~ :. SOU;1CE 10. CO:\CLUSICN Ci vili~n Ast~o (rr.~tecr; ~ 5. L:::NGTH OF CZ.$2~VATION 1 e.nc! C::is:.:~?eareC: to the sou-c.h. Obse~ver st-ated o~je.:~ a?pe:?..re.:i J '1. cou~s= t ~ South ~ ~ 9. ?NYSlCAL ~Vi~:;xcE : j 'I o Yo~ . J 14. Did the object disappear while you were watching it? If so, how? 15. Did the obieet move behind something at any time, particularly a cloud? (Circle One): Yes Don't Know. IF you answered YES, then tell what 16. Did the object move in front of something at any time, particularly a cloud? (Circle One): -,' Don't Know. IF you answered YES, then tell what 17. Tell in a few words the following th ings about the object: 18. We wish to ~:1ow the angular size. Hold a match stick at arm's length in line with a known object and note how the object is covered by the head of the match. If you hod performed this experiment at the time of the sighting, hew much of the object would have been covered by the match head? 19. Draw a pic~u:--~ the wi II show the s h ape of the object or objects. Lobel and include in your sketch any detai Is of the objec~ =~you sow such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an crr~w Se:side the drawing to show the direction the obiect was m'oving. 20. Do you think you can estimate the speed of the object? IF you answered YES, then wh~eed would you estimate? 21. Do you think you can estimate how far away from you the object was? (Circle One) IF you onswered YES, then how far away would you soy it was? _ 22. Where were you located when you saw the object? (C ire le One): 23. Were you (Circle One) a. In the business section of a city? a. Inside o building b. In a cc:- c. In open countryside? \.. (H-e. Outooor:J. -a:--:-ln- -a-n-CTrp lane (type) d. Near an airfield? e. Flying over a city? f. Flying over open country? IF you we:-~ MOVING IN AN AUTOMOo!LE or other vehic,le .at the time, then complete the following questions: 24.1 Whet ::irection were you moving? (Circle One) c. ~ost e. South b. Northeast d. Southeast f. Southwest h. Northwest 24.2 How f=st were you moving? _Jmiles per hour. 24.3 Di d you stop at any time while you were looking at the object? (C ire le One) Yes No Did you obseNe ~he object through any of the following? Eyegbsses Yes No e. Binoculars Sun glc~ les f. Telescope Windshiei~ g. Theodolite Yes Window g;oss 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 In the following sketch, imagine that you are at the point shown. Place an "A" on the curved line to show how the objeet was above the horizon (skyline) when you lirst saw it. Place a "8" on the some curved line to show how high the object was above the horizon (skyline) when you lost saw it. Place an "A" on the compass when you first saw it. Place a "B on the compass where y.ou last saw the object 28. 0:-aw a pictur e that wi II show the moticn that the obiect or obiects made. Place an "A" at the beginning of the path, a "B" ct the end of the poth, and s!.u~ uny changes in dir~ction during the course 29. IF there w <.u MORE THAN ONE object, then how many were there? - . . ..;..-!_ l.: _ Draw a p ic rure ~f how they were orrong,d, 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 dotes and location 31. Was anyone e I se 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 list their names and addresses: 32. Please give the following information about yourself: First Nome TELEPHONE NUMB Indicate ant additional information cbout yourself, including any special experience, which might be pertinent 33. When and to wh:>m did you report that you had seen the object? Day Month Year 34. Date you completed this questionnaire: Information whic:h you feel pertinttnt and whic~ is not adequately covered in the specific points of the questionnoir or a narrative explanation of your sighting. . Wright-Pattenon AFB, Uniontown, Pennay~vania Reference your xecent unidentified observation of 21 July 1966 vh1ch you reported to the D..tty Officer at Wright- Patterson AFB Ohio. '!be intonABtion vhich we received :frca hie report waa not au:ff1c1ent for evaluation. Request you complete the attached or'TD 164 and return 1 t in the envelope provided. We wish to thank you for reporting your observation to the Air Force Sincerely, H'~:t:C'roR (.JJIN'D\NII.t A., Jr, Major, USAF ProJect 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 information as possible concerning the unidentified aerial phenomenon that you hc;~ve 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, condus ions, or publications without your permission. We request this personal information so thot if it is deemed necessary, we may contact you for further details. 1. When did you see the obiect? 2. Time of day: -+-/....liOIE---- (Circle One): 3. Time Zone: - (Circle One): Daylight Savin 4. Where were you when you saw the obi~ct? JJ Nff)_tJ To \tl A./ _ City or Town S. How fong was object in sight? (Tot e I Duration) Hours Minutes G.~ Certa i"n:J c. Not very sure b. Foirly certain d. Just a guess 5.2 Was objec~ ir. s sht 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}: a. In front of you b. In bade of you c. To your right d. To your left e. Overhead f. Don't remember fTD OCT 62 164 Thla form aupened .. Fm 164, Jul 61, which ia obsolete. 8. IF you sow the obiect at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circ:le One): 8.2 MOON (Circle One): t moon I ight Dull moon ig o moon tg -pitch dark on't remember d. Don't remember 9. What were t:,e weather conditions at the time you saw the obiect? CLOUDS ( Circle One): Clear sky~ c. Scatter~d clouds d. Thick or heavy clouds WEATHER (Circle One): og, mist, or I ight rain c. Moderate or heavy rain e. Dont remember 10. The obiect oppeQred: (Circle One): ronspc:-~":t d. As o I i e. ~ 't remember 11. If it oppeore:-as o light, was it brig!"lt~r than the brightest stars? (Circle One): a. Srrghter c. About the same d. Don't know Com;:>ore brightness tq some co:'ilmon obiect: 12. The edges of the object were: (Circle 0!1e l; Fuzz or blur d b. Like a bright st~r c. orp y out ined d. Don't remember 13. Did the object: a. Appear to stond sti II at any time? b. Suddenly speed up and rush away at any time? c. Break up into parts or explode? d. Give off s-,ok~? e. Change br ightness? f. Change shape? g. Flash or flicker? h. Disappear 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 lcnow 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): IF you answered YES, then tell what Don't Know. 16. Did the object move in front of something at any time, particularly a cloud? (C ire le One): Yes Don't Know. IF you answered YES, then tell what Tell in~ ft:Ylf words the following thil"l;s about the obiect: o. s~und tJ n tJ ~;::. We w ish to know the angular size. H~ld a matr:h stick at arm's length in line with a known object and note how the oSject is covered by the head of the match. If you had performed this experiment at the time of the sighting, ho-w much of the object woul d have been covered by the match head? f Ae .-San->~ S 12~ as d 1<1-le>w'YL 'P.M.~? ..rt'o/Vl AINE 7" ~s w IJA-tJ..y 19. Draw a picture tr.::r will show the shape of the obiect or objects. Label and include in your sketch any details of the object ~net you sew such os wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an arrow ~side the drawing to show the direction the obiect was moving 20. Do you think you con estimate the speed of the object? (Circle One) ~V No IF you answered YES, then what speed would you estimate? 3oo-l 0 0 0 21. Do you think you can estimate how far away from you the obiect was? (Cirde One) IF you ~nswered YES, then how far away would you say it was? 1~ 22. Where were you located when you saw the object? (C ire /e One-}: a. Ins ide a building b. In o c~r ~-Out~oor s ::> c. tnanoirplane(type) 23. Were you (Circle One) a. In the business section of a city? r t,."' In the residential section of o city? (c:: In "op~n c""o~nt,Yside?:) d. Near on airfield? . e. Flying over a city? f . Flying over open country? 24. IF you were MOVING IN AN AUTOMOoiLE or other vehicle at the time, then complete the following questions: 24.1 What 2 irection were you movin;? (Circle One) c. t::cst e. South g. West b. No!'~heast d. Southeast f. Southwest h. Northwest 24.2 How L:st were you moving? -------miles per hour. 24.3 Did y~v s top at any time while you were looking at the obiect? (Circ le One) Yes 25. Did you obse rve ~he object through any of the following? Eyeglcss~s Binoculars csse~ Yes No Windsni~:d Yes No Theodolite Yes Window g; :ss Yes 26. In order that you can 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 give the some appearance as the object which you sow. 27. In the following slcetch, imagine that you ore at the point shown. Place an "A" on the curved line to show how obiect was above the horizon (skyline) when you lirst sow it. Place o "B" on the same curved line to show how high the obiect was above the horizon (skyline) when you last saw it. Place an "A" on the compass when you F;rst saw it. Place a "B" on the compass where you last saw the obiect 28. Draw a pictu~e that will show the motion that the obiect or obiects made. Place an "A" at the beginning of the path, a "B" ct the end of the path, O"''d st.v~ uny changes in direction during the course. A-~c, o-f fA~ sky A-MP rAe. Souf-1; .. D I~ ,fP peate.ed 29. IF there was MORE THAN ONE object, then how many were there? ----------- Draw a picture ef how they were orrcnged, 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 date or dotes and location 31. Was onyO('e else with you at the.time you SOY~ the obiect? (Circle One) 31.1 IF y~u ~nswered YES, did they see the obiect too? (Circle One) 31.2 P lees~ I ist their names and addresses: 32. Please g iv e the following information ob<>ut yourself: tJ J o tJTow l6'1ol T ELEPHON!: NUMS lndicat~ O"''f ~dditional information about yourself, including any special experience, which might be pertinent. R e e;_e. t1-I-L y -7c s 7u/Jy When and t o wh ~m d id you report that you hod seen the object? 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 c~ncerning the unidentified aerial phenomenon. that you have observed. Ple\25~ ~ry to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your name wi II not be used in connection with any statements, concll.!sions, or publications without your permission. We request this personal information so that if i t is deemed necessory, we may contact you for further details. 1. When did you see the object? (Circle One): A.M. or P.M.', . Month-. 3. T ime Zone: (Circle One): ,a. t:ast~r~ b':-central (Circle One): a . Day I ight Saving j b. Standard - c. Mounto;i1 d. Poe ific 4. Where were y:xJ when you sow the object? (.;Jv! I ()J\/f Q LtV f/ Nearest Postc:s City or Town State or County 5. How long wes object in sight? (Total Duration) Hours Minutes Seconds \ .. o.w Certain c. Not very sure b. Foirly certain d. Just a guess 5.2 Was obi~c~ in :;ignt continuously? 6. What was the cor.d it ion of the sl<y? 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 In bade of you c. To your right d. To your left e. Overhead f. Don't remember FTO OCT 62 164 Thle form aup,.rel!lt1n Fm lfi4, jul 61, wJ\lc:O, le ob11olete