1. DATE TIME GROUP 4. NUMBER OF OBJECTS PROJECT 10073 RECORD 2. LOCATION New Carlisle, Ohio 10. CONCLUSION Astro(Moon) 155 Az-20 Elevation @ 0535Z 5. LENGTH CJF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS Few minutes 6. TYPE o:: OBSERVATION Ground Visual Is. ?HOTCS 9. PHYSICAL EVIDENCE Observer noted bright light in sky at 003 5. The object was visible tor several minutes then disappeared be8ind some clouds. From noted location ot sighting in sky, the moon should have been visual between the scattered FTD SEP63 0329 (TOE) Prnloued!Uoneofthlefonamp'"u .. d 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 phenomenore that you have observed. Please try to answer as mc;my questions as you possibly can. The information that you give will be used for research purposes. Your ~armt will aot be used in connection .with any statements, : concl~sions, or publications without yolJr permission. We request this personal informatJon so that if it is deemed necessary, we may contact you for further details. 1. When did you see the object? Time of day: Month Year 3. Time Zone: (Circle One): a } c. Mounto!n d. Pocifi: 4. Wherre were y ou when you sow the object? (Circle One): a. Daylight Sovinir. b. Standard -.. (Circle One): Nearest Postal Addreaa City or Town State or County 5. How long wos object in sight? (To,::l Duration) o. Certain b. Fairly certain c. Not very sure ~ Just a guess Minute a Second 5.1 How wcs t i :ne in sight determined? ------------------ 5.2 Was o!lje~t in sight continuously? 6. What was the c~:'ldition of the sky? 7. IF you sow the object during DAYLIGHT, where was the SUN located as you looked at the object? (Circle One): a. In front of you b. In back of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thle form auperudee FTD 164, Jul 61, which Ia obsolete, /.~ :. t r tJ ( i"" f) ' '"\) 8. IF you sow the object at NIGHT, what did you notice concerning the STARS and MOON? STARS (Circle One): 8.2 MOON (Circle One): a. Bright moon I ight . . b . Dull moon I ight . d. Don't rememoer--: - Don't remember . 9. What were the weather conditions at the time you saw the obiect? CLOUDS (Circle One): WEATHER (Circle One): a. Clear sky ~ scait8redj Thick or heavy clouds -r.-F~g, mist, or light rain c. Moderate or heavy rain e. Don't remember The object appeared: (Circle One): - d. As a l ight T ron sparer: t e. D::~ t remember If it appeared as a light, WQ.S it bri~t.e: than the brightest stars? (Circle One): 11.1 Compare brightness ta some common object: 12. The edges of the object were: (Circle One ): c:. Fuzzy or blurred b. Like a bright star e. Sharply out!~ d, Don't remember 13. Did the object: a. Appear to stand still at any time? b. Suddenly speed up and rush away at any time? c. Break up into parts or explode? Give off smoke? Change brightness? f. Change shape? g. Flash or flicker? h. Disappear and reappear? (Circ:le One for each question) 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. Did the obiect disappear while you were watching it? If so, how? 15. Old the oh!ect move behind something at any time, particularly a cloud? Don't Know. IF you answered YES, then tell what (C ire /e One): ( Yes Did the o~ject move in front of somethina at any time, particularly a cloud? (Circl~ One): Yes /No' Don't Know. IF you answered YES, then tell what 17. Tell in a few words the following m in;s about the object: 18. We wish to know the angular size. Hold a match stick at arm's length in line with a known object and note how much of t he object Is covered by the head of the match. If you had performed this experiment at the time of the sighting, how much of the object would have been covered by the match head? 19. Draw a picture thot will show the shape of the object or objects. Label and include in your sketch any detulls 1~ of the obj~et r;,ot you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an Cl~?w beside the drawing to show the d irection the object was moving. 20. Do you think you con estimate the speed of the object? (Circle One) Yes ~) IF you answered YES, then what speed would you estimate?------- 21. Do you think you can estimate how for away from you the object was? (Ci rcle One) Yes IF you answer~d YES, then how for away would you say it was?--------- 22. Where were you located when you sow the object? (Circle One): 23. Were you (Circle One) a. In the business section of a cityt .... ~Inside a buildi~ b\..'ln the residen~- ction of a city? ) b. rna("ur c. In open country side? - c. Outdoors d. Near an airfield? d. In on oirp:cne (type) e. Flying over a city? f. Flying over open country? 24. IF you were MCVING IN AN AUTOM061L!: or other vehicle at the time, then complete the following questions: 24.1 Whot direction were you moving? (Cirele One) b. Northecst d. S::>utheost f. Southwest h. Northwest 24.2 How fast were you moving? _.miles per hour. 24.3 Did you st~p at any time while you were looking at the object? (Circle One) Did you observe t;,e ob ject through any of the following? Eyeglasses No e. Binoculars Telescope Yes No Windshield g. Theodolite Yes No Window glass 26. In order that you con give as clear a picture as possible of what you saw, describe in your own words a common object or objects which, when placed up in the sky would give the same appearance as the object which you saw. 27. In the following sketch, Imagine that you are at the point ahown. Place an .. A" on the curved line to show how the object was above the horizon (skyline) when you lirst saw it. Place a "B" on the same curved line to ahow how h igh the object was above the horizon (skyline) when you lost sow it. Place an " A" on the compass when you fir~t saw it. Place a "8" on the compass whereyou lost saw the object. 28. Draw a p i: ture that will show the merion that the object or objects made. Place an "A" at the beginning of the path, a ''B" at the end of the path, end show any changes in direction during the course. 29. IF there was MOR~ THAN ONE cbj~ct, then how many were there?---------- Draw a pi:tu~e cf hew they were arranged, and put an arrow to show the direction that they were traveling 30. Have you ever seen this, or a similar object before. If so give dote or dotes and location. 31. Was anyone else with you at the.time you saw the object? (Circle One) 31.1 IF you onswered YES, did they see the object too? 31.2 Please _list their namei and addresses: (Circle One)_. 32;! Please give t!-:e following Information obout yourself: , Yes ' No First Nome Zone State T:.: LE PHONE NUMBER Indicate any odc!itional information about yourself, including any special experience, which might be pertinent 33. When and to whom did you report that you had soen the object? Day T Month Year 34. Date you completed this questionnaire: 35. Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting.