did you report that you hod seen the object? tha Air Base informotion 3h Was onyone else with you ot the time you saw the object? (Circle One) 31*2 Pleose list their names and oddresses: South ^akot^ odditional information experience, pertinent* ins--rr.nce comoany-area incltt'des --taerica, Lost -No>^e TELEPHONE NUMBE Midd le Nom Zort Stott 34. Dot* you completod this questionnoiro; 35. Information which you fosl partinont and which is not adequotaly coversd in tha spacific points of tha quostionnoira or o norrotiva explanation of your sighting. irritiediately information information We questioned what it was, im inly because it went ck up. It V7- s centinious for the tirra x^e sax/ it. If you h.-ve an explanation v;e x.'ouLd be interested in hearing about it Sincerely, yro (tdsw) -Patterson Sfforte to contact 70a by telephone regarding ussuccessfni. ve hare recelred vn* Ineon^lete for eonrenlesee* the unidentified iafomatlon HSCTOR gjUTEAinm, Jr., Major, USA? PTD (CTBW) Vrlgb*-PttroaQ A/3, Ohio ^^5^33 17 JacDoarj 66 Effort* to coataot yon by tolspboeo xiaeueceeaful vhids ve iuc? reoolTed vas Incei^lete then to cKxr office ab yoor cosreniance the imideatified aaalyete of your r* fcras end retttzn ESCTOR QJiyrxmiA, Jt., ;4a^or^ U3A7 U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire hos been prepared so thot you con give the U>S> Air Force as much inforrnction os possible concerning the unidentified aerial phenomenon that you have observed. Pleose rry to answer as mony questions as you possibly con. The information that you give will be used for research purposes. Your name will nof be used in connection with ony statements, conclusions,, or publications without your permission. We request this personal information so necessary, 1. When did you see the object? (Circle One): 3. Time Zone: (Circle One): (Circle One): a. Daylight Soving b. Standard 4. Where were you when you saw the object? p09fo\ Addr>t City or Towf> Korth Dakota 0. Certain b. Fairly certain X determined? c. Not very sure d. Just a guess 5.2 Was object in sight continuously? 6. What wos the condition of the sky? a. Bright b. Cloudy o. Bright 7. IF you so-w the object during DAYLIGHT, where was the SUN locofed as you looked at the object? (Circle One); a. In front of you d. To your left e. Overheod f. Dont remember nupers*Jii concerning 8.2 MOON f Circ/e One); Bright moonlight Dull moonlight- No moonlight - pitch dark conditions c. Scattered clouds d. Thick Of heovy clouds WEATHER fCrrc/e One); b. Fog, mist, or light rain c. Moderote or heavy rain e. Don't remember b. Transparent e. Don't remember b. Dimmer c. About the same d. Don't know 11.1 Campore brightness to some common object; 13. Did the objecr; Appear to stand still at any time? Suddenly speed up and rush away ot any time? Breok up into parts or explode? Give eff smoke? Change brightness? Change shape? Flash or flicker? Disappear ond reappear? CQch question) Dor>*t know Don't know 15. Did the oDiect move behind something at nny time, porticulorly a cloud? vC'Vc e One): t moved behind: Don't Know. IF you answered Y5, th?n tell whnt 16. Did the object move in front of something ot any time, porticulorly o cloud? (Circh One): IF you answered YES# then tell what 17* Tell in o few words the following things about the object: 13. We wish to know the ongutor size. Hold a motch stick ot arm's length in line with a known object and note how much of the object is covered by the heod of the match. If you hod performed this experiment at the time of the 19. Draw a picture thct will show the shope of the object or objects. Lobel and include in your sketch ony detotU of the object that you sow such cs wings, protrusions, etc., and especially exhaust trails or vapor troiK. Ploca an crrcw beside the drawing to show the direction the object was moving. 20. Do you think you can estimate the speed of the object? fCi>c/e One) IF you ons^wered YES, then whot speed would you estimote? (Circle One) IF you onswered YES, then how for owoy would you soy it was? ^ tre were you located when you saw the object? ircle One): Inside o build In on oirplone o. In the business section of o city? b. In the residential section of a city? c. In open countryside? X d. Near on airfield? e. Flying over a city? f. Flying over open country? AUTOMOBILE questions: N'orthecst d. Southeast f. Southwest (Circle One) h. Northwest following? 0. Eyeglasses e. Binoculars b. Sun glosses f. Tetpscope c. Windshield Theodolite d. Window glass appearance Refer iSf 10 follo>ving (s!<yline) beginnirrg Draw a pictura of how they were affonga<i, oni put on arrow to show the 'Jiraction that they ware traveling.