1. DATE TIM! GROUP 3. SvtJF:CE PROJECT 10073 RECORD 2. LOCATION 10. CONCLUSION 4. NUMBER OF OBJECTS Sgt Moodl' made a field trip to Chicago and made contact with the witness. Witness said that the lateral movement was connict with the tion. S. LENGTH OF OBSERVATION 11. IRIEII SUMMARY AND ANALYSIS sighted the object on clear nif.Pta over a 30-dq 6. TYPE OF OBSERVATION period. 'l'he object as AD orange, flickering light. Ground-. 'l'he object wae stati and it faded awq as a di '"'iDg _,light. once, the object disaweared md rea}:P It vas siBJttecl in the West about 45 del abon the horiZ~. 9. PHYSICAL EVIDENCE FTD SEP 63 0-329 (TOE) Pl" edltloae of tJt.ls fesa .. , M U.S. AIR fORCE TICHMICAL. IHPORMATIO~ Thlt questionnaire hat l.en prepared 10 that you can ilve the U.S. Air Force as muc~ information as pottlble conceming the unidentified aerial phenomenon that you have obse,eu. Pleate try to answer as many questions a1 you possibly can. The information that you give wilt be usecl for rech purpoMt. Your na will not be used in con"ectfon with any atoternent, conclusions, or publications without your pertnltalon. We ,..,.,t thlt peraonol Information eo that If It Ia d .. med neceaaary, w n.at contact you for further details. 1. When clld you see the obtect? 2. Time of doy: (Circle One): 3. Time Zone: (Circle On): ~ Eaatem ' UV Central . ~ (Circl~ One): la:) Daylight Saving . . c. Mountain d. Pacific 4. Where ware ,., . when you .ow the ol:lect? 5. How font 5.2 Wat obiect In tight continuously? 6. What woa the condition of the alcy? ~'Cloudy ( pPtL " 'i' 7. IF you saw the obiect during DAYLIGHT, where wat the SUN located as you loolced at the obiect? (Circle One]: a. In front of you In baclc of ~au c. To your riFt d. To your left e. Overhead f. Don-'t remember FTO OCT 62 164 Tide f aupenall 1'1'1) a Jul 61, ,..Mh le obeolete. L IF you the ol.iect ot NIGHT, whot cll4 you notice 8.1 STARS (Circle O...J: 1.2 lheSTARSoftd~? (Circle 0...): b. Dull MOOftllaht ccNitl-et the tl .. Y the olaiect? 10. . The olalect @ Brlter th the lwlthfeat ? (Circle Otte): te .._ c.--oltt_ect: . . 12. The .... of the oltiect (Circle 0.): a. Fuaay ltl 1. Lllce a wl.t at Sh.,t, outlined 13. Dlcl th ol.iect: a. to still at t tl,..'l II. Suclclenly apeecl an4 rvah away at any time? brl.tneaa? I Flath or fllclcer? h. Oiaappe ancl (Circle OM for e.h question) \.Yea> ::J -No (Yes)j;._.j-/, No {jea;b"i!~ No Don't lcnow Don't lcnow Don't lcnow Dan't lcnow Don't lcnow Don't know 14. Dlcl the oblect cllaappe~ while you w~e watching it? If so, how? 15. Dlcl the ol.iect (Circle One): lng at any time, particularly a cloud? No Don't Know. ' of ,.,..thing at any time, particularly a cloud? Don't Know. IF you answered YES, th .. l fl heat 17 .'Tell in a few worcla tlw following things about the obfact: 18. We wish to 'lcnow the angular size. Hold o matdt sticlc at arms length In line with a lcnown object and Mt!l w much of the oliect Is ccwerecl by the head of the ~tch. If you had performed this experiment at the titM of fhe sighting, how much of the oO;ect ~ould hoe been covered ' the match h~? . 19. Draw a picture that will show the .hape of the oblect or oliiecta. Label and lnclu In yrNr slcetch any cletoila of the ablect you sow .. uch oa wings, protrusions, etc., ancl especially exhauat trail or vapor trails. Place an arrow l.eside the clroeving to show the direction the obiect was mOYing. 20. Do you think you can thttot th speed of th obfect? (Circle One) IF you answered YES, thn what sped would you esthr,ate? ------ 21. Do you think you can estimate how far away from you the obiect was? (Circle One) IF you an1w.recl YES, thn how far away would you say it was?-------- 22. Where were you locatecl when you aow the obfect? (Circle One): , ' G) Inside a lau1.14ing d. In an afrpa-. (type). 23. Were you (Circle One) .. a. In the business section ol o city? ~In th residential aectic;e1 of a ty? { f'#l 'l~h c. In open countryside? f'e 7 ,..!) -d. Near an airfield? e. Fl)ing ov a city? f. Flying over op1n country? - 24. IF you were MOviNG IN .AN AUTOMOBILE or. other vehicle at the time, then complet the folfowir.g queationa: --~ 24.1 What cUrection were you (Circle One) . f. Southwest 2.t.2 How fast were you nMHing? ,mils per hour. 24.3 Did you atop at .wy time while you were loolcing at the obiect? (Circle One) y. West ~ h. Northwest 25. Dhl you olt~ th obJect through any of the following? EyeglaaMa : .. b. Sun glaes . Yea c. Windshield d. Window glass Binoculars No g. Theodolite 26. In order that you can give a1 clear a picture as possible of what you saw, describe in your own worcfl a commort l obiect or obiecta which, when placed up in the slcy, would give the sorN appearance os the ob;e~ whl you aa"i 21. In the following 1lcetch, f M that you are at the point 1hwn.. Place an ''A" on the c:urv.d line te ehew high the olllect woa alto the horlaon (ally line) ,., II,. I 1ow lt. Plac a "8" on the curve4 11,. to ahow how hlth the obiect o~ the horlaon (al&yllne) when you lost aw it. Place an "A" on the c ...... when ,ou llrtl aaw lt. Ploce a "B" on the where you lal 1aw the object. 28. . Draw a picture that will ahow the ntutlon thot the. ol.lect or objects made. P.lace an "A" at the ~lnnl"' of the path, a "B ~at the encl of the path, and ahow any : In direction during the cow 29. IF there waa MORE THAN ONE ~lect, then how ....., there? . Draw a plctute of how the, were ranged, ancl put on row to ahow the direction tf..at the, were 30. Have you ever sHn this, or o similar obiect before; If so give dote or dotes and location. ..s I n'J I hi/P 31. Was anyone else with you at the time you sow the obiect? (Circle One} 31.1 IF you answered YES, clicl they IH the object too? (Circle One) 31.2 PleoM list their non:es oncl 32. Please give the following lnformotlon about yourself: Loat No,... Firat HolM TELEPHONE NUMBE ~hhlle HelM tndicote any additional '"'' ion about youraelf, Including any special experience, which might be ~rrirw~tt. 33. When and to whom did you report that you had seen the object? Month Year Date you this lnforiMtlon which you '-I queatlonnalre or a narrative ancl which Is not adequately co-~ere4 In the apeclflc points of the of your sighting.