PROJECT 1G073 RcCO~O l. Dt, : f T IMe G;<CU? 2. LOCATION . ~ t. N~I,~P.ER OF oa.;ECTS 10, CONCLUSION LENGTH OF cas:RVATION ~I. -: 'frf OF ORSEi<VATION ; 7. COU~SE ~ 9. PrlYSICAL EViDENCE 11. BRIEF SJ.'AMARY AND ANALYSIS r-TD St:P 63 0-329 (TOE) Prevloua edltlon o l thh fonD may be uaed. U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire ha~ lK'on propar&d so that you can gi"'e the U.S. Air Force as much in format ion as pos s iblo concerning tho unidontif i~d no rio I phenomenon that you have obst)rvod. Pl~aso fry to answer as mont questions as you possibly can. The information that you give will be u~ed fer research purposes. Your name will not bo used in connectin,, with any statements, conclusions, or publ;r.ation$ Without your permission. We roque .it this personal information 10 that it :t i ' deemed necessary, Wft may contact you for further dotails. . . 2. Time ef do/': 1. When did )'Ou sea the object? Hour Minutes ( C i rclu 0" o): A.M. 3. Time Zono: (Circle One): a. t o sterG (Circla OniJ): a. Daylight Saving ~:tar1d!fjl' 4. Whore were yOY when you so tho objoct? City or Town Stote or Count~ 5. How long wo:. objec:t in sight? (To'~ I v urotion) ,..41nutoa c. Certain c. Not very sure 6. What wos t!1~ "'l:l ~ l?!'i of tha sl.cy? b. Cloudy 7. IF you sow fhe obj~c~ during D AYLIGHT, wh-ere wos thn SUN 1\-,cO~.ld o-, you loo~>d a: th3 objoct? (CirdtJ Ona): o. In front of you b. In bock of you c. To your rirjlt d. T o vc.,Jt l..,ft f'). Qv,.rh ;,t:Jd fORM Reprod u ced by Libra ty of Co r!e r oss, Legislative Referance Service FTD OCT 62 164 Thi form eupereed .. YTD lh. jut t\l ..,: .. tc:, obattlt. May. 1966 8. IF you saw th~ ob,~ct at Nh:;HT, what did you notic:e co-cNntng the 5TARS and MOON? CLOUDS (Clfc 01~): ...,i~t, or liqht r:1in c. Sc otter~1 c '~ud ~ c, Mod~,,, ... nr heo"y ra1rt d. Th:ck or h vy ct?uds d. ~now The obi ec? c : -:-.eored: ((irdt! On-.): o, Sol1d A~ o li3ht ort 1 rtt~mbe; ~. About th~ -sa-n(' d, Don t lc:now 11.1 Compare ~ight-r-~Ji tD Sf.f~ eor"J~ ~jKt: (Cird~ Or1i"): c. Fll":.zy c;r bl-ur~ ?3. Did tho obj~ct: Ap or to s H:rd ~t;ll nt nny ti,.e? Suddenly s Ut) o"d rush tJwoy a' tsny time? Brf!ok uo il"!t:-::l~fs ~ ewolo<'te' Change sh.o~? Flah ~ flic:C:-? Oisopl)eor erd '-'O~Deer? (Circle One for ttaeh Question) Don't know Don't know Don't know Dnn't know Don't know Don't know Don't know Don t kno"W \ 14. Did the ob,ect di!.oppe\lr while you were watching it? If so, how? 15. Did t he ot:1~:t move ~hind something at any time, particularly o cloud? I (Ctrd~ O.,e): ~ No Dono't Know. IF you answered YES, then tell what mov~ in front of s om!>thing at any time, particularly a cloud? (Circ/~ Cne): Don't Know. IF you answered YES, then tell what We w t sl1 tc :.:. w t he angular size. r-:~ld o motch stick at arm's length ln line with o known ob1ec::T and note how much of t n e cS;cct is covered by tn~ need of the match. If you had performed this experiment at the t i me of the sighti,g, ho-much of the object .,...old d have been covered by the match head? 19. Draw 0 ;:>i C'J.'e ~ot will show the s;,op~ of the object or'objocts. Lobel and include in your sketch any details of the ob:l2!~ :-.~t y ou sow such a s w;nss, protrusions, etc., and especially exhaust trails or vapor trails Place o n =r:~-= oe the drowi~9 to show the direction the obiect was moving IF you answered YES, then whatt speed would you estirnate? ~ ;-~t/ 1-~J!l..t(;.[ " ... ........ ~:.~).1:-... 20. Do you thin~ you can estimate the speed of the obiect? 21. Do you think y ou can estimate how for away from you the object was? IF you ons'*~red YES, then how for oway would you soy it was? . Where wer e ~ou (Circle One i: located when you sow the obiect? a, Ins ide o ~ .... i ld ing (c. Outdoor,.; d. In on oir;:~ione (type) 23. Were you (Circle One) a. In the business section of a city? b. In the residential section of a city? c. 1 n opon countrysido1 d. Near on oirfiold? Flying over a city? f. Flying ov~r opon country? 24. IF ) '0\J war!! ~OVING IN AN ~UTOMCaiLE or othllr vehicle ot the time, than complete the following questions: 24.1 What oirec:tion weN you mov ing? (Cird:t On&) c. Eost e. South g. West b. ~on:"\~ost d. So\Jt hoor.t f. Southwest h. Northwest 24.2 How f:;it wera you motng? ---------rnilea per hour. 24.3 Did y=>w st -Ct any time wh i I~ y04J_ wer looking at the-object? ( C trC:e On~) 25. Did you o bserve :he obr.t:' thrO\Igh c ny of the following? e ... Binoculars b. Su n giQs:..es Theodolit~ Yes r g. Yes 26. In order thor 7ov '":C:n git~ea cldar o picture os possibl-. of whot you saw, d~scribe in your own words a common obict or ob;eea ....-htch, when .plooed .up in th. aky, ..w.Quld give the . .-ame appearance as the object which you sow. 27. In the follow eng ,ketch, imagine that you are at the point ahown. Place an "A" on the curved I in to a how how the ob1ect wos above the horizon (skyline) whn you lirst aaw it. Plo(e a "8" on the same curved lin to show how hiwh the object was above the horizon (skyline) when you lost saw it. Place an ''A" on the compaaa when yov frrl t sow it. Place o "B" on the compas where you last aow the obiect o~o..,. o pi~t-re thot will show the m o t io n that the obiect or obiects mode. Place an "A." at the beginning of th path, o o" ct tn~ end of the path, cr.d ,!.u-. -:any changes in direction during the course. . ; 29. IF there wo$ MO~E THAN .ONE object, then how many were there?------------' J Draw a ~ ic~ ..:re ;.f n~w they were O"r:~nged, and put an arrow to show the direction that they were traveling. 30. Have you ever s~n this, oro similar ob1ect before. If so give dote or dotes and locotton. lro~ onyc,ne t-h e with you at the tim~ you saw the obiect? (Circle One) No 31.1 l~ you o .uwered YES, did they see the object too? (C~rcle Onei No 31 2 P '&.J~too i '~t their names and addrsses: .!2. f'Jieo~ft gi..,e tne following informoti~ c~out yourself: Firat Nom M;dd le 1-~ome City 'ione TE L E ?~C .. : NUMBER 1nd i cot e onv a-d d'i t ioi\O I information a!:.out yourself, inc hiding any special experil!rrec6, which rn;g~,t ~ r>;rr inenr . ., J J ~.i:.S. Wi~en ond to ...... om did you report thot you hud n the obi!:ct? 34. Dote yQ u .~o!"pl d 1t~ia questionnaire: Information .~nich you fel pertinent and which is not 9~quotely covrd ir the spe.~ific poi"ta of th queationnoir or o norrotive planation of your sighting.