl th thelwlthtnt .._,, (Circle O..el: c. About the 12. The .... el the '*feet weM: (C lrcle One}: a. Fuaay . Ia. Lille lwi.t at ~ _ c. Sh~ly ... 13. Dlcl th ol.ject: (CiN:Ie One for ea&:ft queetiOft) Appear to atCMd atlll at., tiM? Suctcien ly ,..d up ancl ruth at any tln:e? Braalc up Into part a ~ explade? Don't know Give off smolc' Dcn't lcnow OtartC}e ,h.,., Datt't lcnow f~a.A or Hie._? 14. Dlcllhe obfect disappecr while you were watching it? 15 . Dlcl the obiect move behincl something at any th11e, particu-larly a cloud? (Circle One): , . Yea .,. @ Don't Know. IF you anaweted YES, then tell what 16 . Dlcl the NJeat move Itt front of lng at any time, particularly a cloud? Don't Know. IF you answered YES, th 'tff whGt 17 . Tell in a few words th. following things about the obiect: We wish to know the angular 1ize. Hold a match aticlc ot arms length in line wi.th a lcnown obiect ond n,t.lj P,ow much of the obiect Ia ccw.,ecl by the head of the 11'Qtch. If you had performed thla experiment at the time of the sighting, how much of the ob;ect would have been covered by the match head? a picture tt.at wiU show the ahape of the obiect 01 o'iects. La!.l and lnclucl. In ywr slcetch any detoil1 of the oeject that y ar uch as wlnga, protru1ion1, tc., ancl especially exhau1t trail or vapor trails. Place an orrow. bnld. the clrowing to show~ direction the obiect wa1 moving. I , 20. Do you thinlc you can estimate the speed of the obiect? IF you answered YES, then what speed would you estimate? --'oll{;~.,'-0=---- (Circle One) 21. Do you thinlc you can estimate how far oway from you the object wos? (Cirele One) IF ' you onswered YES, then how far away would you say it was?,_--.&...~ L.-...-...-...,;;;;-...,.. :g. 22. "Where were you rocatecl when yfiAI saw the obiect?- - (Circle One): d. In an airplane (type)-- 23. Were you (Circle One) --- In the business section of .o city? In the res;dential section cf a city? In open countryside? ::> Near an airfield? Flying over Fly; ng over open country? 2... IF you were MOVING IN AN AUTOMOBilE or other vehicle at the time, then complete the folfowir.g questions: What cUrectlon were you moving? (Circle One) e. South East) a Natltt b. North"'' d. Southeast f. Southwest 24.2 How fast were you moving? ---~2'--.~""4-------lmiles per hour. 24.3 Did you ttota atony thn while you were loolcing at the obiect? ! 2.5. Olcl yw ole~ the olfect through arty of the followtng? a. Eyegla .. b. Sun glasset c. Windshield d. Window glass e. Binoculars f. TelescCJ~e g. Theodolite high the oltect wa1 abwe the horizon (1lcyllne) when you flrsf 1aw lt. Place a "B" on the 10me cur+4 line to ahow how high the obiect was above the horizon (1lcyllne) when you last saw lt. Place an "A" on the c ...... when you llrsl aaw it. Place a "8" on the compca11 where you last aaw the object. 28. . Draw o picture that wi II show the motion thot the object or abiecta made. P.lace an .. A" at the '-tiM I,. ol the path, a "8" at the w of the path, aM ahow any : In diNctlon during the cautae, - 29. IF the,. was MORE THAN ONE o~fect, how many war ther.? i Draw a ~icture ot how they were arrang_., and put an row to show the di,.ction that they were trav.ll,.. 30. Hove you ever seen this, or a similar obiect before. If so ~ive date or dates and location. 31. Was anyone else with you at the time you saw the obiect? (Circle One) 31.1 IF you answered YES, did they'" the object too? (Circle One) 31.2 Please list their names and addresses: 32. Please give the following infornation about yourself: TELEPHONE NUMBE tndicate any additional inforn~ation about yourself, incluclinv any apecial experience, which ,tght b. ~lirwtn. When and to whom did you report that you hod seen the object?