1. ATE TIME GROUP 4. NUMBER OF OBJECTS 5. LENGTH OF OBSERVATION 5 -1 minutes f--4.Jt"VAV I 6. TYPE OF OBSERVATION Ground Visual 9. PHYSICAL EVIDENCE PROJECT 10073 RECORD 2. LOCATION Middletown, Obio 10. CONCLUSION Aircraft {possible) 11. BRIEF SUMMARY AND ANALYSIS Oboerver noted object 1n the south which appeared as a light, being about 20 times brlp,hter thnn ll s tar. There was also a roar hcnrd. 'l'hc ob ,)ect woo in the south then stopped, then NE - W -S. The wllt.te color went out and suddenly two sanll red dots apJ>CAred. U.S. AIR FORCE TECi1NICAL INFORMATION This questionnaire has been prepared so thor you con give the U.S. Air Force as much information as possible concerning the unidentified aerial phenomenon that y o u hove observed. Please try to answer as many questions as you possibly con. The information that you give w i ll be used for research purposes. Your nome w i ll not be used in connection with any statements, conclusions, or publications without your permission. We request this personal information so that if it is deemed necessary, we may contact you for further details. 1. When did you see t 'le o b ject? 2. Time of day: ------ Hour Minutes (Circle One): T ime Zone : f C i rcle One ); a. t:astern (Circle One): a. Daylight Saving b. Standard c. Mountain d. Pacific J Where were you when you sow the object? C ol y o r T o w n State or County 5. now long was obtec , "1 ;..ght? (Total Duroonl a. Certa;., c . '~at very sure b. Fcrr ly cerro i"l d . Justo guess 5.2 'N-:Js object 1:1 sight continuously? 6. What wcs tne condit ion of the sky? 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? (C~rcle One): a . In front of you b. In bock of you c. To your r ight d. To your left e. Overhead f. Don't remember FTO JCT6l 164 ~. IF you s o w t he ob1ect a t N IGHT, what did you notice concerning the STARS and MOON' STARS (Crrcle One): MOON (C~rcle One): o. Bright moonlight Dull moon I ight No moonlight -pitch dark Don't remember Don't remember 9. What were the weather conditions at the time you sow the object? CLOUDS (Circle One): o. Clear sky c. Scattered c I oud s d . Thick or heavy clouds WEATHER (Circle One): b. Fog, mist, or I ight rain c . Moderate or heavy rain e. Don't remember 10. The object appeared: . Circle One ): b. Transparent I f i t oppeorea ~s ~ 1;'1 , o. Brghre r b. D1nn-e r ~. As a light e. Don't reiT'ember t brighte r tho~ r'1e brghresr :;rors' ( C ircle One ): c. About tn e some d. Dcn'r '<l'low .11.1 Compare :lfl~nrness t~ some common ob1ect: 12. The edges of the cbjec oere (C,cle One ) o. F:..tzy or blurred b. L !Ke o b r ight star c . Sharply outlined d. Don't remember 13. D id '"e ocect : (Circle One for each question) Appear to stand still a t any t ime ? Yes No Don't know Sudcer ly soeed uo ond rush away at al'ly t1me? Yes No Don't know orea< u p inro ports or explode? Yes Don't know Give of' smoke? Don't know Change !:lrigh tness? Yes No Don't know f. Change sl,ope? Yas No Dont know Flash or flicker? Yes No Don't know D i soopeor and reappear? Yes No 14. D td the obtect disaooeor whtle you wl!!re watching i t ? If s o , how ? 15. Did the object move behind something at any time, particularly a cloud? (C,rc le One): Ye~ Don't Know. IF you answered YES, then tell what ved behind: 16. D id t h e objecT mov~ n f ront of something a t any time, particularly a cloud? (Circle One): Don't Know. IF you answered YES, then tell what in front of: 17. Tell in a few words tne follow1ng things about the object: io. We wtsh to o<now the angular s ze. Hold a match st1ck at crm's length in l1ne w i th o know n obtect and note how much of tr.e d~1ect :s ~::Jv~red by the head of t"'e match ' f you hod perfor.,~d this experiment at the time of the sighting, how ';'IUCh o r the '.:>bject would hovo Seen covor'td by tht'l match head? 19. Draw c ;>icrure ,or w d l srow the shape oi tne vbp!ct or obtects. Lobel and include rn your sketch any details of the ooject th= vou s~w suc!-1 as wings, protrusions, etc., and espec1ally exhaust trods o r vapor trails. Place o;-; c rrow tesid e r~e drawing to show rhe direct1on the object was moving. 20. Do you think you con e s t1mot e th e spee d of the ol>tect ? IF you answered YES, then what speed would you est1mote? 21. Do you think you con estimate how far a way from you the objec t wa s ? ( C i rcle One ) Yes No IF you answere d Y!:S, rnen how for away w ould you say it wa s ?--------- 22. Where were yo1. loc ::ted whe n you saw the object? (Circle One): a . Inside a bu;lding d. In an a irolane (tv:>e' _23. Were you (Circle One ) 24. IF y o u were MOVING I'- .lN ~UTOMOBILE o r othe r vehicle at th e t ime , th e n complete the fallo w ing q uestions: 2-1. I What darection ICVing? (Circle One) North c . Eos r e. South g . West b. North"!OS t d. Southec st f. Southwest h. Northwest How fos1 ...,ere vO(. miles oe r hour . 2-1.3 Di d you -;op ::r or.v :....,e while you were looking or the obje c t ? (Circle One Yes No Did you observe the oo ~c ';rough a ny of the following? a. Ey e glasse s e. Binoculars Sun glosses Telescope Yes No Windshie ld Ye s No g. Theodolite Yes No d. Wend o w gloss Yes 26. ,., orde r that o v con give ::J::> :::l~or.:: ;:>1cture os possible of .... hot you saw, -lescribe in your o wn w ords a c o mmon "'btect or obtects Nhich, when place d up in the sky, would give the some aopeara nce a s the o b je c t which you saw 27. In tho followtn g s:Cetch, imagine that you oro at the poin t shown. Place on "A" on th e curved ltn e to show h ow tho obje c t was above the horizon (skyline ) when you ftrst sow i t . Place a "g" on the s ame curv d line t o show how htgh th e obje c t wa s above th e hor izon {skyline ) whe n you lost s ow it . Pbce on "A" on the compass when you flfst sow it. Place o "B" on t h o compass where you lost sow t h e ob1ect. 28. Orow a p tc ture that N 'I s -:::w the motion that the object or objects mode. Place on ''A " a t the beginning of tn path, a "B" a t tne er::: :: - e :)Oth, ond s,v .... ny ::honges tn direclton dur ing rh e course. 29. IF there wo~ MORE Tr,.l" Jt'.E object, the n how many were there? Draw a ptcture of l..ow --... ~"!e :~rronged, on.:! out on a r row t o show rho direction thor tl, e y were traveling . 30. Hove you ever see n this, oro s1milor obrect before. If so g1ve dote or dotes and location. 31. Was anyone else with you at the t ime you sow the object ? ( Circle One) Yes No 31.1 IF you answered YES, did they see the object too? (Circle One) 31.2 Please I ist : he ir names and addresses: 32. Please g ive t he follo""..,g ,., . ,motion O;:)cu: yourself: F ~rst Nome Midd Ia Nome Indicate ont a or!ttiorc -::r - .::on obo1. , ourse lf, inc luo '19 any spec1ol experience, wh1ch might be perttnent . 33. 'Hhen and t o wh:>~ did you r~oort that you hcd seen the oStect ? Month Year 34. Dote you completed tns questionnaire : 35. Information wnich you feel pertinent and which i s not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting