1. DA lc TIME GROUP 2. LOCATION lakeland, Florida 3. SOURC E 4. NUMBER OF OBJECTS 10. CONCLUSION CmTFLICTDU DATA 5. LENGTH Of OBSERVATION 11. IItlE, SUMMARY AND ANALYSIS 3 5 Seconds TYPE OF OBSERVATION Object. like North Star in si. ght fo r 35 s econds. Bright o ran e . No soun:l. Disappeared by fading. Sharply outlined. Speed est:iim.ted at. 2- 4 , 000 m}il. Str a ig,t flight. Could have been Ground-Visual in outer space. Observati. on in NE PCH-n-miTS: Initial letter ind icated tha t the object was moving a1 5Q0-700 mph. Initial let-ter indicated that the object was obse1~ed 1-------------i in the \'lest moving Nli. Also object was reported to disappear ir to t hin air, nat fade. EOiO I and ll not. in area at reported time y.. :>f observati. on. Case regarded a a oonfi icting data in view of thE a---:l::U.::..:.::H.:.-------~ f acts as stated in the or ginal letter a !rl those r~'Por ted on the 9. PHYSICAL EVIDENCE Fonn 164. .=,~e 6 Au1 &"/-Au~. 20. Do you think you can estimate the speed of the object? (Circle One) IF you answered YES, then what speed would you estimate'~ d,-400Q fttp./-4. 21. Do you think you can estimate haw far away from you tha object was? (Cirde One) IF you answered YES, then how far away would you soy Where were yw locat.O wflenywiawthe object?- 23.-Were you (Circle One) (C irc:le One): in the business section of a city? lr. the residential sctcticu or a city? a. Inside a building In open countryside? Nttar an airfield? b. In a cor d. In an airplane (type) -- Flying over a city? . Fly;ng over open c:KJntTy? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at tha time, then complete the foHowir.g questions: 24.1 What direction were ya.J mOYing!. (Circle One) c. East '"' South b. NCH theast .. d. SouttMast f.-Southw.st h. Northwest ~ ~ 24.2 How fast were you moing? -------J ilu per hour. 24..3 Did }'OU stop of orry time wnll you we ... looking at the object? (Circle One) No 25.-Drd you ob .. rve th. obiect through any of rhe following? ',.,adyeglauei) ' b. Sun glass Y No Binoculars f. 'Telesc:op~ c. Windahield Yes d, Window glass g. Theodolite; In order rhor you can giv~ as clear a picrur~ os possibl~t of what you saw, descrJbe in yovr own words a common ~ objec\ or objecta which( when placed up in the sky, would give th~t some appearance os th e objec-t whlc:h-you aow; In the following "tch, imagine that you ore at the point shown. Place on '' A.' on the curv~ I in. to 1how how ' high the object waa abOYe the horizon (slcyline) when you first aaw lt. Plac a "B .. on the ~me c:urvttd line to ahow how high the object was above the horizon (slcyllne) when you last :tow it. Place an "A" on the CO!npOU when you first saw it. Place a "B" on the compass where you lost saw t he object. 28 . Draw a picture that will show the motion that the object or objects made. PJoce on "A" at the begiMing of the path, a "B" at the end of the poth, and ahow any change: In direct I~ during the ccur ... rlOTIOflJ) 3TREHGHT 29. IF there woa MORE THAN ONE object, then how many were there?---------- Draw o picture of how they were arranged, and put an onow to show the direction that they w,.,.. trawling 30. Have you ever seen this, oro simi lor objDct before. If so give date or dates ond location. 31. Was anyone else with you at the time you saw the o b je ct ? (Circle One) 31.1 IF you answered YES, did they see th, object too? (Ci:-cle On e ) Please ist '"ir names and addresses: 32. Please oive the following information about yourself: TELEPHONE NUMB When and to whom did yov repcxt that you hod seen tho object? J , "' , 34. Date you completed this questionnaire: 35. Information which you fHI pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting b-rffi _[> -Dt A GRAfYJ -~TARTJrJG POIT'JT OF U.f.O . / -jlli1~&LIIJgj$1A~ ' -~--- uArJt~Htfl.XS Poin;r ------ (PnoJcGT 6LUE (3001<) f)6PARl(t)GruT C>r THE. AIR FOf?Gt DfF IGE. OF THe-Sf-GRETAR'( cJf(J 116 0 5 TATD~ A If? Fo~Cc OFF, c TAl f3U5 Jll)5S.S 24 November 1964 . With rererence to your recent letter. attached ia Jl'D J'orm 164 to be WJed tor reporting OFO a1ghtings to the Air J'orce. I.ak8land, Sincerely, MASTOH M. JACKS fujor~ USAP Ch1er. Pictorial Branch Public Intormation Div~on Ottice ot Intormat1on U.S. AIR FORCE TECHNICAL IHfORMATIOI'I This questionnaire has been prepared so that y ou can give the U.S. Air Forc e as muc h rmation as possible concerning t he un identified ae ria l ph e no.ne non tha t you hovo ol:.:;erveti , ease try to answer os many questions a s you possib ly con. The in formation t hat y()u g ive will be used f research purposes, Your name will not be used in c onnection with any stoterr .. nt:.;, conclu'sions, or publications without your permission . We request this personal Information sc that If It Ia deemed necessary, we may contact you for further details. 1. When did you s" the ohject? 3. T i me Zone: Month Year (Circle One): a. c. Mountain d. Pacific (Circle One): (Circle One): Hour Minute a a . QW.iYh,! Sa ving .C. Where were you when you saw the Obfect? C ity cw Town State -., County . f S .. How long wo ohiect In aJght? (Tote I DwotiOft) \...) _ _ - Mlnvtoe "-- Soconch-' --------- o. Crtaln c. Not very sure _b(F~Irty certo~ d. Just a ~u -5.2 Was object In alght continuously? 6. What was the condition of the. slcy? o. Bri ght- b. C loudy o . lB!ighj 7 . IF y ou s ow the object during DAYLIGHT, where was the SUN located o s you loolc~d a t the obje ct? (Circle One): o. In front of you b. In ':lode otJ,ov c . r., your ri t d. To yCXJr l~ft o . Overhe~ fTO OCT 62 16... Tt.le r-eupereedee PTD 164, jul 6 1, whleh l e oba o lte. 8. IF you saw the object at NIGHT, what did you notice conceming the STARS and M~? 8.1 STARS (Circle One): 8.2 MOON (Circle One): b. Oul moonlight Many No moonlight -pitch dark Don't rerMmber Oe11't remember 9. What were the weather ccncUtie111 at the ti~ you aaw the olaject? . : : _. ..... , -~ ....... f' \' .. : .2 WEATHER (Circle One}: <ftear alcV b. Fog, "''''' ar li;ht rain c. Modetote ar heOYy rain c. Scat1ered clouda d. Thiele ar heavy clouds e. Don't rememD. The object appeared: (Circle One}: d~ a llghJ) T ranaporent e. on't ,.memD. 11. If It appured 01 a light, wa It brighter than the brightest atara? (Circle One}: o. '1rJght.!,) c. About the some Fuaay ar blun-.d (Circle One): a e. b. ~Ice p brl.t atar _: 13. Old the o!ject: (Circle One far 'each question) r., A~or to tfom:j atilt at 01tf time 1 Don' t lmow b. 5yddenly speed up and rush OWtl'f atony tlnwt? Don't lcnow Brea1c up Into porta ar explode? Yes Don't lcnow Glv off smolce? Yes Don't lcnow e. Ch~ brl~tneaa? Don't know Chon~ ahaptJ? Yea Don't lcnow Flo~h 01 flic\ter? Oon 't Xnct'Jf Oict the object move behinct aomething ot any time, particularly o cloud? (Circle One): Don't Know. Yea you answered YES, thon tell what 16. Oid th object move In front of methlng at any time, particularly a cloud? (Circle One): Yes ' Don't Know. IF you answered YES, th~., tftll what 17 . Tell in a few wcwda the following things about the ob ect: We wish to know the angular size, Hold o match sticlc at arm's length in line with a known ubject and Mtv how much of the ob;ect is coverect by the head of the l'(latch, If you hoct perfcwmed this experiment at the timu of tl:e sighting, how much of,the obiect would h,, .... been covered by the match head? am lc:J> . Craw a picture that wilt show the ahope of the object ot ol)jecta. Label anct Include In your Ieetch any details of the object that you sow 'Such 01 wlnga, protruaion1, tc., and especially exhauat trallt or vopcw troila. Place on arraw beside the drowinv to show the direction the object was moving.,