1. D~ rt TIME GROUP 5 April 66 O X>Z 3. !lOliRCE 4. NUMBER OF OBJECTS S. LENGih OF OBSERVATION ~. TYPE OF OBSERVATION Gr ound 'lisual 8. PtiOTOS 2. LOCATION Lyco:~j r. ~, 10. CONCLUSION 11. BRIEF SUMMARY AND ANALYSIS Obse.rv~r not d \ r, ~ c cam~ do~1n ;. tht-r, r ounc: . ?. PHYSICAL EVIDENCE inform;1::.ion. Con:-.:et .. l-.ir.~ t,; i : ;.v ... ilble infon;:.t,lo n :.o . .: Date you completed thia questionnaire: 35. ion which you feel pertinent and which Is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting frititit ~ ihHc;, -i: 816-.o 5E45w 91708 iHJiftHi Houston, 'l'~xas :?ecos, ':e:~s U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force as much information as possible concerning the unidentified aerial phenomenon that you have observed. Please try to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your na1n1 will not 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 cletai Is. 1. When did you SH the obiect? li.-C8ntra I c. Mountain d. Pacific 4. Where were you when you saw the object? Nearest Postal Aclclreu (Circle One): (Circle One): a. Day I ight Saving b. Standard C ity or Town State or County s. How long was object in sight? (Total Duration) Hours Minutes Seconds a. Certain e. Not ver.y sure b. Fairly certain d. Just a guess 5.2 Was object in sght continuously? 6. What was the condition of the sky? 7. IF you saw the obiect during DAYLIGHT, where was the SUN located as you looked at the object? (Cirele One): a. In front of you b. In back of you c. To your rig,t d. To your left e. Overhead f. Don't remember . FTC..: OCT 62 164 Thill form aupen~des FTn 164, Jul I) I, which is obsol~t~ . 8. IF you sow the obiect at NIGHT, what did you notice concerning the STARS and MOON? STARS (C rcle One): 8.2 MOON (Circle One): a. Bright moon I ight Du(f moon I ight No moon I ight -pitch dark Don't remember d. Don t remember 9. What were the weather conditions at the time you saw the obiect? CLOUDS (Circle One): HEATHER (Circle One): o. Clear sky '-b.--Fog, mist, or light rain c:. Scattered clouds c. Moderate or heavy rain d. Thick or heavy clouds e. Don't remember 10. The obiect appeared: ( Circle One): b. Transparent d. As o light e. Don't remember 11. If it appeared as o light, was it brigohter than th e brightest stars? (Circle Jne); a. 8rt gh~er c:. About the some d. Don't know 0 11.1 Compare brightness to some common object: 12. The edges of the object were: (Circle One): ~. Fuzzy or blurred !::J._L~e a briyht star ~ -~orp~y -~tl i~e.cf d. Don't remember Did the object: Acoear to stand sti II at any time? Suddenly speed up and rush away at any time? Break up into ports or explode'? Give off smoke? Ch~nge brightness? Change shape? Flash or flicker? Disappear and reappear? (Circle One for each quest-ion) Don't know Don't know Don't know Don't know Don't know Don't know Don't know Don't know 14. Oicl the object clisapoenr whi If! you were watching it? If so, how? Oicl the object move beh i,.,d something at any time, particularly a cloud? (Circle One): Don't Know. IF you answered YES, then tell what it moved behind: 16. Oicl the object move in front of son:ething at any titr:e, particularly a cloud? (Circle One): Don't Know. IF you answered YES, then tetl what 17. Tell in a few words the foil owing things about the object: 18 . We wish to know tj,e angu lor s 1 ze. Hold a match stick at arm's length in I ine with a known obiect and note how much of the object i s covered by the head of the match. If you had performed this experiment at the time of the sighting, how much of the ob ject would hove been covered by the match head? Draw a picture that wi II show the shape of the object or objects. Lobel and include in your sketch any detai Is of the object that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails . Place an arrow beside the drawing to show the direction the object was moving 20. Do you thinlc you can estimate the speed of the obiect? (C irc:le One} IF you answered YES, then what speed would you estimate? -------~ 21. Do you thinlc you con estimate how far away from you the obiect was? (Cirele One) IF you answered YES, then how for away would you say it was? 22. Where were you located when you sow the object? (Circ:le One): 23. Were you (Cirele One) ,. a :. Inside a bui ;~ a. In the business section of a city? b. In the residential section of a city? c c. In open countryside? -d.-.-N~--on airfield? b. In a car c. Outdoors d. In an airplane (type) e. Flying over a city? f. Flying over open country? 2~. tF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24.1 What direction were you moving? (Circle One) a. North c. East e. South g. West b. Nort.,east d. Southeast f. Southwest h. Northwest i les per hour. 24.3 Did you stop at any ti me while you were looking ct t he object? (Circle One) Did you observe the object through any of the following? a. Eyeglasses Yes No e. Binoculars Yes 5\Jn glasses Windshield Theodolite Window glass , 26. in order that you can give as clear a picture as possible of what you saw, describe in y our own words a common object or obtects which, when placed up in the sky, would give the same appearance as the object which you saw 27. tn the following slceteh, imagine that you are at the point shown. Ploce an "A .. on the curved line to show how high the obiect was above the horizon (slcyline) when you First saw it. Place a "B .. on the same curved line to show how high the obieet was above the horizon (slcyline) when you lost saw it. Place an .. A .. on the compass . when you first saw it. Place a "B" on the compass where you last saw the obiect. 28. Oraw a picture that wi 11 show the motion that the obiect or objects made. Place an "A" at the beginning of the path, a "8" at the end of the path, and shu"-wny changes in direction during the course 29. IF there was MORE THAN ONE obiect, then how many were there? ----------- Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling 30. Have you ever seen this, or a similar obiect before. If so give date or dotes and location. 31. Was anyone else with you at the time you saw the obiect? (Circle One) 31.1 IF you answered YES, did they see the obiect too? (Circle One) 31.2 Please list their names and addresses: 32. Please give the following information about yourself: L.ast Nome F irst Name TELEPHONE "'UMBE~ Middle Name Indicate any additional information about yourself, including any special experience, which might be pertinent 33. 'Nhen and to whorr. did you report that you hod seen the object?