think vou can estimote how far away from you the object was? IF you answered YES/ then how for away would you say it was? a. h the business section of a city? residential C In open countryside? d. Near on airfield? e. Flying over a city? f. Flying over open country? 0. Inside a building d. In an airplane (type) e. At sea AUT0MC3iLc dt Southeast f. Southwest a . N orth b. Northeast following? appearance Eyeglasses Binoculars b. Sun glcssee c. Windshreifl Theodolite d. Window class 29. IF there was MORE THAN ONE object, then how mony were fhere? Draw o picture of how they were arranged, and put on arrow to show the direction that they were travel ing 30. Hqv9 you var saan this, or a similar objact bafora. If so giva dots or dotes and locution. 31. Was anyone al-.a with you at the time you sow the object? (Circlo One) 31.1 IF you onswarad YES, did they sea the object too? (Circle One) 31.2 Piaose list their names end addresses: 32. PUcase give rSe following informotion cbouf yourself: Lost Nome Middle Heme Indicoto any additional informotion obout yoursalfi including ar^y speciol exparienca, which might ba partinant* 33. When and to whom did you report that you hod seen the object? 34 Oofa you complafad this quasftoonoira: Informorion <Mhich you feel perrinent and which is not adequately covered in the specific points of the questionnaire or a narrative explonation of your sighting. 'pMy'^Oyu^ PCCiA.X'y-^^ yrisht-Patteraon ohaervatlon Slacerely^ I U.S. AIR FORCE TECHNICAL INFORMATION This ques^ronnaire has ben prpard so that you con give the US. Air Forco as much information as possibi* concarning th's unidentifiad aerial phenomenon that you hove observed. Ptsose try to onswer os mony questions os you possibly con. The informotion that you give will be used for research purposes. Your name will oof be used in connection with any statements, conclusions, or publications without your permission. We request this personal information so that if it is deemed necessary, we may contact you for further details. 1. When did you see the object? (Circle One): 3. Time Zone; (Circle One); o. Central (Circle One): a. Daylight Saving c. Mountain d. pacific e object? Pottoi Addrt > City or Towrt S>dt9 or County 5e tong was objsct in sight? (Totol Ourotion) Oe Certain be Fcrrly certain determined? 5.2 Was objecr In sight continuously? c. Not very sure 6. What wos the condition of the sky? a. Bright b. Cloudy 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked ot tne object? (Circle One): a. In front of you |n hack of you To your right concerning 8.1 STARS rC/rc/e One}; a. Bright moonlight I b. Dull moonlight c. No moonlight pitch dork d. Da.n't remember d. Don't remember conditions WEATHER ('CrVdo One}: Q. Clear sky be Fog, misf, or light rain Scattered clouds Ce Modefot^ or heavy rain d. Thick or heavy clouds e Don't remember ' b. Transparent e. Don't remember a. Brighter b. Dimmer c. About the same d. Don't know 11.1 Compare brightness to some common object; fC/rc/e One}; a. Fuzzy or blurred b. Like a bright stor Sharply outlined d. Dont remember 13. Did the abject; (Circle One for eoch question) Appear to stcnd still at any time? Don't know Suddenly spoed up ond rush away at any time? Don't know Break up into ports or explode? Don't know Give off smoke? Don't know Change brightness? Don't know Charge shape? Don't know Flash or flicker? Don't know Disappear end reappear? Don't know Draw a picrcrs ^ha^ will show th shop* of th objscf or objtcts. Lobl and include in your sl<9ich any details of the objecT thot you sow such cs wings, protrusions, etc., and ospeciolly exhaust trails or vopor trails, place on cr'ow beside the drawing to show the direction the object was moving. porticulorly It moved behind: Don't Know. particularly (Cifc'e Ons): in front of; _ Dont Know. IF you answered YES, then tell wnnt experiment