1. DATE TIME GIIOU' Civilian ... NUMIEA 0' OIJICTS 2. LOCATION 10. CONCLUSION S. LENGTH 0' OISIItYATION 11. lltll' SUMMARY AND ANALYSIS 5 iO.nutes 6. TYPE OF OISIIVATION 11hite light moving throuz,h the slcy at ve!j'-high altitude. Hanuvere d from Ti'ast to ~Jest turne d to' r:or+ .... l-} and then tt!me d '}rou."Xi-Vis ua.l back to I!,ast. !rur!lbling so~ heard durinl on portion of fii~ht. 001-1:TIITS: ~!o data pre s e:1te d to indicate th.:1t the object could have b een an a/c. Sound a:."1:l description of objact in accord L---- I..~cn~u~v:e~r.t.~""L Jtrith this analysis. Tale phone co~1versation ui. th ui tne ss on 19 a. PHOTOS l-ey. She \ras inforned of our .evnlu~tion. Distortion of sound lights e~plaL~ed ~J atmos~her.ic conditions. 9. PHYSICAL !YIDINCI U.S. AIR fORCE TECHNICAL IHFORMATIO&~ This questionnaire hat been prepared 10 that you can give the U.S. Air Force as mu~h Information as possible concerning th unidentified aerial pheno111enon that you hnve oLse"'eu, Please try to answer as many qustiona as you possibly can. The Information that y~u ; ive witt be uaed for research purposes. Your name will not be used In connec:tion with any st~tement1, conclusions, or publications without your p.rmlsslon. We request this personal lnformQtion sc that if It Ia neceesory, we mc~y contact you for further details. . 1. When did you '" the obiect? Hout Minute a (Circle One): or 3. TIme Zone: (Citde One): a; Easter c. Mountain d. Pacific: (Circle t)ne}: o, Daylight So\ing Cb. Stanaard ~ 4. Where were you when you saw the obfect? City ot Town 5. How long woe o~lect in sight? (Total DwotiOft) Minute a Second a a. Certain c:;: Not very su~ b. Fairly certain d. Just a gu . 5.2 Wat object in sight continuously? 6. What WOI the condition of the sky? a. Bright Qa-Brigfft ") b. Cloudy b. Cfoucfy 1 7. IF you saw the object during DAYLIGHT, where was the SUN located os you fook~d a! the o':ieet? (Circle One): a. In front of you d. To your left e. Overhead FTC OCT 62 J64 b. In haclc of you c. To your ri~t f. Don't remember Thla form aupend PTD 1&4, jul 61. whlch te obeolete. 8. IF you saw the object ot NIGHT, what did you notice conceming the STARS oncl MOa-.? 8.1 STARS (Circle One): 8.2 MOON (Circle One}: a. Brlsltt moonlight t remember b. Dull moonlight CLOUDS (Circle One): c. clouc .. conclitlont at the tl~e rou saw the o~i.ct? WEATHER (Circle One}: b. Fog, mist, or light rain c. Moderate or heavy rain d. Thiele or heavy clouds 10. The object appeared: (Circle One): -. (d. As a lfaht =:-. e. Don'trememHr a. Solid b. T ran aparent c. Vapor .. 11 . If It appeared a light, wal it brightr than the brighteet ltars? (Circle o,.J: c. About the same d. Don't lcnow lwlghtn to lOIN c~........, olalect: 12. Th edge of the obict were: (Circle One '-= .a: Lik a briSI}ht star c. Sharply outlined d. Don't remember 13. Did the obJect: (Circle One f01 each question) a. Appear to atoncl atilt ot G"f time? b. Suddenly apeed up and ruah away at any time? Don't lcnow Don't lcnow Don't lcnow Don't lcnow Don't lcnow Da~t't lmow oont lcnow Ocn't lcnow c. Brealc up into porta 0# explode? d. Give off smoke? e. Change bri~tnesa? f. Change shape? g. Flosh or flicker? . h. Oieappear and reappear? -./); ~ .. IJ,,I' J 1~. Did the obiect diaappec:w while you were .,otching it? If so, how? 15. Did the obiect move behind something at on particularly a cloud? Don't Know. IF you answered YES, then t.ll what (Circle One): Yes N,o. .. 16. Did the olai ... move In front of Jocnething at any time, particularly a cloud? IF you answered YES, ths ... t .. H wh<Jt (Circle Onel: Don't Know. a. Sound J1f ~ne l'qr"lof "b><.~rv"/t!1h-k.Jr:tr I ; A ~ ;e._ Jjqr ~w~--t . b. Color .just !t;z/,r -,tfl,,f 18. We wish to lcnow the angular aize. Hold a match aticJc at arm~s length in 'line with a lcnown c.Jbiect and n~t..;~ ~oN much of the oltiect Ia covered by the head of the q~Gtch. If you had performed this experiment at the tiwne of the . aightint, haw much of the ob;ect would have been covered by the match head? 19. Draw a picture that will show the shape of the obfect or oliiects. Label and include in your slcetch any detoila of the obiect that you saw uch as wings, protrusions, etc., and especially exhaust trail or vopor trails Place on otrow beside !h drawi~g to show the direction the obi~t was moving. . I- VI1uh/~ fe. J/rcellrtJ, ct l' ch, dt-sc, 'f' 20. Do you thinlc you can eatimote the apeed of the object? (Circle One) Yes No IF you answered YES, then what speed would you eatin-.ate'f ------- - 21. Do you thinlc you can estimate how for away from you the object was? (Circle One) Yes (No ) IF you answered YES, then how far away would you say it was?-------- 22. Where were you located when you saw the obfect? (Circle One): o. Inside a building b. In o car ,,. (c. Outdoors \ d. In on airplane (type) 23. Were yCkl (Circle One} a. In the business section of a city? 1>. ial sctic;ea oi a city? Near an oirfield? Flying over Fly;ng over ope" country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete ~e followirg questions: 24.1 What direction were you moving? (Circle One} b-Northeast d. Southeast f. Southwest h. Notthwest 24.2 How fast were you nwi~g? ......~miles per hour 24.3 Did you stop at any time while you were loolclnt at the ol:iect? (Circle One) Yes 2.5. Old you observe the obJect through any of the following? o. Eyeglassea Binoculars b. Sun glassea Yes Winchhield Theodolite d. Window glass Yes 26. In order that you can give aa cleor a picture as posa_ible of what you saw, describe in your own worcls a commCMt obiect or obiect which, when placed up In the slcy, would give the same appearan~e as the obiect whlcf! you sow CciHJj'e;)~c(,/ 1 6 f'tiillt~ i ~-c/ 'II. In the fellewlftl eketth, 1'"11 th.t you.,. tit the ,.ant h PI aft.,,._,. on t~t r.urvr! ltn. t ehew how high the oltlect WI "- the herla (alcyllne) whet~ yw llrt .,,, Place a "8,. on th 1,1me c~eclllne tC\ ahow hlth the ol.lect we11 oltoe the horizon (al&yllne) when 1ou lost saw it. Place an ''A' Oft the co~Rpaa when yeu ,,,., HW It, Ploee "I" on the here you I' IIW the o~tect. 28. .Draw picture wiiJ ahow the that the.oltiect or olfects made. P.lace an "A" ~ at the betnn:te of the at the encl of the path, oncl ahow ~ In direction during the courae. 29. IF there waa E THAN ONI ~lect, then how ......, were there? --------- Draw plctule of how th., were , oncl put Oft row to thow the clirecti that the1 were traveling 30. Have you '"" this, o almllor object bef If ao give dote or cl an4 locotllft, ~Je OJ-f ~II ft/~ 31. Woa anyone else with you at the tl you aaw the oltiect? (Circle One} No 31.1 IF you onawerecl YES, cllcl.they the oltiect too? (Citele One} No 31.2 Plea .. llat their nae1te1 ancl aclcl1: / tlos6&~u4) s1s.~er ~ bro/At>r-1/'1-/t!tV . (!f rt>,Porler 32. PI give the followlftl lnf..tlon about yourHif: 34, Dote you c..,letetl thl M/R: ON the mo~iq ot 19 ~ 65 ~gt David N }.t)ody talked to Mrs rega.rdins her observation on the nisht ot 18 Ma7 65. M18 save the same details that ,.,_+ioned 1n the report siven by the Duty otticer(MaJ ) Told Mrs that a/c were 1n the area. practicins refueling and other missions. She tinall.y agreed that this ia what 1 t could have been.