. PROJECT i00/3 RECO~D 11. DAi~Tt~fiGROUP 2. LOCATION ~ Civilinn Other(Confusing data) . t. NliHP.C R OF OBJECTS ~. LENGTH OF OBSERVATION 6 m1nut.ft:. 6. T1PE OF ORSERVATION Ground Visual 9. PrlOTOS ?. PHYSICAL EVIDENCE 11. BRIEF SUMMARY AND ANALYSIS lights. T\Tice ~l:e _ obj ~ct wo.s to haVt" dis.;. eo.r~ci oe:v: An aircraft could nav~ o.cco~r.t~d fo~ .. t.ne ever, the data.. is so;r.ewhat confusing. f T D S C P 6 3 0-329 (TO E) Prevlou ed1Uon of lhl fo,.. may b ua~. n this, 01 a aimilat obiect before. If ao give dat ot dote oncl locotlon. 31. Wo anyone elae with you at e time you aaw the obiec:t? (Circle One) 31.1 IF you answerM YES, did they SH the object too? (Circle One) 32. Please alve the fellowlftt lnfIMtlon at,out yourself: 'TELEPHONe NUMBER lntllcote Oft)' .ddhl lnfor.-tiOft about yow1elf, lnelucllng any 1p.elol experience, which might bt p~rtlnent. 33. Wtten ar"Mt te whew,. did you r~t that you had n th object? Def WMth Yer 34. Date you co...,letM thia questionnaire: 35. Information which you fHI pettln.nt ancl which Ia not adequately covered in the apeclflc polntl of the queatlonnalre ot a norrotlve explanotlon of your alghtlni. Be1'erenee your un1dent11'1ed observatiou 1n.toz mat i on in yoUl letter vas not surfieient -ror you. e ontplete the attache d F.rD Fo:rm 164 and evaluatiorJ .. you f"or reporting your obser'vat1on RW.fWI7N"'UR QJI~TANILLA, h', Mljor, Chi ex-, P:v jeet Blue Book U.S. AIR FORCE TECHNICAL IHFORMATIOti Thia questionnaire has been prepared ao that you can give the U.S. Air Force as much information as poaaible concerning the unidentified aerial pheno.nenon that you hnvu oLserve1i, Please try to answer as many question as you possibly can. The information that y~u give wiU be uaed for reaearch purpo Your name will not be used in connec;tion with any st~ten .. ni~, conclusion, or publications without your permission. We request this personal Information J~C that if it is deem.d necessary, we may contact you for further details. . 1. When did you e the ob;ect? (Circle One): 3. Time Zone: (C lrcle One): a. (Circl" L)ne): a. Day tiyht So.,. ino Sta,.,dord c. Mountain d. Pacific Where were you when you saw the obl.ct? ,Lf/d'/tiz If C'ty or Town Stote ~ CoJ~t; . S. How long waa object in sight? (Total Durotlon) Minute I Seconch @ Crtoin . c. Not .very sure b. Fo~rly certain d. Just o guess/} Was obiect In sight continuously? 6. What was the condition of the sky? (a) Bright (a) Bright 7. IF you saw the objct during DAYLIGHT, whare waa the SUN located as you lock~d at tht obi~t? (Circle One): a. In front of you b. In baclc of yOAJ c. To your riW.t d. To your left e. Overhead f. Don't remember FTO OCT '2 16~ Thle fa.M euperad .. PTD 164, Jul 61, whlch 1 obnlete. a. IF you saw tho obJeCt ot NIGtiT I what did you nottce conceming "' STARS end MO~? 8.1 STAR~, (C trcle One): c. Many .. d. Dont rememlaer 8.2 MOON {C:irc/e One): o. Bri~t moonlight Dull rrioonl ight No moonlight - pitch dark Cl Don:t remember . . 9. What "'ere tn ..... oth., ~onditian1 at the tlmeyou saw the obiKt? . CLOUDS (Crrde One): @ Clea r slcy b. t-l\ll y c. Scorter ... d clo,,d s d. Th i < ~ tH htt\l'w'( c:l~d WEATHER (Circle One): b. Fog, mist, or leght rain c. Moderate or heoyy roin e. Don't remember 10. The objt~tct oppelred; {Circle One); d . A I 0 ll gh t . b. T Hlnspmenf Don't relhember c. Vopt..lr 11. If it appeared oa a light, woa it brighter than the brighte1t stars? (Circle OneJ: a. Brighter c. About the same 11.1 Compare brightn to once com1non obfect: 12. The edgea o; m ooict were: {(i,clo ,;l'~ti fl. Fuxxy 01 blurred h. Like a bright star @ Sharply out I ined d. Don't remembef 13. Did the obJect: a. Appear to stand still at any tilfle? b. Suddt~tnly tpeed up end rush oway at any tim? . c. Brbak up into ports ct explode?_ d. Give off smoke? Chan~ brld1tness? f. Change shape? g. flash or flicker? h. Oi H1p~ar and nappeor? (Circle One for each queation) (Yey No D~'t know L'Y es No Don't lcnow Yea .. <@ . Don't lcnow t Yei] No Don't lcnow (Yi) No DCft't lcnow V: @ Dor,'t len ow 0"~ No , Don't lmow I YiiD No Don't !l,.,w ~. Do you think you con estimate the speed of the object? (Circle One} IF you answered YES, then what speed would you estin-.ate'f 5# 0 0 t'0.f-~ 21. Do you think you can estimate how far away from you the object was? (Circle One) IF you answered YES, then h~w far away would you say it was? _5 f'Yr'\J.~J. !:::::-:jJ-. Where were you locotd when you aaw the oblect? (Circle One): Q, Inside a building b. In a car @ Outdoors d. In an airplane (type) 23. Were you (Circ/u One) ir1 the business section of a city? In thQ residential s~cticea vc o city? In o pfm country~ ide? Near an airfield? Flying over a city? Fly;n\i over opert country? 2.C. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complehJ t~e followiao.g questions! 24.1 What direction were you "'oving? (Circle One) b. Northeost d. utheost f .. Southwest h. Northwest 24.2 How fast wre you moving? A _,miles per hour. 24.3 Did you atop at any time while you were loo"ing at the ob-iect? (Circle o,.) 25. Old you observe the obict through any ol the following? Eyeglaa e. Binoculars Yea Sun gloss Yea f. Telescop~ c. Windahield Theodolite Window glass In ordar that you can giv as elear a picturs as possibl8 of what you ~aw, d~:scribe in your own wor a comm~ object or objecta which, when placed up In the aky, would giv the same op~aronce as the obiect which rcu IO\W~ LU I i h ( I ci L r5 14. Did the obiect di soppeOf while you w"'~ .totching it? H ~o, how? ..,. 15. Did the object move behind something at any time, particuhnly a cloud'! (Circle One': Don't Know. it moved behind: 16. Did the objeat move in front of (tpmething at any t1me, porticu Iori~ a cloud? (Circle One): Yes o~nt Know. IF you answered YES. th..,., ., P wi"Jt 17 . Tell in o few words the following things about the object: 18. We wish to know the angular size. Hold o match stick at arm~ length in lint.t with a known ubjo-~t ancl ,.~r much of the object h covered by tho head of the match. If you hod perforrneJ this OXF'erimont at tht~ tit.'W; .1t ~Le sighting, ho~ much of the ob;ect would have .bee~ covered by.Jbe motch.h~od? . . . . . Draw a picture that will how the shape of the object or objects. Label and include in your sketch any detaili