,1 .. DATe TIME GltOU' 2. LOCATION Kettering, Ohio J. SOUitCE 10. CONCLUSION CiviJian Satellite (P.nASUS I) NUMI!R 0' OIJICTS Sighting conforms lttith Satellite report Pz.GASt.B I over Dayton a t 2110,17 minutes prior tc. observation. Possible the.t this "ia.s t r e S. LENGTH Of OISIItVATION 11. IRII' IUMMAitY AND ANALYSII 2 1fulut es 6. TYPE OF OIS!RVATION Ground-Visual 9. PHYSICAL !VIDINCI Observa-tion of liLil t through. Object ar;\ red as a tlhit.e s phere. Looked li~ it lras errl.ttin~ lijlt. l tuch brij'lter than the stars. Sha~ly outlined vrhite dot. No de~J1 to object. SouthHest to !E flic;ht. Disapr-en.red ewe r the horizon. :.:,stir_:.s.ted speed at, 90-100 mph and C.ista."lc e c:.s 1 2 miles. Thoujlt mijlt b a sate l lite except nova-:L:nt seen.ed i oo U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared sa that you can give the U.S. Air Farce as much I fon as posslbt. lng the unidentified aerial phenomenon that you have observed. Please try to answer as many questions as yau possibly can. The Information that you give will be used for research purposes. Your name will 110t be used in connection with any staten:ents, conclusions, or publications without your permission. We request this personal Information so that If It Is dHmecl necessary, we inay contact you for further details. 1. When did you s" the obfect? 3. Time Zone: Central c. Mountain d. Pacific (Cirde One): (Circle One): Daylight Saving 4. Where were you when you saw the obiect? City or Town State or County 5. How long was obiect In sight? (Total Duration) Ml nute s S.concla a. Certain c. Not very sure b. Fairly certain d. Just a guess I oo ~ /r;J;-M.t-jt.l_ 5.2 Was obiect In sight continuously? What was the condition of the sky? /&':) Bright 7. IF you scrw the obiect during DAYLIGHT, where was the SUN located as you looked at the obiect? (Circle One): a. In front of you b. In baclc of you c. To your ris#tt d. To your left Overhead f. Don't remember FTO OCT 62 164 Th!a loren auperaed .. FTD 16-4, Jul 61, which ta obeolete. 8. IF you saw the obiect at NIGHT, what did you notice conceming the STARS and MOON? 8.1 STARS (C irde One I: 8.2 MOON (Circle One}: f} -t": a. Bright moon I ight b. Du II moon II ght c. No moonlight - pitch clcwlc d. Don't reeneml.r d. Don't remember - 9. What were the weather conditions at the time you saw the obiect? CLOUDS (Circle One): a. Clear a ley Thiele or heavy clouds WEATHER (C lrcle One): Fog, mist, or I ight rain c. Moderate or heavy rain e . Don't ren:1mber 10. The abtect app1arecl: (Circle One): Transparent e. Dan t rem mber 11. If it appeared as a light, was it brighter than the brightest stars? (Circle One): a. Brighter "-"~bt'. Dimmer 11.1 Compare lwightnes 1 to 12. The edges of the obiect were: c. About the same d. Don't lcnow onie common obJect: (Circle One): a. Fuzzy or blurred ~Like a bright star arply outlined Don t remember 13. Did the obiect: (Circle One for each question) Appear to stand still at any time? rN;) Don't know b. Suddenly speed up and rush away at any time? No./ Don't know c. Break up into parts or explode? No Don't know d. Give off smoke? . Don't know e. Change bri~tness? Yes _ Don't know f. Change shape? or fl iclcer? h. D i a appear and reappear? Y rN~ Don't lcnow Yes ~ .. !fo 1 Don't know Yes Don't know 14. Did the obiect disappear while you were watching It? If so, ow? 15. Did the obfect move behin~ sontething at any time, particularly a cloud? (Circle One}: Yes ( No.., Don't Know. IF you answered YES, then tell what 16. Did the oblect In front of something atony ti particularly a cloud? Yes ,.~'No Don't Know. IF you answered YES, then tell what (Circle One}: 17.. Tell In a few words the following things about the obiect: We wish to lcnow the angular size. Hold a match sticlc at arm's length in line with a lcnown obiect and note how much of the obiect is covered by the head of the ntatch. If you had performed this experiment at the time of the how much of the obiect would have been covered by the match head? 19. Drcrw a picture that will show the shape of the obiect or obiects. Label and include in your sketch any details of the obiect that you saw such as wings, protrusions, etc., and especiatly exhaust trails or vapor trails Place an arrow beside the drawing to show the direction the obiect was moving. 20. Do you thinlc you can estimate the speed of the obiect? ( lrcle One) Yes' No IF you answered YES, then what speed would you eatimate? -""'~,. -_1_o_-:..', ..;.., !v4 Do you thlnlc you can eatlmate how far away from you the obiect waa? (Circle One) \. y~y No IF you anawerecl YES, then how far away would you soy it was? _...a.(_L_W0-I( t_A 22. Where were you located when you saw the obiect? 23. Were you (Circle One) (C Ire le One J: a. In the business section of a city? @In the reaidential section of a city? lnaide a building b. In a car c. In ~open countryside? d. Near an airfield? e. Flying over a city? In an airplane (type) f. Flying over open . ntry? ~ n A .I' 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24.1 What direction were you moving? (Circle One) c. East e. South d. Southeast f. Southwest How fast were you moving? miles per hour. Did you stop at any tinte while you were loolcing at the obiect? (Circle One) h. Northwest 25. Did you observe the obiect through any of the following? Eyeglasses Yes No e. Binoculars . Yt_s b. Sun glasses Yes No f. Telescope Windahield d. Window glass Yes In order that you can give aa clear a picture as possible of what you saw, describe in your own words a common obiect or obiects which, wlten placed up in the slcy, would ~ive the same appeora~ce as the object which you saw. 27. In the following sketch, imagine that you ore at the point shown. Place on "A" on the curved line to show how high the object was above the horizon (skyline) when you llrst sow ft. Place a "8" on the some curved line to show how high the object was aboYe the horizon (slcyline) when you lost saw it. Place an ''A" on the compass when you lirst saw it. Place a "8" on the compass where you last saw the obiect. 28. Draw a picture that wi II show the motion that the object or objects made. Place an "A., at the beginning of the path, a "8" at the end of the path, and show any changes in direction during the course. 29. IF there was MORE THAN ONE object, then how many were there? AJ ~------ Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling 30. Have you ever seen this, or a similar obiect before. If so give date or dates and location. else with you at the time you saw the obiect? (Circle One) 31.1 IF you answered YES, did they SH the obiect too? (Circle One) 31.2 PleaM list their names ancl addresses: 32. Please give the following information about yourself: TELEPHONE NUMBER uwlicate any aclclitional 33. When and to whom did you eport that you had seen the object? 34. Date you this questionnaire: Month Yeor 35. I on which you fl peat lnent ancl which Ia not adequately ccwerecl In the specific points of the questionnaire or a narrative explanation of your sighting. ' r ~ tj ,J-;p