PROJECT 10073 RECORD ~ NUMBER OF OBJECTS Medway, Ohio 10. CONCLUSION Satellite (pos Ri.ble} ./ S. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS 5 -1 minutes 6. TYPE OF OBSERVATION Ground Visual 9. PHYSICAL EVIDENCE Observer watched s~r like object move in a northerly direct- ion. Object was bright white appearing flatter than an oval being not completely round. Observer saw a similar object previously; however, helieved that to be a satellite. This object was traveline too fast for a satellite. 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 conc.erning the unidentified aerial phenomenon that you have obsrved. 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 connec~ion wfth any stateme~ts, 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 you see the obiect? 3. Time Zone: (Circle One):( b. t:o !!Q' c. Mountain d. Poe ific 4. Where were you when you sow the object? Nearest Postal Address 5. How long was obiect in sight? (Total Duration) (Circle One): (Circle One): . Day_lig t -~oving \Ji:_ Stand : a. Certain c. Not very sure c.Cf:-~-;rj_c_ert~id d. Just a guess Yes .x No Was object ir. sight continuously? 6. What was the condition of the sky? ..i:.ArighD 7. IF you sow the ob;ect during DAYLIGHT, where was the SUN located as you looked at the obiec:t? (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 Thla form eupened Fm 164, Jul 61, which !a obaolete. 8. IF you saw the object at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One}: 8.2 MOON (Circle One): a. Bright moon I ight b. Dull moon I ight d. Don't remember - d. Den't remember 9. What were the weather conditions at the time you saw the obiect? CLOUDS (Circle One}: WEATHER (Circle One): a. Clear s ky Ca~"Q-.:.YJ b. Fog, mist, or I ight rain c. .~oderate or heavy rain d. Thick ~r heavy clouds e. Don't remember 10. The obje:t appeared: (Circle One): b. Transp:r~nt e. Don't remember 11. If it oppec~ed as a light, was it br ighter than the brightest stars? (Circle One): c. About the some b. D immer d. Don't know 11.1 Compere brightness to some c::>mmon obiect: 12. The edges of th e object were: (C ircie One ): a. Fuzzy or blurred ~.:-'S: tlke a brigh t _3tn&.l ::. -sh" ai1)ly- mitTi ned d . Don't remember 13. Did the object: a. Appear t~ stcnd still at any time? b. Sudd~n ly s peed up and rush away a~ any time? c. Break up into ports or explode? d. Give off s moke? e. Change brightness? f. Change shape? g. Flash or flicker? 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 know Did the obiect disappear while you were watching it? If so, how? 15. Did the object move behind something at any _time, particularly a cloud?. (Circle One): it moved behind: 16. Did the obj~ct move in front of something at any time, particularly a cloud? (Circle One}: t) No Don't Know. IF you answered YE~, then tell what in front of: 17. Tell in a few words the following things about the obiect: We wish te know 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 had performed this experiment at the time of the sighting, how much of the obiect would have been covered by the match head? 19. Draw a picture that will show the s hape of the obiect or obiects. Label and include in your sketch any details of the objecT that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing to show the direction the obiect was moving 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 First saw it. Place a "B" on the same 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 you lost saw the object 28. Draw o pic!ure that will show the motion that the object or objects made. Place an "A" at the beginning of the path, a "8 '' ot the end of the poth, and sf.u,., uny changes in direction during the course 29. IF there was MORE THAN ONE object, then how many were there? ----------- Draw a pict~re of how they were orronged, and put on arrow to show the direction that they were traveling 30. Hove you ever seen this, or a similar obiect before. If so give date or dates and location. 31. ~as anyone e lse with you at the time you saw the obiect? (.Circle One) 31.1 IF you answered YES, did they see the obiect too? (Circle One) 31.2 Please list their names and addresses: 32. Please give the following information about yourself: City Zone State TELEPHONE NUMBER Indicate a ny additional information about yourself, including any special experience, which might be pertinent. j 33. When and to wh:>7. did you report that you had seen the object? Month Year 34. Date you completed this questionnaire: 35. Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or o narrative expla!'ation of your sighting