1. DATE TIMI: GltOU' J. SOUitCE Ci v.llia.rul NUMIER 0' OIJICn 2. LOCATION 10. CONCLUIION Pennsylvania 5. LENGTH 0, OISIItYATION 11. 111111' IUMMAitY AND ANALYStS 12 Hinutes 6. TYPE OF OISERYATION Object like a star mo-ving to the right am lett in a UE direction. Observed below the base of the l:d.g dipper. Groum-Visual . CCIJ1ENTS: Object lta.s NOT Echo I or II, or Pegasus I or II t-7-.-c-o_u_R_S_E .Description of sighting is in accord ldth a Satellite observati ~n. Possible the.t this object is one of the other visible Satellite~ such as Centaur 2 Saturn 5 or T:vros 9 all of l-lhid'l are as 1-.-.-P-H_O_T_OS--------tbrlght or brighter thm ECHO I. 9. PHYSICAL EYIDINCI U.S. AIR FORCE TECHNICAL IHFORMATIOrl Thla queationnaire has been prepared 10 that you can give the U.S. Air Force as muc~ lnforw~atlon 01 possible concemlng the unidentified aerial phenomenon that you hove obsnted. Plea try to answer a1 questions as you possibly can. The infor1110tion that you give will be usecl for purpoMI. Your name will not be used In connection with any statenaents, concluslona, or publications without your permlaslon. We request this personal Information ao that If It Ia d .. ....cl neceas~, we nMI~ you for futther details. 1~ When dlcl you see the object? . (Circle One}:~ Eaatem D. Central c. Mountain d. Pacific 4. Where were you when you sow the obJect? (Circle OneJ: (Circle One): IQ Daylight Saving ' Standard Neareat PMtel A4.... City or Town ---5-t- -.-cw-C_o_u_ttt_r - oltlect In sight? ... (Tetl DwetiM) . .. ... Howe ~ Mlnutea S.con4a 5. How long a. Certain b. Fairly certain . c. Not very sure cf. Just a guess 5.1 How was time In aidtt determined? ----------------- 5.2 Wot obiect In sight continuously? 6. What was the condition of the slcy? ~ ,v K ,..; r> "-' ,\.J a~ Bright ~;-A r-S PP ~ F< ti-NT~ Y 7. IF you sow the obJect during DAYLIGHT, where was the SUN located at you looked at tha obiect? tv'/ A (Circle One): a. In front of you b. In boclc of ytN c. To your rig,t d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thle for,. upereedee JP'm lU, Jul 61, which 1 obolete. 8, IF you the c*iect at NIGHT, what cllcl you notice conceenlnt the STARS cmcl MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle Otte): Clear~/., t..Hoay J. If PPIQ,q, ~-NrL y v ISI(J~G-. 1. Dull Jght c. No ...... ught -pitch cl.rl& caMitle et the tl .. y HW the Jectf v ,J ~ IV t'&.o~ N WEATHER (Circle Otte): it. fot. lat, .r ll.t roln cl. Thick 10.. The ~ect (Circle 0.): light, w.a It lwlahter th the lwlghteet eta? (Circle One}: v ~: M w IJ ..v AJ c. AIMNt the cl. 't lcr..w 12. The eel of the c*iect (Circle One): a. Fuzzy 01 b. Lllce lwl_.t at c. Sharply outllnH 13. Dlcl the oltiect: a. A~eor to stancl still at tln:e? b. Suddenly speecl up ancl rush away ot any c. Breol. up Into parts ., e., lode? d. Give off smolce? e. brl~tfJeal? f. Change shop.? g. Flash or fllclcer? h. Disappe and (Circle One for each queetlon) Don't lcnow Don't lcnow Don't lcnow Don't lcnow o .. t lcnow Don't lcnow Don't lcnow Don't lcnow 14. Old the obiect disappear while you were watching it? tf so, how? 15 . Did the obiec:t move behincl aomething at any time, particulatly a cloud? (Circle One): Yea No Don't Know. IF you anaweted YES, then tell what 16. Old the objNt move In front of ,.,_thing at any time, particularly a cloud? 1J ttJ I< AJ t:J'-' ,.) Pont Know. IF you answered YES, theo U whGt 17 .'Tell in a few worda the following things allout the. ob'fect: v u t< w c "",...) We wish to lcnow the angular alze. Holcl a match aticlc at arms length in line wi1h a lcnown ~biect and n~tt~ ho.v much of the olt;ec:t Ia cover.d by the head of the ~tch. If you had performed this experiment at the time of lh~ . sighting, how much of the olt;ec:t woutd have been covered by the match head? '/ AJ I( ~ 19. Draw a picture that will show the shape of the oblect or ol;iecta. Label and Include in your 1lcetch any detoila of the obiect that you saw uch as wings, protrusions, etc., and especially exhauaf trail or vapor trail a Place an arrow beside the clrawlng to show the direction the object was moving. 20. Do you thinlc you can estimate the speed of the obiect? (Circle One) IF you answered YES, then what speed would you eatirr.ate~ ------- 21. Do you thinlc you can estimate how far away from you the object woa? V A--~ 1<.,..; t1 e.J 1\J (Circle One) IF. you answered YES, then how far away would you soy it was? -------- 22. Where were you locotecl when you saw the obiect? Were yekl (Circle One) 1/ ~ I< w ~ "-' IV (Circle One J: C) IV J< tJ c 14.1 ~ a. In the business section of a city? . .. b. In the residential sectic;n oi o city? . c. In opn countryside? :):: : d. Near an airfield? ' ,. a. Inside a lulldint b. In a car . . f; Flying over open country? 24. IF you were. MOVING IN AN AUTOMOBILE or other vehicle ot the time, then complete the followir.g 24.1 What direction were you niOVing? (Circle OneJ a. Nor11t b. Northeast e. South . d. Southeast. f. Southwest 24.2 How fast were you mwh:tt? . _.~miles per hour. 24.3 Dlcl you st., at any three while you were loolcing at the obiect? (Circle One} 25. Did you observe the oiJect through any of the following? V "'-' a. Eyeglasses Yes b. Sun glasset c. Windshield e. Binoculars f. T elesc:ope g. Theodolite h. Norihwest d. Window glass In the following 1laetch, lmogfne that you are at the point 1hown. Place an A" on the cur.d liM te hew high the oltlect wo1 alto the horizon (llcyiiM) when you llrst 1 lt. Place a "B" on the curvM line to 1how how high the obiect wa1 abcwe the horlz (ally line) when you last saw lt. Place an "A" on the eoM~H~ when you''"' 1aw lt. Place a "B" on th 11 where you lost saw the oblect. v IV~-< NO..., A...J 28. .Draw a picture that will 1how the lon that the.Hiect or oi,Jects made. P.lace on A" at the begiMI,. of the 8" at the end of the path, and show any In direction during the cour c.. .v A wc1,41 v 29. IF there was MORE THAN ONE oltject then how t1lCifty _..,.there? V"" t< JJ" c.-V IV . Draw a picture of how they were orrongecl, ancl put an 01row to ahow the direction that they were traveling 30. Have you ever seen this, or a similar object before. If so give date or dates ond location. c.. /4J '' ,..,l':'cv J 31. Was anyone else with you at the time you saw the obiect? (Cirde One) 31.1 IF you answ.;ed YES, did they s" the obiect too? (Circle One) 31.2 Please list their names and addres1e1: 32. PJea give the following lnf ton about yourself: Firat H.,... 81 DsBo~o ion about yourself, Including any special experience, which "'ight ~-~rticwm 33. When and to whom did you report that you had seen the object? 35. I on which you feel questlonMire 01 a lnent Mel which Is not acl.quately covered in the apeclflc pointa of th. explanation of yOUtt alghtlng.