rl. < ~t. TE. TIME C~OUP l'. SOURCe i. NliMBE~ OF CaJECTS ~. LENGTH OF OaSfRVATIOH 6. TYPE O F OllSE~'/AT!ON 2. LOCATIO.,. Burbank, Ohio ( 2 ~ilitnasses) 10. CONCLUSION Object a}:.feared :in th~ NNE and disapp7)ared in t h e SS~l on 2. . 3tr~:i ght a1rl l e v el course.. Objc ct a:::pear~d as a i:h i"'~e li6h t No f- n 6S, or e:xhaust end no noise vra s observed. Obaer-ver 1va in a r.loving n.uto a t the time. Ground-Visual 9. PHYSICAL E VIOEHC~ FTD SEP 6J Q.j29 (TOE) Pr .. iou ecUUOftS of tM f-_, 'M "" J)A 17o tJ _, o ~-tr o .J o L 1 tJ ,.J r\ v ll) U.S. AIR FORCE TECi1NICAL INFORMATiON T his questionnaire has been prep(Jred so that you can givs the U.S. Air Force as much information as possible coocerning the unidentified aerial phenomen~n that you have observ~d. Plea:se try to ,answer as many que~tions as you possi.bly can . T he information that you give-will be used for research 'purposes. Your na111e ~ill not be us.,d in conl)ection ,.;;th any stat~ments, conclu~ions, or publications without your p~rmission. We reques t th'is personal information so that if it i s de<!med necessary we may contact' you br further detai Is. 1. When did you see the object? 3. Tim& Zone: (Circle One):(]? ~. Mountai n d. Pocj f ;c (Circ:le One): (Circle One): 9.~ Day I ight Saving ( b .i Standard 4. Where were you when you sow the object? Neorat Postal Addresa Cify ot Town 5. How long was-object in sight? (Total Duro~ion) o.' Certain c. Not very sure- StoU or County s.,.-:onds . (b) Fair.ly certain d. Just a guess 5.2 Was obj~et i n sight continuously? 6. Whor w..:s the c c ndirion of the s !<y? b. Cloudi' .. / !'liGHT 7. If you s ew :he object during DAYLIGHT, wher~ was the SUN loc ated as you lool<ed ot th~ object? ( Circl., One): o . In fron~ of yo; b. In bode of you c. T o your right d. T Cl your left e, Q v erheod f. DonJt remom~er ld. Did the object dis~1poeor while y ou w~re wot~hing it? If so, how? 15. Did t he ob ct move behind something at any t ime, r orticulorly o c loud? ( C, ref:? One); Don't Kno w IF you on sw.,red { ES, th~o tell whot it moved behind: (Circ le One): in front of: IF you answered YES, th!!n tell what Don't K.-,ow. 17. Tell in a few words the following things about the object : We wish to know the angular size. Hold a match stick a t arm's ~ength in lin~ with a known object and no~e how of the object is covered by the head of the !T'atch. If you hod p~rfr,rmed this a;cperiment at the time of the sighting, how. much of the object would hove been covered by the match head? 19. Draw a picture rnot will show the shape of the obj~ct cr o~jets. Lobel and include in your sketch any details of the obiect ~hot you !:aw such as wings, protrusions, etc. -ond aSJ)'ca!.ly exhaust trails OT v apor t;oils. . Plac9 a n arrow beside the drcwing to show the direction the obiecr W<!S moving. 20. Do you think you can e stimate tha speed of the object? (Circle One) IF y ou answered YES, then wh(lt speed would y ou estimot~? 21. Do you thin~ yo~.: con estimate how for away from you th~ object was? (Cir d e One) I F you onsw~rt~td YES, then how fo r away w ould you soy it was? _ - -- - ---_ _ _ 22. Where wer~ you locored when you saw the object? (Circle One J: o. Ins ide ~ building {b':; In a cor c. Outdoors d. In on o ir;:>!ane (type) 23. Were you (Circl<:! One) a. In the business section o f a dty? b. In the residential section of a ciry? :c., In open. countryside? d. Near on airfield? e. Flying over a city? f. Flying over open country? 24. IF you wer~ tvi.OVING IN AN AUTOM031LE or other vehicle ?t the t ime, then comple~e the following qu~stion.s: 24.1 What direction were you moving? (Circle One) f. Southwest f b. J Northeast d. Southeast 24.2 How .fast wer'3 you moving? -_ .., ._miles per hour. 24.3 Did you stop at any time whil& you ware looking a t the object? 25. Did you observe the object through any of the following? a. Eyeglasses b. Sun gfasses c. Wind sh i e l::i e. Binoculars f. T elescop& g. Theodolite h. Northwest d. Window s ioss Yes In order that you con give as clear o pi<:ture a s possible o f wl,ot you sow, descrtbe in y ou r own '~Vords a common obj~ct or objects which, when pl~ced up in tha sky, would 9i1e the soMe cp~arance o~ ln..: obje::::t which y::>v S<:J...,, In the following sketch, i magine that you a~& a t the point s hown. Place on ''A " on th~t cur;od l ine to show how h.gh t h & object wO$ above th e horizon (-skylrne ) when ydu first sow it . Ploc" a " B " o., th3 ~ome curv !td lin to sho w how higl-t the object was above t he-horizon {:skyline ) wh~11 you /o.st saw it. Pbc e a n "An on th e compass when you First sow it. Place o "B" on th e compOS$ where you las~ sow th~ object. 28. Oraw a pic ture that w i ll show the mot ion that the objec t o r objects mode. Ploc(J on " A " a t the beginn ing of th path, a "B, Gt the end o f rhe path, and. s!.v -. .":.ny ~:honge:s in diroction during th cour-se. 29. IF there was MORE THAN ONE object, then h.ow many were th~re-? 0 }/Ly r ' ' . Draw o picture of how they were arranged, and put on arrow to show th e direction that they were .traveling. 30. Hov~ you ever seen this, or o simi lo r object beforP., If so g iva dote o r dotes onJ location. 31. Was anyone else with you ot the tim" you sow the object? (Circle One) 31.1 IF ycu answered YES, did they see the o b jP.ct too? (Circle One) 31.2 Please l is t their names and addresse-s: 32. Please give the following information about yourself: First Name Midd 1,. Noms Indicate any additional information about yourself, including any special experience, which might be pertinent. IHhen on:i town"~" d1d you re port thot you hcci seen ~hP. object? 3J. Oat., you r::ompl~red this qu.,stionnoir~: Information whtch you feetl pertinent and which i 'l not odequat4tly coYer~d in the specific point:~ ot the qustionnaire or o narrative explanation of your sighting.