?xOJECT 10073 ~ECvRD ~ 2. LOCA liON DATE "TIME G~OUP 10. CONCLUSION Civilian O~her(~cnfl~ctin;) 1. NUMBER OF OBJECTS LENGTH OF OBSERVATION TYPE OF OBSERVATION ~. Pt'iOTOS b. PHYSICAL EVIDENCE BRIEF SUMMARY ANO ANALYSIS Observers r o~ted h~adli;;ht v1ho reported the on~ t1our, i~ ~n~t!1~r det~rr;:ind the ex~-..ct. Prevlou edition of thh lonD m.aJ' b. ued. 27. In the following s~etch, imagine that you ore at the point shown. Place on "A" on the curved I ine to show how high the object was above the horizon {skyline) when you first sow it. Place a "B" on the some curved line to show how high the object was above the horizon (skyline) when you last sow it. Place an "A,. on the compass when you first sow it. Place a "B" on the compass where you last saw the object. 28. Oraw a picture that wi I I show the motion that the obiect or obiects made. Place on "A" at the beginning of the path, a "8" at the end of the path, and s !tv" uny changes in direction during the course. 29. IF there was MORE THAN ONE object, then how many were there? ----------- Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling 30. Have you ever seen this, or a simi lor objec t before. If s o give date or Jates a nd location. 31. Was anyone else with you at the time you sow the object? (Circle One) (! 31.1 IF you answered YES, did they see the obiect too? (Circle One) 31.2 Please I ist their names and addresses: 32. Please give the following information about TELEPHONE NU Indicate any additional information about yourself, including any special experience, which might be pertinent 33. When a nd to who~ d id you report that you hod seen th e object? Day M onth 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 a narrative explanation of your sighting Retterence observation your unidentified 'information in your letter suffieient for evaluation. Request you the envelope eomolete the attached FrD Form 164 and r.!turn vish to thank you tor reporting your-observation to the Air Sincerely, (J]DlTk,UJ.A, Project :Blue Jr, Major, USA7 i'TD Form 164 U.S. AIR FORCE TECHt~ICAL 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 hove observed. 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 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 detoi Is. 1. When did you see the object? (Circle One): 3. Time Zone: (Circle One): a. !:astern c. Mountain (Circle One)[ a. tJoy I ight Saving--; d. Poe ific 4. Where were you when you sow the object? Nearest Postal Address Cit~ or Town {ita te CH County 5. How long was object in sight? (Total Duration) Minutes Seconds a. Certain c. Not very sure CJ? Fairly-certain) d. Just a guess 5.2 Was object in sight continuously? 6. What was the condition of the sky? o: Cloudy'~ 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? (Circle One): a. In front of you b. In bock of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 This fcnm auperudes FTn 164, j u l 61, which ia ob~ole t~. ~. IF y o u saw the object at NIGHT, wha t did you notice concerning the STARS and MOON? 8.1 STARS(Circle One): 8.2 MOON (Circle One): a. Bright moonlight b. Dull moonlight d. Don't remember ( -c._ No mo F:l_li_g~t -pitch dar ; ~ Don't remember --.. 9. What were the weather conditions at the time you saw the object? CLOUDS (Circle One): o. Clear sky Scattered clouds .J Thick or heavy clouds WEATHER (Circle One): ,-.-Fog, mist, or I i gh t rain c. .~oderate or heavy rain e. Don't remember 10. The object appeared: (Circle One): b. Transparent C d. -A"s a light:) e: Don't remember 11. If it appeared as o light, was it brighter than the brightest stars? (Circle One): ( a. Br i gh.ter :0::, c. About the some d. Don't know 11.1 Compare brightness to some common ~bject: 12. The edges of the object were: (Circle One): a. Fuzzy or blurred Like a briyht star Sharply_ ~utline_C[) d. Don't remember Did the object: Appear to stand sti II at any time? Suddenly speed up and rush away at any time? Break up into parts or explode? Give off smoke? Change brightness? Change shape? 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