c. NUMl\ER OF 06JECTS s. LENGTH OF OSSERVATION b. TYPE OF OBSERVATION 8, P HOT OS 9. PHYSICAL EVIOENCE ; ~. LOCATION 10, CONCLUSION 11. 8RIEF SUMMARY AND ANALYSIS Connirl~rit': l'.L: vd.lh}t;": ; _'lfOl'h'l.tin:1 t.hc r o j~ no t' tifildtc FTD SEP63 0-329 {TOE) p,.toaaeclltJOfleotthletona .. ,~u 30. Have you ever seen this, or a similar object 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 g ive the following information about yourself: F lrat Name , Mldcf le Name Zone State tndiccte any additional information about yourself, including ony special experience, which might be pertinent When and to whom did you report that you had seen the object? 34. Date you completed this questionnaire: Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative exp.lonation of your sighting. ilt'l...t.; (~) S:-,r ==: . s:-i'":T, CY:...r ....... ~ICt~L 3 ULLET POI:JTED ON SOTH ENDS. (:,) co_r,.-:: YC..LLO. LI T, HI\ZY AT EOGE: aRIGHT INNER PORTION . :LU.: L: ::>i1: :r~ '. ( , REFL~C T r '-.iG ALOI\10 OUtER EOGE OF OSJECT ( D H~L Y) OUT- LIN ... JG ;::u.;:. > .:)~R:'\' :n :.:~' c LA\.:K' VEf~TICAL LINE DIVIOii\IG OBJECT T ,,:: , SEEI"'I NGLY I N EXTREMEL. Y CLOSE Ft-:,,7 ?\ES J-\rIJ u::TS:.Ii...S : LIGHTS t,l\!C DI~i OUTLINE OF THE c~ULL~.:.T Si ~.F.:.G t:\:J:5r :;-:rc:-1 T::..:AVELED PARALLEL TO GROU:-.ID ~'liTH SMALL I c;-1 T I ,t_: T!-IS THAI L I 'JG END C lii TH BLUE LIGHT) (:.>) c:. '-'~:T 1:LSi~Pr;t: .. ~lt:.:n F;:;J ( . SIGHT eEHIND A BUILDING' 227 (FIRE S TATION) GOODFELLOW AFB Cl> .. EJ.-!.:r: T 2.2;JQ ,-;~s L.OCf-;L i'iAS: 5URFACT-180/i~-5 KNOTSr H--S LOCAL :-; . ,o ~:>Tr-=.:::? lJ . . uSUAL ACTIVITY O:=t CONUITION KNO\iN \\fHICH MITHS .l\CCJUt'~T Fo.:; T,-._::: ;1Gi-iT!I'iG. J. Ll ) i'(Sl fi:''' TlTL~ OF ?HEPJ\R li,!G OFFICER: OPERATIONS DUTY c~=F I c::. ~. L?.) C J i _ 1;: 0;352:t~ v:::~ U. ISI...IRE tF I) r STANCE OF OBJECT' CLO !~L 1-\I,~,:::,.;."J) ?;~o~UCc!) rJEGATXVE: ~t:SULTS t N ANY FLYING ~CT.~V.( i'{ .'\"!' T:.:S TI..;:::. f~ Hhi.)J OSO:'I!CE: Bll.LLOON HAD BEEN RELEASED 0:\ ,n;: 2tf-;JtJ.,.: ~\T 2.020 H~S LOCi~t.. N01ENCLATUKE OF 8ALLOON: ... L-~)37/U:.:. _,hL!..CO!'I r~UfST AT lo::>,OOO FT, \'liTH 20 :JtiNUTE U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force as much ormation 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 name will not be used in connection with any statements, conclu s ions, or publications without your permission. We request th is personal information so that if it is deemed necessary, we may contact you for further details. 1. When d id y o u see the object? 3. Time Zone: (Circle One): a. t:ostern c. t.Aour.~oin d. Pacific 2. Time of day: ------ (C irc/e One): (Circle One): a .. Daylight Saving ~ _ Stan~r.d' 4. Where were you when you sow the object? Neorest Postol Address City or Town 5. How long was object in sight? (Totol Duration) :'~. Fairly eertai~ How wos t ime in sight determin~d? Was object i n sight continuously? 6. What was the condition of the sky? b. C loudy Not very sure Just a guess a :. B.rigbt'"' Stote or County 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the obj&ct? (Circle One): a. In front of you b. In back of you c. To your r ight d. To your left e. Overhead f. Don't remember Thl f Ot'm "UO~f'fl ......... F m 1114 . Jill , I, whlc !l , . Obllolete 8. IF you saw the object at NIGHT, what did you notice cc-~.cNning the 5 TARS and MOON? 8.1 STARS (Circle One): Cf. D~!'l't remember 8.2 MOO~ (Circle Onf! ): a. Rright moon I ight . b. Dull moonlight f-~o. moonlight -pitch dark (d. Don't remember-) 9. What were the weather conditions at the time you sow he-object? CLOUDS ( Ct:cle One): (a. Clear sky') c. Scattered ~loud~ d. Thick or heavy cbuds WEATHER (Circle One): b. Fog, r.,i:;t, or light r~in c. Moder'lt"' t~r heavy rain e. Don'~ r~..,Pmber . 10. The object ~ppeared: (Circle One): ( a. Solid' e. t . e mem er 11. If it appeo .: as . ..e_ ligh~, was it brighter than the brightest ~tors? (Circle One): ( a. Brighter c. About the sa'Tlc- '--s;-~ d. Don't know Compere br ightn.,ss to some common object: 12. The edges of tho obiec:t were: (Circle o . .,e): o. Fuzzy or blurred b. L ik~ r. bri~ht star c. Sharply o~tli .) 13. Did the object: (Circle One for eoch question) a. Appear to stand still nt any time? . Suddenly speed up and rush away at any time? c. Break up into par:~ or ewolode? . l. {. e. Change bright.,~ss? ,. f. Change shape-? g. Flash or flicker? Disappear and '"app~cr?. Don't know Don't know Don't know Don't know Don't know Don't know Don't know Don't know , / 15. Did the object move behind something at any time, particularly a cloud? (Circle One): Don't Know. IF you answered YES, t hen tell what it moved behind: 16. Did the o b ject mov e in front of something at any time, particularly a cloud? (Circle One ): Yes Don't Know. IF you answered YES, then tell what Tell in a few words the followin g things about the object : We wis h t o lcno~he a ngular s~ize. Hold a mot~ stick at arm's length in line with a known object a nd note ho w the object is covered by t h e head of the match. If you had performed this experiment at the time of the sighting, how much of the object would hove been covered by the match head? (:.'- Draw o pietu,e that will show the shape of the object or objects. Lobel and include in your sketch any details of the object that y ou s ow s uch os wings, protrusions, etc., and especially exhaust trails or vapor trails Place a n orro-w ~side the drawing t o show the d irection the object was moving.