1. DATE TIME GROUP 2. LOCATION . ,-. .i. NliMBE R OF OBJECTS .'i. LliNOTH OF OB51iRVATION 90 minutes t.. TYPE OF OBSERVATION Ground Visual Statie naiif ?. PHYS ICAL EVIDENCE Beaver Cree~, 10. CONCLUSION Insufficier.t. ii. DAICI' I UMMARY ANO ANAL VSI~ two ....,.it:~es~e5 :or ev~luation ;-r Observ~r r: ?vca a a.- :n;;. ~ed :ln<i greon flashing lit;ht in the n'Jr:.:1cr:~ ~<:: . i..i - h:. peareci to bo chan6ing attr:..,T,t;t.S Wt!:'c unsu:c::szft.;_, l):.vr,e nu.nbe~ waS called an<i no sue;, ;"Jersc..:~ at c.:&;.t nl-::.'.Jer. ~o such persl)n The disc~i;>.,ic.n is cvn!>i::.L=m, ;.;it:. that v.~ an astrv- nc..:-;-,ical observatic.:-., but v:it:1.:.'\.:.t .4daitiono4 ..... infon:~a tion such a conclusion is n ot wa:-rented. r-TO s r P 6 3 0-329 (TD E) sorevtou dltlon or t hta rorm m v t.. u .. d . 8. IF you sow the obre c t o NIGHT, what did you notice cc-cNning the STARS and MOON? 8.1 STARS(Circ/eOrel: d. Don't remember 8.2 MOO:-.! (Ctrcle One): a. Bright moonlight @Du ll moonlight c . No moonlight -pitc~1 dark d. Don't remember 9. What were the weather ~onditions at the t ime you sow he objec t ? CLOUDS (Circle Om ): WEA TH F.~ ( C rclc One): b. Fog, ..,;~+,or ligl,t r~in a. Clear sky (C;. Scattered cloudc c. Mod'!rnt~ or heavy ro in d. Thick or heavy cl-,uds d. Snow e. Don': rc ..,ember 10. The object aooeored: ( C ircle One): T ronsoarent . G; As o light e. Don't remember 11. If it appe ared os o ligf.:, wos it breghter then th e brightes t ~tors? ( Circle One): c . Brig!-:ter ~ A bout the SO"TIC' d. Don't know 11.1 Compare brigh+r~l'S t o some common object: 12. The edges o f the obt-: r were: (Circle One): o . Fuzzy o r blurred ~L i< briyht star c. Sl-o:-ly outlined d . D ::ll"' remember Did the obtect: (Circle One for ecx:h ounstion) Aopeor to stan~ s t II t'll nny t ime? Don't know Suddenly soeed UP one rush owoy ot any time? Don't know Breck uo tnto ports ...,, exo lode' 'r (' s 0 Don't know Give elf o;..,o;.A'> Don't know Change brt: ht.,Ass :- Change shape? Flash or fl ic ker'> (cs D!'ln't know Disopoeor or.d r"o;:>oecr? Don't know U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that yo.u con give the U.S. A ir Forc e as much information as possible concerning the unident ified aerial phenomenon thot y o u hove observed. Please try to answer as many questions as you possibly can. The information that y ou give will be used for research purposes. Your nome wi II not be used in connection 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 you see the object? 2. Time of day: ( CZOL~ (Circle One): 3. Time Zone: (Circle One): ~ !:astern (Circle One): a. Daylight Saving b. Standard Mountain 4. Where were au when you saw the object? Nearest Postal Aclclress Stote or County 5. How long was object in sight? (Tota l Dura t ion) Hours Minutos Soc o ncls @ Certain c. Not very sure b. Fairlycertain J?to'g{u 5.2 Wos object in sight continuously? 6. What was the cond i tion of the sky? Yes / No--- .. Bright 't. Cloudy 7. IF you saw the object dur ing DAYLIGHT, where was the SUN located os y ou lookP.d o t the object? (Circle One): o. In front of y ou b. In bock of you c. To your r ight d. T ~our left f e......Overheod ~. Don't remember FTD OCT 62 164 Thl~ !orm sup.-ro'ltleo f'Tn 164 , jut 61, whlc!l l e oba o l e l e Did the object disappear while you were watching it ? If so, how? Did the object move behind something at any time, particularly a cloud? (Circle One): Ye~ Don't Know. IF you answered YES, then tell it moved behind: Did the object move in front o f s omething a t any time, particula rly a cloud? (Circle One): Yes Don't Know. IF you answered YES, then tell wha t in front of : Tell in a few words the following things about the object : We wish t o know the angular s1xe. Hold a match stick at arm's length in line with a known object and note how much of t h e object is covered by the head of the match. If you hod performed this experiment at th e time of the sighting, how much of the objec t would hove been covered by the match head? Draw a picture that wi II sho w the shape of th e objec t or objects. Lobel and inc lude in y our sketch any deta i ls of the object that y ou sow such as w ings, protrusions, etc., and especially exhaust trails or vapor trails . Place on arrow beside t he drawing to show the direction the object was moving 20. Do you think you can e stimate the speed of the objec t ? (Circle One) Yes \7 IF you answered YES, then what speed would you est imate? ----- Do you th ink you can estimate how for away from you the object was? (Circle One) IF you answered YES, then how for away would you say it was? 22. Where were you located when you saw the object ? (Circle One): 23. Were yo u (Circle One) a. Inside a building b. In a car {c:')Outdoors Y. In an airplane (type) a. In the business section o f a c ity? (g) In the resident ial s e c t ion o f a city? c. In open countryside? d. Near an airfield? e. Flying over a city ? Flying over open country? 24. IF you were MOVING IN AN AUTOMOBILE o r other vehicle at the t ime, then complete the following questions : 24.1 Whar direction were you moving? (Circle One) a. North c. East ortheast d. Southeast f. Southwest h. Northwes t 24.2 How fas t were you moving? --------l i le s pe r hour. Did you stop a t any t ime while you were looking at t he object ? ( C irc/e One) Yes 25. Did y ou observe the ob1ect th rough any of the following? Eyeglasses Yes e. Binoculars Yes b. Sun glosses Yes f. Telescope Yes 'No Windshie ld g . Theodolite Window glass h. Other _ In order that y ou con gve as clear a pi c ture as possible o f wha t y ou sow, describe in your own wo rds a common object or object s which , when placed up in th e sky, would g ive the some appearance as the object which y ou sow. 27. In the following sketch, imagine that you are at the point shown. Place o n "A" on the curved I ine to show how I high th~ object was above the horizon (skyline) when you first sow it. Ploc" a "B" o n tho sarne curvd line to f show how high the object was above the horizon (skyline) when you last saw it. Place en "A" on thtt compass when you first sow it. Place a "B" on the compass where you last sow the object. 28. Orow a picture that will show the motion that the objec t or objects mode. Place on "A" at thtt beginning of the path, a "B" at the end of the path, and sl.v .. .:.ny changes in d ir<}ct ion during the course 29. IF there was MORE THAN ONE object, then how many were there?----------- Draw a picture of how they were arranged, an.:l put on arrow to show t htt direction that they were traveling. 30. Hov~ you ever seen this, or a similar object before. If so give d ate or dates and location. 31. Was anyone else with you ot the time you sow the objec t ? (Circle One) 3 1.1 IF you answered YES, did they see the object too? (Circle One) No 31.2 Please list their names and addresses: 32. Please give the following information about yourself: First Nome Middle Nome TELEPHONE NUMBER Indicate any additional information about yourself, including any special experience, which might be pertinent. 'Hhen and to whom did you report that you had seen the object ? Doy Mont h Year 34. Dote yoo completed this questionnaire: _2 JI--- 35. Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighti ng.