PROJECT 10073 RECORD 1. DATE liME GROUP 2. l.OCATION 3. S()IJJ:C:E 10. CONCLUSION Civ:i.l:in.n Possible (,\IHCR,'\Vi') .,/ C. NlJMf\ER OF OBJ ECTS ,, \r.EHOTH Ofl QI51AVATION 11t INIIfi IUMMI.tn AHii ANA1.V811 t.. TYPE OF 08SEP.VATION Gro urrl-Visu.:::.:!.. 9. PHYSICAL EVIDENCE Observe r not.~d ob ~ct, by t \-ro snn l l e r do t.B. 50 feet overne ac.i. FTD SEP 63 0329 (TOE) p,.loua ecllt!Of\ of thb fo,. .. F be uaed, that:. \-t:t 3 round at all tir.1cs, follo.otnd Objr.ct \'/.:ls like c:t 25 \iatt bulb ;a.bout U.S. AIR FORCE TECHNICAL INFORMATION This questionnoire 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 have observed. Please try to answer as many questions as you possibly can. The information that you give will : be "sed for research purposes. Your na_me will not be used in connection with any statements, concfvsions, 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 the obiect? Day Month Year 3. Time Zon~: (Circ:le One): a. -;Ecst~rn b. Central c. Mountain d. Poci~i: (Circle One): (Circle One): g. Daylight Saving Q~Standard 4. Where wer~. y'OU when you saw the object? Ne:rst Postal Address City or Town 5. How long w~s object in sight? (T~tol Duration) a. Certain c. Not very sure State or County 1~ Fairly certain ; d. Ju~t a .9u!~s A 5.2 Was object i:-t s ight continuously? 6. What was the condition of the sky? a. ~Bright b.' Cloudy 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? (Circle One): a. In front of you b. In baclc of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thle form upered .. Fm 164, Jul 61, whlc~ I obaolete. 8. IF you sow the obtect at NIGHT, what did you notice co- ceorning tho STARS and MOON? 8.1 STARS (Circle Or.e }: 8.2 MOO~ (Circle One): b,.... A few 0... Bright moon I ight ( .) Dul I ":'oonl ight c. No mo~nlight -pitch dark c. Don't remember d. Don't remember 9. What were the weather conditions ot the time you sow he-object? CLOUDS (Circle O.,e): WEA THE~ (C irclc One): , a. '..,leor s~y b. Fog, ... ,i ~t, or fight rain c. Scatter~d cloud~ c. Moderflt"" or heavy rain d. Thick ~r heavy cl?uds e. Don'! re"'lember The object oc:>Deared: (Circle One): d;/h s o I ight -e. D~n't remember b. T ron s ::l:rent 11. If it oppecred as a I i gh, wos it br i ,ter than the brightes t ~tors? (Circle One): a. Brighter ( c"~;About the SO"T!(' d. Don't know 11.1 Com?:re brightn..,ss to some common object: 12. The edges of the obiect were: (Circle On~): o. Fuzzy or blurred b. like r brig~t star /c. ~.-:arply out I in~d ~. ::f" t remernb~r 13. Did the object: a. Appear to stand still ('If any time? b. Suddenly soeed UD and rush away at any time? c. Break u>:> into ports ~,. exolode? d. Give cff Sr"'oic e. Change bright.,'!'ss? f. Change shcpe? g. Flash or flicker? h. Oisappeor or.cl r~oppecr? (Circle One for each question) Don't know Don't know Don't know Do,'t know Don't know Don't know {No J Don't know Don't know 14. Did the obiect disappear while you were watching it? If so, how? 15. Did the obj~ct move behind someth i"ng at any time, particularly a cloud? (C ire le One}: Ye~ tN";J Don't Know. IF you answered YES, then tell whot Did the object move in front of something at any time, particularly a cloud? (Circle One): .lv:s } / No Don't Know!. IF you answered YES, then tell what 17. Tell in o few words the following thin;s about the obiect: 18. We wish to l<:1ow the angular sil.e. Hold o match stick at arm's length in line with a known obiect and note how much of the obj~ct is covered by t~e 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 picture met will show the s hape of the object or obiects. Label and include in your sketch any details of the objeer ~:, y:>u saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on arro'N besde the drawing to show the direction the obiect was moving. 20. Do you think you can estimate the speed of the object? (C ire /e One) Yes IF you answered YES, then what speed would you estimate? ------- 21. Do you think you can estimate how far away from you the object was? (Circle One) Yes ( ~ IF you answered YES, then how far away would you say it was? --------- 22. Where were you located when you saw the object? (C ire /e One); 23. Were you (Circle One) a. Inside ~ building a. In the business section of a city? b. -:In the residential section of a city? b. In a car ~)>utdoors In on airplane (type) <:- n open countryside? 1 d .,Near an airfield? e. Flying over a city? f. Flying over open country? 24. IF you wer~ ~\OVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24.1 What d !rection were you moving? (Circle One) e. South g. West b. N:>rtheast d. Southeast f. Southwest h. Northwest 24.2 How fast were you moving? miles per hour. 24.3 Did you stop at any time wh i fe you were looking at the obiect? (Circle One) Yes No 25. Did you observe the object through cny of the following? Eyeglcss~s Yes No Binoculars Sun glasses Winds~ ie id Yes No Theodolite Window ;bss 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 s9me appearance as the object which you saw. 27. In the following sketch, imagine that you ore at the point shown. Place an "A .. on the curved I ine to show how high the obiect was above the horizon (sky I ine) when you first saw it. Place a "B" on the same curved line to show how high the obiect 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 you lost sow the object. 28. Drow o pi::~Jr& that will show the mot:cn that the object or objects made. Place on "A" at the beginning of the I path, a "5" at the end of the path, ond s!.v" vny changes in dir~cfion during the course. 29. IF there wos MORE THAN ONE obj~ct, then how many were there? ----'~=) _ Draw a pic:rure of how they were orro:1ged, 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 dates and location. 31. Was any.,ne else with you at the time you sow the object? (Circle One) 31.1 IF you answered YES, did they see the object too? (Circle One) 31.2 Ple=se list their names and addresses: 32. Please give the following information about yourself: Last Name lrst Name Micld le Name TELEPHONE NUMBER Indicate any cdditional information cbout yourself, including any special experience, which might be pertinent. When and to wh orr. d id you report that you hod seen ,the object? 34. Date you completed this questionnaire: Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or c narrative explanation of your sighting.