~ 0~ l E TIME GROUP 3. SOUf:CE Ci vil:i.;m 4 . NUMBER OF OBJECTS PROJECT 10073 RECORD 2. LOCATION 10. CONCLUSION Possi blP. (~ALIDm;) 5. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS 15 .3cconds 6. TYPE OF OBSERVATION Ob0crver vF:>Lchrrl chJI\ /~1''\,/ ohj(:ct tlt:-.t .1prc.4r nd to i.v.! i' J.lln,~ dowmvard. Objc ct. lonk~ ri Jn if it .. m s t;ct. ti.n fnrtr.<" r omy. ver COI1}l'.'r'Cd :tlk,Gcj UFO. to a dark c r;w t"Xllloon. Descript.ion i.s <on:;i.:.t.w .. 'l. ~-oi.Lh Ll <1t oi 1:1lnon. C k.TVI 'l' contactc~d wu;lt.h)' b:J'P-tU nn.:i thry told him it <'ulll.i h<..v: llt.'t...n v. balloon. 30. Have you ever seen this, 04' a simi lor object b.fore. If ao giv date or dot ond locotlon. ,y.- 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 One) 31.2 Please liat their nomea and addresaea: 32. Please g ive the following Information about yourself: _ KENTUk,.l<Y SEX I!Z.fl. L &: . Indicate any additional Information about younelf, Including ahy tp.clol experience, whlc:h might b. pertinenT I ~ f'VZ' HtlNSICY o"_.I~NG P'r'tt ~ YGJJN:, When and to whom did you report that you hod a .. n the object? 34. Date y041 coMpleted this queatlonnalre: ( THIS Sf DE O F CARD IS F'OR AD~RESWS) obse~t.ton. U.S. AI R FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you con give the U.S. Air Force os much information os possible concerning the unidentified aerial phenomenon that you h ove ob~e,..,fui. Please try to answer as many question as you possibly can. The information that ycu give wilt be used for research purposes. Your nome will not be used in connec.:tion with any st~temeni:r, conclusions, or publications without your permission. We request this personal Information 5C that if it is deemed necessary, we may contact you for further details. 1. When did you see the object? Hout Minvtn (Circle One): or 3. T ime Zone: (Circle One): <:f. Easter~ c. Mountain d. Pacific 4. Where were yov whon you sow the object? S. How long wa' ubjec:t In sight? (Total OuratiOf'l) a . C&rtoin c. Not very sure Foir ly :ertain d. Just a guess 5.1 How was t ime In sight determined? ---=C~I~.. :.cJIU.'K~------------------ Yu v' No 5.2 Waa object in sight continuously? 6. What was the condition of the sky? a . ar~ght 7. IF you saw th& object during DAYLIGHT, where was the SUN located as yoo loc.ked ;:: th~ obier~t? (Circle One): a, In front of y~u b._({!]~oc;IC o f iou) c. To yoor flg'lt d. To your left e. Overhead f. o.,n't rdmembttr TM fcwm UJMned Fro 164, jul 61, "'"'"" h ob.,lt 8. IF you saw tho object at NIGHT, what d id you not ice conceming the STARS ond MOON? STARS (Circle One): 8.2 MOON (Circle One): Bri~t moonlight b. Dull moonlight c. No moonlight -pitch doric d. Don't remember Don't remember 9. What were the weath., conditions at the tllfte yOAJ aaw the object? CLOUDS (Circle One): WEATHER (Circle One): Clear alcy b. Hazy b. Fog, mist, or light rain &:'Scattered cloud~ c. Moderote or heavy rain Thick or heavy clouds Don't remember (Circle One): 10. The object appeared: ~ Sol idJ d. As a l ight b. T ranaporent o . Dcn't remember 11. If It appe<Jred at a light, was it bt ighter than the brightest stars? (Circle One): a . Bt igMr Tlte .Ogea oi m .,C,JeCt were: (C ircle One/: a . Fuzzy or blurred b. L i\ce o loht star C= Sharply outlined) d, uon't remem_, c. About the same d, Don't know Did rlole o b ject: ( Circle One for ~ach qu..tion) Appear to stand atilt at O"'f t ime? Yes Don't lcnow b. Suddenly ~eel up cmcf rush away at any time? Yes Don't lcnow Braalc up into parts or e xplode? Yes Don't know Give off smoke? Yes Don't lcnow Change br idttneu? Don't know f. Chan be shape? Ye s ( No Don't know Fia ,r, Of' fl,c~er? ('t~ Don't !mow Ohcppe 011d reo~cw? Yet. Ng Don't know 14. Did the object disappear while you were ,tatching it? If so, how? T h~ obj!,t "-'fpea..t-eo To ~et"fo."lheP. f.fw~ 15. Did the object move behind something at any time, particularly a cloud'? (Circle One): Don't Know. IF you answered Yf.:S, lhM htll~ihat 16. Did the object move in front of ISRmething at any time, particularly a cloud? (Circle One):~ in front of: 17 . Tell in a few words the following th ings about the objec t : a. Sound I lucud/Jd JllvNtt'. 18. We wish to ~now the angular size, Hold a match stick at arm' s length in line with a known objK.t and Mt{, ~oN muc h of the obj .. ct is co"ered by the head of the ~atch. If you had performed this experiment at thc. tiroo of ' I:<:J sighti~g, ho~ much of the ob;._ct -;ou.ld hove been crered by th~.:o.'ch head? ... -'- Draw a picture tnat will show the shape of the object or objects. Label and include in your ,ketch any detoil~ of the object that y~sow -such as wings, protrusions, etc., and especially exhaust trolls or vapor trails Place on arrow besid.-the drowing to show the direction the object was moving. 20. Do you think you con estimate th e speed of the object? (C irc/e One) IF you answered YES, then what speed would you ostirY.ote'{ ------------- 21. Do you think you can estimate how far away fro m you th" object wos? (Circle One) IF you answered YES, then how far away would you soy it was?--------------. 22. Whore were you located when you saw the object? (Circle One ): a. Inside o building b. In a car d. In an airplane (typo) 23. Were you (Circle One) In the business section o f a city? Jr. rh~ residential so..~ct ic.a _,;a city? In opon countryside? Near an airfield? Fl)'ing over a city? Fly;ng over open country? Other ;A'N .. IY!.INT of 7~. '-!' S'~HfiLw_ 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle a t th., time, then complete t~e followir.g qu .. tlona: 24.1 What direction were you moving? ( Clrc:le One) c, East e, South b. Nonhea,t d. Southeast f. Southwest 24.2 How fast wer11 you moving? . m, .. ,iles per hour. 24.3 Did you stop at any time while you were looking at the object? 25. Did you observe tne object through any of the following? h. Northwest 26. In order that you can give as clear a picture as possible o f wh~t you saw, describe in your own WOfds a COf'I\I'I\Oft object or objecta which, when placed up In the aky, would give the same appearance as the object which you ao"" 19 lllf"l( 4/tl,r 8/H.LON #'IS~JHT LOOJc L.':rk~"t'IIC tJtl7Cd In the following alcetch, Imagine thot you ore at the point ahown. Place on ''A" on \he r.urv,.! l n to show ho~ high the object woa obcwe the horizon (akyllne) when yc.u llr$t sow lt. Place o "S" on t hs ,,,.,. cur"ed line 1<~ ahow how high the object was abcwe the horizon (altyllne) when you lost ~aw it. Place on "A'' on the compou when you llrJt aaw lt. Place o "8" on the compau where yov last aaw the object. 28. . Draw a picture that will show the motion that the object or objects made. P.loc e on "A; ' at the begiN1i.19 ot the path, a "B '' at the .nd of the path, and ahow any changes in d irection during the C-'vru. IF there woe MORf THAN ONE obf.ct, then how many w.,. there?---------- Draw a picture of how they w.,. arranged, and put an orrow to show the direction that they were trovoling.