1. DATE Tlit4E GROUP 3. SOURCE 10. CONCLUSION Civil:.: . .-: . Astro (liETEOR) ./ U 4. NUUBE R OF OBJECTS S. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS 2 -10 Seconds 6. TYPE O F OBSERVATION Object went straieht down ldth a vapor trail. bright as a 100 \'tatt bulb. Round yellow and disappeared behind trees behind hruse. 1 Grow1~-Vis a. PHOTOS . 9. PHYSICAL EVIDENCE FTD S E P 6:! 0-329 (TOE} p,..Ylou ecUUon of thle fCAa .. , b. ueed. Appear ed a s oranee. Object U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force as much informc:t ion as possible concerning the unidentified aerial phenomenon that you have observed. Please try to answer as many question~ as you possibly can. The information that you give will be used for research purposes. Your name will aot be used in connection ~ith any statements, cone Ius ions, or publications without your permission. We request th.is personal information so that H it is deemed necessary, we may contact you for further details. 1. When did you see tho object? 2. Time of day: (Circle One): 3. Time Zone: (Circle One): Ca:) Eost~rn b. Centre! c. Mou;:tain d. Pcc ii ic (Circle One): a. Daylight Saving b. Standard 4. Where w~r~ y ou when you saw the object? City or Town State or County 5. How long w~s objoc1 in sight? (ToMI Durotion) Hour a Minute a Second a = Certain c. Not very sure (9 Foirly certain d. Just a guess 5.2 Was obj~cT in sight continuously? 6. What was th~ : o.,d i t ion of the sky? r--ti;) Bright 'li: Cloudy 7. IF you sow the object during DAYLIGHT, where was the SUN located as you looked at tho object? (Circle One): a. In front of you b. In bode of you c. To your right d. To your leh e. Overhead f. Don't remember FTO OCT 62 164 Thla form aup .. raed .. FTn 164, Jul 61, whlcll Ia obaolete. 8. IF you saw the ob1ect a NIGHT, what did you :1otice co~ceorning the ~TARS and MOON? 8.1 STARS (Circl~ Or.eJ: Don't remember 8.2 MOON ( Circlt! On~): G Bright moonlight '6. Dull moonlight c. o moonlight -pitch dark d. Don't remember 9. What were t h e wenther :-onditinns at the time you saw the object?.- CLOUDS ( C ircle O,n ): rei) Clear skv '--D: Hazy c. Scattere~ claude d. Thick or heavy ci:Juds 10. The object c:~oeared: fCirclt! on~): WEATHE~ (Circle One): Y. Fo~, .,;:at, or light r:1in c. ModertJt~ nr heavy rain e. Don'~ rt!..,t-mber b. Tron,oer~nt @As o light. e. Don't remember 11. tf it oppeor os a ligh~, was it brighter than the brightes t Ftors? (Circle One); ~ s~ighter o. D immer c. About the so.,(' d. Don't know 11. 1 Comp ::re brightn.,ss to some common object: 12. The edges ot the obif'ct were: (C ircl~ One): a. Fuzzy or blurred ;f)L ik,. r briyht stor c. S~arply outlined d. D~r'' remel"'''ber 13. Did the objec! a. Appear to sto:"~"d still nt nny tim~? b. Suddenly S::>e'!'d up and rush away at any time? c. Break u::> into ports or ~xolode? d. Give off s..,o '? e. Chonge bri~!.,'!'ss? f. Change sh~l)e? g. Flash or f l ;elcer? h. Disappear or.d r,.appeer? 14. Did the obiect disappear while you were watching it? If so, how? 15. Did the obj~ct mcve behind something at any time, particularly a cloud? (Circle One): Don't Know. IF you answered YES, then tell what 16. Did the object move in front of sorne~hing at any time, particularly a cloud? (Circle One): Yes_ ~ Don't Know. IF you answered YES, then tell what 17. Tell in a f~w words the following things about the obiect: 18. We w ish to bow the angular size. Hold a match aticlc at arm's length in line with a known obiect and note how of the o~ject 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 be.n covered by the match head? Draw a picture tnat will ahow the shape of the obiect or obiects. 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 on arr~w :,.side the drawing to show the direction the object waa moving. 20. Do you thinlc you can estimate the speed of the object? (Circle One) IF you answred YES, then what speed would you estimate? ------- 21. Do you think you can eatimate how for away from you the object was? (C irele One) IF you answered YES, then how for away would you say it was? ------~--- 22. Where were you located when you saw the object? 23. Were you (Circle One) . (Circle On): a. In the business section of a city? c~;lnside a buil.ding 6. In a cor c. Outdoors d. In an a irplane (type) b. In the residential section of a city? (!} In open countryside? cl. Near an airfield? e. Flying over a city? f. Flying over open country? 24. IF 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. Norrl1 c. East e. South g. West b. Northeast d. Scutheast f. Southwest h. Northwest 24.2 How fast were you moving? miles per hour. 24.3 Did you stop at any time while you were looking at the object? (Circle One) Did you o~serve the obiect through ony of the fol.lowing? a. Eye;leues Binoculars Sun glcsses Wind sl, i a-ld g. Theodolite Yes d. Window g loss 26. In order that you can 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 followin; slcetch, imagine that you are at the paint shown. Place on "A" on the curved line to show how high the obiect wos above the horizon (skyline) when you lirst saw it. Place a .,S" on the same curved line to show haw high the object was above the horizon (skyline) when you lost saw it. Place an "A" on the cornpass when you firs: :ow it. Place a "B" on the compass where you last saw the object 28. Drew a picture that will show the m:~tion that the object or obiects made. Place an ,.A" at the beginning of the p::th, a ''B" ct the end of the poth, end ~1,u._ ~ny changes in direction during the course. 29. IF there was MORE THAN ONE object, then how many were there? ---.J.4bll~6;tt _ Draw a pic:t\.1:-e of hew they were om:nged, and put an arrow to show the direction that they were travelin;. 30. Have you ever seen this, or a similar obiect before. If so give date 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 object too? (Circle 'bne) 31.2 Please I ist their names and addresses: 32. Please give the following information about yourself: TELEPHONE NUMBER Indicate any additional information cbout yourself, including any special experience, which might be pertinent 33. When and to whom did you report that you had seen the object? 34. Date you completed thia queationnoire: 35. Information wnich you f .. l pertinent ond which is not adequately covered in tne specific points of the questionnaire or a narrative explanation of your sighting. /-(J)tl OOCJ{) Th0 clescr:. pt.ion :1nd tine o:t s:i. r:hting coincides \Ti t h t:1. bright moto~e\rllich Hc.s s e e n ir. ~:.c Colt'Jnbus, L.:;c::bonrnc .!u i :=t.reo.. /l?eret~,e 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 oerial phenomenon that you hove observed. Please try to answer as many questions as you possibly con. The information that you give will .. be used for research purposes. Your name will ltot be used in connection with any sta,ements, coneb s ions, or publications without your permissian. We request this personal information so that if it is deemed necessary, we may contact you for further details. When did you see the object? 2. Time of day: (Circle One): Time Zone: (Circle One): f. (Circle One): o. Daylight Saving Central b. Standard . c. Mount::in d. Po:ifi~ 4. Where were y01.1 when you sow the !:>bject? City or Town State or County 5. How long w~s object in sight? {Totol Duration) a. Certain c. Not very sure b. Fairly certain d. Just a guess How was time in sight determi:"led? ----------------------- Was oo,~et in sight continuously? 6. What was the ::mc!ition of the sky? o. 'iright b. Cloudy b. Cloudy 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 bock of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 6:Z 164 Thle form eupereed .. Fm 164. Jul 61. whlc:O. 1e obeolete. 8. tF you saw the obtect a NIGHT, what did you notice co-ceorning the STARS and MOON? STARS (Circle Or.e): 8.2 MOO~ (Circle One): a. Bright moonlight b. Dull moonlight c. ~'o mo~nlight ....,. pitch dark Don't remember d. Don't remember 9. What were the wenther =onditinns at the time you sow +he-object? CLOUDS (Ctrcle O.,n): WEATHEP\> (Circle One): a. Clear s<v b. Fo~, ..,i:it, or light r:lin Scctter~d cloudc Moder11t~ ~r heavy rain Thick or heavy chuds Don'~ re..,l'!mber 10. The object oooeared: fCirclt: One): a . Solid d. As a I ight D~ Transoorent e. Don't remember 11. If it cppeor~d as a ligh~, was it brighter than the brightes+ !'tars? (Circle One): o. Bri~hter c. About the sa'Tl(' d. Don't know 11.1 Compere brightn"tU to some common object: 12. T e edges of the obic:t were: (Circle One): o. Fuuy or blurred b. Likl!' r briynt stor ..-e, Sl-:arply out I ined Did the object: Appe.:~r to stend still nt nny time? Suddenly soeed up and rush away at any time? Break uo into pnrts ~,. exolode? Give off s,.,o:.. Chon;e b!t;""''!'ss? Change shope? Flash or fl idcer? Disappear or.d r~appecr? (Circle 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 object disappear while you were watching it? If so, how? 15. Did the object move behind something at any time, particularly a cloud? (Circle One ): Don't Know. IF you answered YES, then tell what 16. Did the object move in front of somethi ng at any time, particularly a cloud? (Circle One}: Don't Know. IF you answered YES, then tell what 17. Tell in a ;ew words the following thin;s about the object: We wish to lcnow the angular abe. H~ld a match stick at arm's length In line with a known object and note how much of t he ebject is covered by the heacl of the match. If you had performed this experiment at the t ime of the sighting, ho-. much of the object would have been covered by the match head? 19. Draw a picture tn~t will show the shape of the obiect or objects. Label and include in your sketch any details of the object tno~ you saw such cs wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an crro'W ceside the drawing to show the direction the object was moving 27. In the following slcetch, imagine that you are at the point shown. Place an "A .. on the curved line to show how high the object was above the horizon (slcyline) when you lirst saw it. Place a "8'' on the same curvd line to show how high the object was above the horizon (slcyline) when you last saw it~ Place an "A .. on the compau when you lirsr saw it. Place a "B" on the compaas where you last saw the object. 28. Draw a pictur~ that will show the motion that the object or objects made. Place an "A" at the beginning of the path, a "B" c:t the end of the path, ond s!'u"' ~ny changes in direction during the course 29. IF there was MORE THAN ONE obj.ct, 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 object before. If so give dote or dates ond location. 31. Was anyon~ else with you at the t ime you saw the object? (Circle One) 31.1 IF you answered YES, did they see the object too? (Circle one) Yes 31.2 Please li 32. Please give the following information about yourself: Firat Name City Zone State TELEPHONE NUMBER Indicate any additional informatior'l about yourself, including any special experience, which might be pertin~nt. 33. When and to whom did you report that you had seen the object? U. Dot you completd thia queationnoir: 35. Information which you f .. l pertinnt and which is not adquatly covrd in th specific paints of the questionnaire 01 a norratlv xplonation of your sighting. /1 (rO i3 bJ Ci vil t-.ircre.1"'t '\oter e cr::ri ving und dopt .rting l'or t Col tunbus h.irport on the dP-t 9s / ti::-.. :..s indicated. Dc~cri~Jt:i.onn :-:;d dir3ct~.ons of si~h-~ings t i e i n l rith Ci-:1.1 :~:rcr!ft n)~aro:c::.ng l.,ort Colu..'~'~lous. ~ms b. 3ALLStiTH Capt. , USAF