h OA TF TIME GROUP 2. ~ocA TION Enon, Ohio J. !iOr met: 10. CONCLUSION 4. NUMBER OF OBJECTS 5. LENGTH OF OBSERVATION Five Minutes 6. TYPE OF OBSERVATION Ground-Visual PHYSICAL EVIDENCE INSUFFICIENT DATA FOR EVAWATION 11. BRIEF SUMMARY AND ANALYSIS J>rlouo odlllono ol lhlo lorm "" " " lH uoetl, 20. Do you think you con estimate the speed of the object? (C ire le One) IF you answ~red YES, then what speed would you estimate? -------- 21. Do you th i~l< you can estimate how for away from you the object was? ( C i r cf e One ) IF you answered YES, then how far away would you say it was?---------- 22. Where were you located when you sow the object? (Circle On~): 23. Were you (Circle One) a. In the business section of a city? a. Inside o Suilding b, In a car .. _.,)>;- 'fr,-;-re-sidential section of a city?. d. Near an airfield? .._ c. Outdoor~ d. In an cin:dane (type) e. Flying over a city? e. At sea f. Flying over open country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 2-1.1 Whot c :r,ction were you movins? (Circle One) /~IJ/i I e. South g. West b. North~ost d. Southeast f. Southwest h. Northwest 24.2 How fest were you moving? miles per hour. 24.3 Did yo~J st:>p at any time wh :le you were looking at the object? (Circle One) Did you obse"'Y~ the object through ony of the following? a. Eyeg lo 3 s~s Yes No e. Binoculars b. Sun g l=sses f. Telescope No g. Theodolite Yes No d. Window s ;css 26. In order that you con give as clear a picture as possible of what you saw, describe in your own words a common obiect or objects which, when placed up in the sky, would g iv e the same appearance as the object which you sow 27. In the following sketch, imagine that you are at the point shown. Place an "A .. on the curved I ine to show how the obiect was above the horizon (skyline) when you lir.st saw it. Place a "B" on the same curved line to show how high the obiect was above the horizon (slcyline) when you last saw it. Place an "-A" on the compass when you first saw it. Place a "B" on the compass where you last saw the obiect. 28. Drew ~ pic:~ure that wi II show the :r:ot ion that the obiect or obiects made. Place an "A" at the beginning of the I path, ~ " 8 " at the end of the path, ~ nd s!.v .. ~ny changes in direction during the course. 29. IF there was MORE THAN ONE object, then how many were there?----------- picture of how they were ~rronged, and put an arrow to show the direction that they were traveling Have you ever seen this, or a similar objec before. If so give dote or dates and location. 31. Was a nyone e lse with you at the time you saw the obiect? (Circle One) No 31.1 IF you answered YES, did they see the object too? (Circle One) 31.2 Pleas~ list their names and addresses: 32. Please g ive the following information a bout yourself: First Name TE LE PHON~ NUMB Indicate any odditional information about yourself, including any special experience, which might be pertinent. 33. When and to whorr. did you report that you had seen the object? Day Month Year 3te. Date you completed this questionnaire: lnfornation which you feel pertinent and which is not adequately covered i~ the specific points of the questionnaire or a narrative explanation of your sighting. UFO Sighting bright spot, of XXXKX luminous yellow-white light, steady over roof of house in small town at elevation of 10. no unusual appearance or change in appearance, 1, Fairborn, Ohio and a friend, Mr. Sky condition: visibility good, no precipitation or e0! cloud, no UFO Sighting brig~t spot, of txXKX luminous yellow-white light, steady observed was over roof of house in small town at elevation of 10. --------Wheallast seaa five minutes 1 Disa~peared. No sound, no unusual appearance or change in appearance, , Route 1, Fairborn, Ohio and a friend, Mr. Sky 9ondition: visibility good, no precipitation or ez~ cloud, no Ther~ were no more VFO questionnaires in the duty officer folder. Noted from tele hone conversation. Ma or A. H. Paine D.O. 17 Jul 66 ; 2. LC.CAT.Ok ~. ;,)tiRC t: 10. CONCLUSION Civilia!'l INSUFi-'ICli:NT DATA FOR EVALUATION .t. NUMBER OF OBJECTS 5 ltirPlt e s 6. TYPE OF CaSERVATION Ground-Visuai 8. PtiOTOS 9. PHYSICAL EVIDENCE FW ( TDrri'R) Wr18bt-Patterson AFB, Ohio 45433 Reference your recent unidentified observation of 21 JUly 1966 which you reported to the ~ty Of"fiaer at Wright- Patterson AFB Ohio. The information 'mich \le received from his report was not sufficient for evaluation. Request you complete the attached FT.D Form 164 and return it 1n the envelope provided. We v1sb to thank you tor reporting your observation to the Air Force Sincerely, ~roR ~'fnJA, Jr, MaJor, USAlP Chief, PI ojeet. Blue Book . U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force as much informotion as possible c~ncerning the unidentified aerial phenomenon. that you have observed. Pleose t-:-y 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, conclu s ions, or publications without your permission. We request this personal information so that if it is deemed necessary, we may c ontoct you for further deta i Is. . 1. When did y ou see the object? 3. Time Zone: (Circle One): a! E stern -=-6. CentcCJ c. Moun t o i r. d. Pacific (Circle One): (Circle One): a. Daylight Saving c b;-staiiefard-""' 4. Where were y ou when you saw the obje:t? Neores1 Postal Address 5. How long w:;s object in sight? (Total D uration) r.-Fcirly certain City or Town c. Not very sure d. Just a guess State or County 5.2 Was obi~c! in s ight continuously? 6. What was the condition of the sky? 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the obiect? (Circle One): FTD OCT 62 164 a. In front of you b. In bade of you c. To your right d. To your left e. Overhead f. Don't remember Thie form euperaedea FTD 164, jul 61, which ie obeolete 8. IF you sow the obiect at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle One): a. Bright moonlight Du-ll moonlight No moonlight -pitch dark a. "u:n't remember d. Don't remember 9. What were ti-le weather conditions at the time you saw the obiect? CLOUDS f Circle One): WEATHER (Circle One): ,~. Clear s ky) . b. Fog, mist, or light rain c. Scattered. clouds c. Moderate or heavy rain d. Thick or heavy clouds d. Snow e. Don t remember 10. The object oppeared: (Circle One): b. T run s;~cr~nt e. Don t remember If it opp~cre~ os a light, was it bris:.,t~r than the brightest stars? (Circle One): , a. Brighter) c. About the some d. Don't know 11.1 Compcr~ brightness to some c~mmon obiect: 12. The edges of ~!-:e object were: Other (Circle o .l: o. Fuzzy or blurred S. Like a bright star -~-:=-sh'cirply outHneci> ' l . --oon't remember 13. Did the object= a. Appear to stond still at any time? b. Suddenly s peed up and rush away at any time? c. Break ~p into parts or explode? d. Give off s moke? e. Change brightness? f. Change shape? g . Fia~b_or.flicker?-lu ~.,\_.k-_ h. Di~appear and reappear? (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 obj~ct move behind something at any time, particularly a cloud? . (Circle One): Ye!l; ~3\ Don't Know. IF you answered YES, then tell what Did the obj~ct move in front of s omet hing at any time, particularly a cloud? (C ire le One): Yes , Don't Know. IF you answered YES, then tell what 17. Tell in a f~w words the following th ings about the obiect: We wish to k~ow the angular size. Hold a match stick at arm's length in line with a known obiect and note how much of the object is covered by t he 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 pictur~ f."lat will show the s!1ape of the object or obiects. Label and include in your sketch any details of the objec t that y ou saw such os wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an orrow beside the drawing to show the direction the obiect was moving.