U,S. AIR FORCE TECHMICAL INFORMATION This qusstionnoire has been prapored so that you con give the U*S Air Force os much informar'on cs possible concerning ^ha untdanHfied aerial phenomenon that you hove observed, pleflse Try to onswar as nony questions as you possibly con. The information that you give will be used for research purposes* Your noma will not be used in connection with any stotements, conclusions, or publications without your pernission. We request this personal information so thct ff it is deemed necessary, we may contoct you for further details. (Circ/e One); o. Doy light Saving b. St'indord fC/rc/e One):(a, Eostern ^Sere were you when you saw the object? hleorest Posfol Address . JiTt* in sighr de^^mined? fcr :n sight continuously? 6. What was conaition of the sl<y? a. Brigfit 7, Ir you saw the object during DAYLIGHT/ where was the SUN 'ccoted as you looked ot the object? (Cifcift Onej; a. In front of you d. To your left b. In back of you e. Qverheod c. Tovourridit f. Don't rei-nember aup*rnec!^4* 11.1 Compara brightnass to soma common objact: 12a The edges of tne ooject were Did the object: a. Appaar to stond still ot any tima? b. Suddanly soead up and rush away at any time? c. Break up m*a parts or e-<ploda? d. Gtva off smoke? D. Cbanga brijd'tness? f. Changa shops? g. Flash or flickar? h. Disappear end reappear? IF you sow tha objact at NIGHT/ what did you notice concerning the STARS and MOON? 8.1 STARS (Circ/e One): d. Dont remamber ^iS^Brlght moonlight r* )\ c. No moonlight - pitch dark d. Dont remambar 9. V>rhat were tha weather conditions at the time you saw tha object? 10. The object eppaared: (Circ/o One}: Transperant WEATHER fC/refe One}: c. Moderate or heavy rain e. Dont remambar c. Scatterad clouds d. Thick or heavy clouds pcrticulorly IF you onswarsd YES, than tall wht it moved behind porticulorly (Circle Onm); Yes Don't Know. IF you answered YES# then toll what experiment Drow a pic^jre that will show the shape of the object or objects. Label ond include in your sketch any details of the object thor you saw such as wings, protrusions, etc., and especially exhaust troils or vapor trails. Place cn cr^ow beside the drawing to show the direction the object was moving. 20. Oo you think you con estimato tho spod of thiv objoct? (Circta On) IF you onswered Y5, then whot speed would you ostimote? 21'. Do you think you con estimate how for owqy from you the object was? (Circis One) Inside o buiiding in 0 cor a< In the business section of a city? residentiol countryside? Neor on airfield? _ e. Flying over o city? f. Flying over open country? / AUTOMCBiLE questions; b. Northeast d. Seutheost f. Southwest F7"Northwest _miles per hour. fC/rc/e One) following? o. Eyeglosses b. Sun glasses c. Windshield d. Window glass e Bineculofs fe Telescope Theodolite he Other .5 ^ appearance when you first saw it. Place o "B'* on the compass where you last sow the object. 29. IF there was MORE THAN ONE object, then how many were there? / L ' L' ^ Dfow 0 picture of how they were orronged, and put an crrow to show the direction that they were traveling 30. Hcva you ev9f sn this, or a similar objact b^fora. if so giva data or dotas and locatioHi 3]. Was onyoo* aUe wifh you at th tima you saw the object? (Circ/e One) 31.1 IF you answered YES/ did they see the object too? fOVcie One) 31.2 Plecse list their names and addresses; 3Z. Ploose give the following informotion about yourself; ADDRESS ^ F?rst Nama Middia Hoffi# TtLcPHONc Indicate any additional information about yourself, including any special experience, which might be pertinent. 33. Wh-'tn and to whom did you raport that you hod seen the object? 34 Cats you compUfad this questionnaifa: 35 Informotrco which you feel parrinant and which i$ not adaquataly coverad in tha specific points of thi quastionnoira or o norrotlva explanation of your sighting.