al? o.rcd solid and h~ci distinct round ~.,_.., "' ........ con::;istent \vi th that of a meteor sichting . U.S. AIR FORCE TECHNICAL INFORMATION Thi s questionnaire has been prepared so that Y.ou can give the U.S. Air Force as much on os possible c.oncerning 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, conc::lu.sions, or publications without your permission. We request this personal Information so thct if i t is deemed necessary, we may contact you for further details. 1. When did you see the object? 3. Time Zone: (Circle One): ( a-. t:a;t;rr;-:, ~. Mount::h d. Pacific Hour Minutes (Circle One): (Circle One): (a-:-Dayligflt 'S"aving ~;; Stondar<f - 4. Where were you when you saw the ob ject? S'OU Tf/ f1A!AI f?D, Nearst Postal Address 5. How long wcs object in sight? (Tctol Duration) a. Certain b. Fairly certain City or Town c. Not very sure Just a guess.. State or County / Minutes Seconds 5.1 How was ~l~e in sight determined? ------------------ 5.2 Was obiec~ in s ight continuously? 6. What was the c::mdition of the sky? 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? (Circle One): a. In front of you b. In bac:k of vou c. To your right' d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thla form auperaedea FTO 164, Jul 61, which Ia obsolete. 8. IF you sew the object at NIGHT, what did you notice concerning the STARS and MOON? STARS (C ircle One): MUON (Circle One): r a : - None . Bright moon I i ght b. Dull moon I ight b. A f!!W No moonlight -pitch dark d. Don't remember d. Don't remember 9. What were the weather conditions at the time you sow the object? CLOUDS (Ctrcle One}: a. Clear sky C.Sea_t_t _e _re-:2-. c T~s. ;c--riiTc1<0r-n eavy .... c I oud s 10. The object o:Jpeared: (Circle One): WEATHER (Circle One): b7" Fog, mist, or light rain c. .~oderote or heavy rain e. Don't remember a. Soli d d. As a light b. Tr;:,:upor~nt e. Don't remember 11. If it appeare d os a light, was it brigi"iter than the brightest stars? (Circle One): c. About the some d. Don't know 11.1 Compare brightness to some common object: 12. The edges cf -:-h e object were: (Circle One l: o. Fuzzy or blurred b. Like a briuht star c." Sliarply - i"in~d ci. !:5on~r remember Did the object: (Circle One for each question) a. Appear to stand still at any time? Don't know b. Suddenly sc-eed up and rush away at any time? Don't know c. Break up into pa!"tS or explode? Don't know d. Give off s moke? Don't know e. Chonge bri~htness? Yes Don't know Change shape? Don't know g. Flash or flicker? Don't know Disappear end reappear? Don't know Did the object disappear while you were watching it? If so, how? Did the o bject move behif"d something ot ony time, particularly a cloud? . (Circle One): Yf'!~ ("No 'l Don't Know. IF you answered YES, then tell what it moved behind: 16. Did the o b ject move in front of s o me th ing at any t ime, particularly a cloud? (C ire le One): Yes Don't Know. IF you answered YES, then tell what Tell in c few words the following th ings about the object: 18. We wish to know the angular s ize. Hold a match stick at arm's length in line with a known object and note how the object is covered by tiTe head of the match. If you had performed this experiment ot the time of the sighting, how much of the object would hove been covered by the match head? 19. Draw a picture th at-will show t he s ha pe of the object or objects. Label and include in your sketch any details of the object thot you saw such o s wings, protrusions, etc. , and especially exhaust trails or vapor trails. Place on arrow bes ide the drawing to sho w the direction the object was moving. 20. Do you think you can estimate the speed of the object? (Circle One) Yes IF you answer~d YES, then what speed would you estimate?---- -- 21. Do you th ink you can estimate how far away fr~m you the object was? (C i rcle One) Yes IF you answered YES, then how for away would you say it was? --------- 22. Where were you located when you sew the object? (Circle One ): 23. Were you (Circle One) a. In the business section of a city? (~")n ope,!" countrysid,) d. Near an airfield? e. Flying over a city? b. In the residential section of a city? a. Inside o building b. In a car ~ c. Outdo2:J: d. In a~ a irplane (type) f. Flying over open country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the t ime, then complete the following questions: 24.1 Wha t ~ irection were you movin;? (Circle One) c. t:cst e. South g. West N:!rtheast d. Southeast f. Southwest h. Northwest 24.2 How fast were you moving? .miles per hour. 24.3 Did you stop at ony t ime while you were looking at the obiect? (C ire /e One) Yes Did you observe t he object through any of the following? Eyeglcs ses No e. Binoculars Sun g losse s Yes Windih ield Yes Theodolite Window class 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 some appearance as the object which you saw. 27. In the following slretch, imagine that you are at the point shown. Place an "A" on the curved I ine to show how the objec t was above the horizon (skyline) when you first saw it. Place a "B" on the same curved line to 1how how high t he obj~ct was above the horizon (skyline) when you last saw it. Place an ... A" on the compass when you f i rs t sow it. Place a "B" on the compass where you last saw the. object, j._C C (\ u tl t-It s.:7 Pft Crt 28. Draw o p ictur!! that will show the mction that the object or objects made. Place an "A" at the beginning of the path, a " B : t the end of the path, ond situ~ llny changes in direction during the course. 29. IF there was MORE THAN ONE object, then how many Vlere there? ----------- pictur~ 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 object before. If so give dote or dates and location. 31. Was al"yon~ e lse with you at the t ime you saw the object? (Circle One) No 31.1 IF y~u answered YES, did they see the object too? (Circle One) 32. Please gi ve the fallowing information obout yourself: Indicate o ny cdditional informotior. about yourself, including any special experience, which mit;H be pertinent. When and to whorr. did you report that you had seen the object? Month Day Year ;.1 ILL.' VV Gt:-.' oV I P;J 34. Date you completed this questionnaire: 35. Information which you fHI pertinent and which is not adequately covered in the specific paints of the questionnaire or a narrative explanation of your sighting. F'TD (TDBW) ~riabt-Patterson AFB, Ohio 45433 llev Jersey o8 36o Reference your recent unidentified obaervation. The informa- tion vhicb we have received is not suf~icient ~or evaluation. Request you complete the attached Fl1> Form 164 and return 1 t in tbe envelope provided. We wish to thank you for reporting your observation to the Air Force Sincerely, Esx:TOR g,JINTANILI,A Jr, Major, USAF chief, Pl oject Blue Book