PROJECT 10073 RECORD 1. D/.. TE TIM= GROUP 2. LOCATION 4. NUMBER or: CSJECTS 5. LENGTH OF OISEAYATION t.. TYPE OF OSSE RVATION 9. PHYSICAL EV .OEHC 10. CONCLUSION SateJ.ljtc (GHC I)./ ~ E(}IO I w~s ruszir'-: t,o t he ~Jorth headinG E nt O.S06Z. 11, IRIIP IUMMARV AND ANAl..VSII Object app.~1cd l i l<e a st.cr. A very bright \..hitc round object Object cli&'l.Jlp~tlr( l i(~JCll<.~ r l011.Wn in 1 lilinute. It J.lOVe d on a straieht J.:i.kn t ot!( u:;. FTO S E P 6 3 0329 (TOE) PNYlou t~lt1~ of thla fort Y be uaed. U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can giv' the U.S. Air Force as much . information as possible concerning the unidentified aerial phenomenon that you hove observed. Please try to answer as m"Ony questions as you possibly can. The information that you give will be used for research purposes. Your name will not be used in conn.ection with any statements, conclusions, 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 y ou see the obiect? "' Month ( 3. Time Zone : (Circle One): a J tcstem ( : c~ntrol c. Mou;,~o in d. Paci f ic (Circle One): (Circle One): a. Daylight Saving . ~)Standard 4. Where wer e you when you saw the ~b:ect? Nearest ?ostol Address State or County 5. How long w~s object in sight? (To to ! Duration) Hours Minutes Seconds o. Certain c. Not very sure b. Fairly certain d. Just a guess Was o~iect ir. s ight continuous fy? 6. What was the c ond it ion of the sky? a. Bright a. Bright b. Cloudy b. Cloudy 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at tho obiect? (Circle One): a. In front of you b. In back of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thle form e\lpereedes f "TD 164, Jul 61, whlch !e obsolete 8. IF you sow the ohject at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle One): Bright moonlight b. Dull moon I ight No'moonlight -pi~ch dark Do:-; I t remember Dont remember 9. What weo:e ~he weather conditions at the time you sow the obiect? CLOUDS (Circle One): (a/~Ciear sky c. Scot~ered clouds d. Thick or heavy clouds WEATHER (Circle One): b. Fog, mist, or I ight rain c. i~oderate or heavy rain e. Don't remember 10. The object cppeared: (Circle One): a. Sot id d. As o I ight b. T r on S!:l:l!"'ent e. Don't remember 11. If it opoecrec a s a light, was it brig:,ter than the brightest stars? (Circle One): c. About the some d. Don't know 11.1 Comp~re brightness to some co~mon obiect: 12. The edg~s cf the objeet were: (Circle Or:e ): ~ Fuzzy or blurred :. Sharpry outii:--ed d. Don't remer"''b"!r Did the objecr: (Circle One for each question) Appecr to s rond still at any time? Yes Don't know b. Suddenly s~ed up and rush away at any time? Don't know Break up into ports or explode? Don't know Give off s moke? Ye~ Don't know Change brightr'less? Don't know Change shc~e? Don't know Flash or flicker? Disappear and reappear? Don't know 14. Did the object disoppenr while you were watching it? If so, how? 15. Did t he obj~ct move behil"d something at any time, particularly a cloud? (C ircle One): No Don't Know. IF you answered YES, then tell what it moved behind: 16. Did th~ object move in front of somet h ing at any time, particularly a cloud? (Circ!e One): Yes Don't Know. IF you answered YES, then tell what 17. Tefl in o few words the following things about the obiect: 18. We wish to ~now the angu lor s ize. !-iold a match stick at orm s length in I ine with a known object and note how much of t he obj~ct is covered by tf,e head of the match. If you had performed this experiment at the time of the sighting, how much of the object would hove been covered by the match head? 19. Draw a pi.::tue t t ~ill show t he s;,ope of the object or obiects. Lobel and include in your sketch any details of the o b jec t ~!..:::t you sow s uch os wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on cr;-ow hes ide the drawing to show the direction the obiect was moving. 20. Do you think you con estimate the speed of the object? IF you on swered YES, then what speed would you estimate? t -- Do you think you can estimate how for away from you the object was? (Circle One) IF you. onsw~red YES, then how for away would you say it was?---------- 22. Where were you located when you saw the object? 23. Were you (Circle One) (Circle One): a. In the business section of o city? a. Inside a building b. In the residential section of a city? c. In open countryside? d. Near on airfield? e. Flying over a city? b. In o cor 6~ 1 Outdoors d. In an a ir?lane (type) f. Flying over open country? 24. IF you we!"e MOVING IN AN AUTOMCSILE or other vehicle at the time, then complete the following questions: 24.1 What :::rection were you moving? (Circle One) c. Ecst e. South g. West d. Southeast f. Southwest h. Northwest 24.2 How f=st were you moving? -------~miles per hour. 24.3 Did you stop at any time while you were looking at the object? (Circle One) Did you obs~rve the object through any of the following? Eyeg!osses Binoculars Sun glc~ses Yes Yes N'c::> Theodolite Windsh tel= Yes d. Window ; !css 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 object or objects which, when p,loced up in the sky, would give the some appearance as the object which you saw. 27. In the following slcetch, imagine that you are at the point shown. Place an "A" on the curved I ine to show how high the object was above the horizon (skyline) when you lirst saw it. Place a "B" on the some curved line to show how high the obiect was above the horizon (skyline) when you lost sow it. Place an "A" on the compass when you first saw it. Place a "B .. on the compass where you last saw .the obiect. (;u-rt1Sl- 28. Draw a p ic t:;re that will show the rr.otion that the obiect or obiects made. Place an "A" at the beginning of the path, a "B" at the end of the po~h, end shu~ -lny changes in direction during the course. 29. IF there wos MORE THAN ONE o Sje c t, then how many were there?----------- Draw a pictur~ of how they were orr:1~g ed, and put on arrow to show the direction that they were traveling. Have you ever seen this, or a similar object before. If so give date or dotes and location. 31. Was anyone ~se 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 Plecse list th 32. Please give the following information about yourself: Middle Nome ADDRESS , TELEPHON= NUMBE Indicate ony additional information cSout yourself, including any special experience, which might be pertinent 33. When and to who~ did you report that you hod seen the object?