PROJECt 10073 RECORD 1: DATE : TIME GROUP ' 2. LOCATION . . Long Dcach, California (1 Witness) ~ l. SOURCE 10. CONCLUSION DfSUFFICIEt!T DATA FOR EVALUATIOi~ 4. NUMBER OF OBJECTS lssential data is lackine to permit a firm evaluatim. S. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS 17 Seconds SEE CASE FilE 6. TYPE OF OBSERVATION Observer a youth of fJ ycnrn Grourrl-Virunl Nob Reported 9. PHYSICAL EVIDENCE 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 "Y to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your name will DOt be used in connection with any statements, conclusions, or publications without your permission. We request this personal information so that if it is dHmecl necesaary, we may contact you for further details. 1. When did you sH the obiect? (Circle One): Month Year 3. Time Zone: (Circle One): a. Eastern (Circle One): a. Dgylig_lu._Saving b. Central c. Mountain 4. Where were you when you sow tj,e object? In -oy fr~ntyard . tal A4dres s 5. How long was object in sight? (Totol Duration) City Ot Town . a . C:.rtoi"' c. Not very sure b. Fairly certain d. Just a guess State or County Minutes Seconch I o.elJuted. 5.1 How was time in sight determined?------------------ 5.2 Was object in sight 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 obiect? (Circle One): a. In front of you b. In bade of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thle !or-n upr .. dea Fm 16~. J Jl 'I, . ..,hac:, ob olete . 14. Did the ob,ect disapoeltr while you were watching it? If so, how? It ~nt eyer ~ h111 15. Did the obiect move behi.,d something at any titne, particularly a cloud? (Cirele O"e ): No Don't Know. IF you answered YES, then tell what it moved b.h ind: Did the object fT'OYe in front of something at any time, particularly a cloud? (Cirele One}: (v~ .a. No Don't Know. IF you answered YES, then tell what in front of: Tell in a few words the following tn ings about the object: L1~- aeft a1rn. b. Color i 18. We wish to know tl"'~ ~ngu l~r s 1 ze. Hold a match stick at arm's length in I ine with a known object and note how much of tl,e obtec s :ov~r~d by the head of the match. If you had performed this experiment at the time of the sighting, how much ~' +~ ob11!C:t would ~ove been c:ov~red by the match head? Ont r~urtJl. 19. Draw a picture that wtll show the shape of the object or objects. Label and include in your sketch any details of the object that you sow such as wings, protrusions, etc:., and especially exhaust trails or vapor trails. Place an arrow beside the dr~wing to show the direction the object was moving. d. IF you saw the obtect a Nll,HT, what did you notice cc-.:e-rneng the 5TAR5 and MOOf\4? 8.1 STARS (( rrcle 0,..~ d. Don't reme,ber CLOUDS (Crreltt C,P. : a. o~lea0-"G: Scattered c I ~ud c Thi'Cic or heavy :i~uds a. Bright moonli~ht b. Dull moon I rght c. ~-rlghlJ-cite~ dark d. \ocHr remember WEATHF.~ (C,rcfe One): b. Fo::, ~i ~t, or I i~t r~in Moderf1t"' nr heavy rain Don'~ ~..,e4'T'ber 10. The obiect aooeored ' C,r::l'! o,~): o.,~Solid o b. Trartsoarent d . 0 lrght e. Don't re.,ember 11. If it apoeared os a ire-, ....,.::s ;t brrghter thon the brightf!!.;+ ~t::Jrs? (Circle One): a. BrigL,t.,. c. About the s::2.,..~ d. Don't know 11.1 Comcare brigh:"""'~S t o sorr~ common object: 12. The edges of the ot@O::f w'!"'!: (Circle One): a . Fuzzy ~r b I urred ~. L. .c orr~nt st.a,r c. "SF= :l~::--v ~ou-mned 13. Did the obtect: (Circle One for each auestion) Aooecr t=:~ str.,d :5t'll rot ~roy tr ? Uon't know Suddenly soeed up ::2,1'1 ru s h o wny at any time? Don't know Break u o ,.,to onrts "'" ewolode., Don't know G ive .... u ~-oirA., o('l,. t know Don't know Change sh::2oe? Yes Don't know Flash ..,, fl icke!"'., o~n't know Don't know 14. Did the object disapoec'tr while you wfiJre watching it? If so, how? It went Ter ~ h111 Did the object move behi~d something at any time, particularly a cloud? ( C i rc:le One): No Don't Know. IF you answered YES, then tell what it moved behind: Did the object movt~t in front of something at any time, particularly a cloud? (Cirele One): Don't Know. IF you answered YES, then tell what in front of: Tell in a few words the following th inqs about the object: We wish to know t he o~gu la r s ' ze. Hold a match stick at arm's length in I ine with a known object and note how much of the object is covl!rl!d by the head of the match . If you had performed this experiment at the t ime of the sighting, how much of the obiect would hove been coverl!d by the match head? .. One furtll. 19. Draw o picture tt1at wi II show the shape of the object or objects. Label 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. 27. In the following slcetct,, imagine that you are at the point shown. Place on "A" on the curved I ine to show how high the obiect was above the horizon (slcyline) when you lirst saw it. Place a ,.B" on the some curved line to ahow how high the obiect was above the horizon (alcyline) when you lost saw it. Place on "A" on the compass when you lirst sow it. Place a "B .. on the compass where you last sow the object. 28. Draw a picture that w i II show the motion that the object or objects mode. Place an "A" at the beginning of th path, a "B" ct the end of the path, ond s!au-. .:.ny =:nanges in direction during the course 29. IF there was MORE THAN ONE object, then how many were there? ------------ Draw a picture of how they were arranged, an.:J put an arrow to show the direction that they were traveling 30. Have you ever seen this, or o similar object before. If so give dote or dates and location. 31. Was anyone else with you at the time you saw the object? (Circle One) 31.1 IF you answered YES, did they see the obiect too? (Circle One) 31.2 Please I ist their names and addresses: 32. Please g~ve the follawing infermation about yourself: Middle Name 1..0st Narne TELEPHONE NUMBER _ .; Indicate any additiona! information about yourself, incl udi ng any special experience, which might be pertinent 33. When and to horr. did you report that you hod seen the o~ject? Wr1pt-Patteraon An, Ohio 45433 1QU.r 1n14ent1t1ec! obaervation or 1 April 1966. T.be 1atormat1on 1D your letter waa not autticient tor ~ tion. Requeat you com.plete the attached 1'i1> Fo ... xa 164 and .return it 1D the envelope provided . we viah to thank 10U tor the Air Poree . ins your observation to . . Chiet, gJilf"...ANIIJ,A, Jr, Major, Plvjeet Blue Book