1. DA Tf .. ttM .GROUP . 2. LOC~ TION L-.di:lnapoli s ~ 3. ~iOURCE 10. CONCLUSION L~SUFFICIC~ DATA FOR EVAI~ATION NUMBER OF OB.jECTS LENGTH OF OSSfRVATION 11. BRIEF SUMMARY AND ANALYSIS )J Minutes 6. TYPE OF 08SE.;VATION sr:r: CASE Grou.~-Vi.S\.:.a.l Uot Re~: rtec 9. PHYSICAL EVIO E ~CE P'l'D ( 'tl!lfrR) Wrigbt-Pattersoo Al'B, Ohio 45lt.33 e your unidentUied observation ot 3 August 1966. The 1ntoxuat1oa vhich bave ived is not autticient ~or evalua tiOQ. Beque at you ccoplete the at tacbed Fl"D Form 164 and returD it 1n tbe envelope provided. We viah to thank you tor report1Da your observation to the Air Force nB~BC ... !"fiV"ntW'lll , Jr, MaJor, tJSAlP Ch1er, Pt oJect Blue Book U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can gi~e 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 wilr be used for research purposes. Your name will not be used in connection with any state conciusions, or publications without your permission. We request .this personal inform~tion so that if it is deemed necessary, we may contact you for further details. When did you see the obiect? Time of day: (Circle One): 3. Time Zone: (Circle One): a. astern c. Mov~;Jin d. Po:: =~ic N&e-rest Postal Address (Circle One): a. Daylight Saving C i,Y or Town State or County 5. How long was object in sight? {lot::l Duration) a~, ertaan c. o very sure =r y certa1n " us a guess ./ 5.2 Was object :n sight continuously? 6. What was the ccndition 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 baclc of you e. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thle form eupereedea Fm 164, Jul 61, which Ia obaolete. U.S. AIR FORCE TECtiNICAL 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 have observed. Please try to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your n.a1ne will not be used in connection with any state s, conciusions, 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? 3. Time Zone: (Circle One): a. t:cstern c. M~-:;Jin (Circle One): (Circle One): a. Daylight Saving CiJ't or Town State or County 5. How long was object in sight? {i~t=l Duration) Hours Minutes o~,.Certain c. Not very sure b. F::irly certain d. Just a guess / . t. 5.2 Was objeet ir. s ight c;ontinuously? Yes V' No 6. What was the ce:-~dition of the sky? b. Cloudy b. Cloudy 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 Thle form eupereed F'm 164, Jul 61, which le obaolete. 8. IF you sow !he obiect ot NIGHT, what did you notice concerning the STARS and MOON? a:2-MOON (eire le One): 8.1 STARS (C_ircfe One,: b. Dull moon I ight c. No moonlight -pitch dark d. Don't remember Don't remember 9. What were ~he weather conditions at the time you sow the obiect? CLOUDS {Circle One): ~ Clear sk~ c. Scotter~d clouds d. Thick c-r heavy clouds WEATHER (Circle One): b. Fog, mist, or light rain c. Moderate or heavy rain e. Don't remember 10. The object appeared: (Circle One): b. Trcnspcr~r.t d("""A.s o I ight"' e. o~ 't remember 11. If it oppe~r~ci as o li3ht, was it br:~r:-r~r than the brightest stars? (Circle One}: c. About the some d. Don't know 11.1 Compere brightness to some co~mon obiect:/ ( .., 12. The edges of the object were: (Circle On~ j: o. Fuzzy or blurred ~- e a bright.Jtor"':. c. Sharply. ~t! ined d. Don't remember Did the objecr: (Circle One for each question) Appear to s~ond still at any time? Don't know b. Suddenly s~ed up and rush away atony time? Yes Don't know Break up into po,.ts or explode? Don't know Give off s moke? Don't know Yes Change br ightness? Yes c.No .. Don't know Change shape? Yes Don't know Flash or flicker? Don't know Disappear and reappear? Don't know 14. Did the object disappear while you were watching it? If so, how? 15. Did the ~oie~t move behi!"d something at any time, particularly a cloud? (C ircie One): Dont Know. IF you answered YES, then tell what it moved behind: 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 o fe w words the following thi,.,gs about the obiect: 18. We wish t-;) ow the angular s i ze. Hold a match stick at arm's length in line with a known object and note how much of the obiect 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 pi~tur~ ~=Twill show the shope of the obiect or obiects. Lobel and include in your sketch any details of the object r~e y ou sow such as wings, protrusions, etc., oncl especially exhaust trails or vapor trails. Place on cr:""~w ~side the drawing to show the direction the object was moving 20. Do you think you can estimate the speed of the object? (Circle One) Yes (No IF you answered YES, then what speed would you estimate?_------- 21. Do you thin~ y ou con estimate. how far away from you the object was? IF you answered YES, then how far away would you say 22. Where wer~ you located when you saw the object? (C ire le One): a. Inside c:: building b. In a car d. In on air;:>lone (type) 23. Were you (Circle One) a. In the business section of a city? b. In the residential section of a city? (c.Jn open countryside? . a. Near an airfield? e. Flying over a city? f. Flying over open country? 24. IF you we .Y.OVING IN AN AUTOMC31LE or other vehicle at the time, then complete the following questions: 24.1 What =::ire::tion were you movir.;? (Circle One) a. Norrl-1 e. South g. West b. Nor~neost d. Southeast f. Southwest h. Northwest 24.2 How f:~st were you moving? miles per hour. 24.3 Did you '=>Pat any t ime while you were looking at the object? (Circle One) Did you observe the :>bject throu;!-: ~my of the following? Eye; losses Yes Binoculars Sun sics z;~s f. Telescope Yes Theodolite Window ;'css 26. In order that ycu con 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 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 object was above the horizon (skyline) when you lirst saw it. Place a "8" on the same curved line to ahow how high the obiect was above the horizon (skyline) when you last saw it. Place an "A" on the compass firs t sow it. Place a "B" on the compass where you last saw the obiect 28. Draw o picrure that will show the mot1o n that the obiect or obiects made. Place an "A" at the beginning of the path, o .. B,. .:it t he ~nd of the path . end shu~ \lny changes in direction during the course. 29. IF there was VORE THAN ONE objKt, then how many were there? _::;;_,.. , _t....;. J _ Draw a picturl!! of h~w they were or rcnged, 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 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 Pleose list their names and addresses: 32. Please give the following information about yourself: Lost Name .First Name ~ TE LE PHON= NU tndicate or:y additional information about yourself, including any special experience, which might be pertinent. When and to whorr. did you report that you hod seen the object? 34. Date you compfetd this questionnaire: 35. Information which you f .. l pertinent and which is not adequately covered in the specific: points of the questionnaire or a narrative explanation of your sighting. .