.. 4. NUM3c~ Or OaJECTS 10. CONCLUSION 1s L.EHGI;; Or OBSERVATION 11. B Rier SlJ,i.',.I.\ARY ANO 1\NAI..Y'I S TYPE OF 03SERVATION aoouc :ive saco~ds. no;:,ea O'J 0 servuvlOn 34. Oat you completed this queatlonnalre: Information which you fHI pertinent and which Ia not adequately covered in the specific polnta of th. questionnaire o narrative explanation of your alghting. U.S. AIR FORCE TECHNICAl. INFORMATI0'-4 Thia queationnaire haa b.ttn prepared so that you can yive th U.S. Air Force aa much information as possible concerning the unidentified aerial phenotnenon tt1at you ht~vu oLae"'eti, Please try to answer as many question as you possibly can. The information that yc.:u give wiH be used fet reaearch purpose1. Your nome will not be used in connection with any st~t"nt;.;, coneluaions, or publlcotlont without your permission. We request this personal information 1<: that if it is deemed necesaary, we may contact you for further details. 1. When did you the obiect? 3. Time Zone: (C lrcle One): ~ c. Mountain d. Pacific 4. Where were you when you sow the object? (Circl~ '.)ne}: a. Daylight So..-i" O (b. Sto.,dar'!) oatal Adclr Cit~ or Town S. How long was object in sight? (Total Ourotlon) Hours Minute a 5.2 Was obiect in sight continuously? Y 6. What waa the condition of the sky? (Q.) Bright State o:,r CoJ..,t; 7. IF you aaw th object during DAYLIGHT, wJ,ere was th~ SUN located as you lockPd ~t the ol,;e~t? ( C lrcle One): a. In front of you b. In bock of yOAJ c. To your ri~t ~ To your left ~ Overhead f. Don't remember FTO OCT 62 164 Thl fOPm auperaedea P'nl 164, Jul 61, whleh Ia obanlete. 8. IF yoll suw tho obtec:t of Nll;til, what did yo.J no1tte conc:arning th STARS and MOON? 8.1 Sl Ak~ (C rrcle One): 8.2 MOON (C..,cle One): Sught moonlaght Dull moonlight No moon I ight -pitch darl& Oont remember ocnt remember 9. What .... ere the weather condttions at the time you aaw the object? CLOUDS (Crde One): a. Clear slcy c s~arterttd c fe>u\.11i Tt.td r;t heu-y d\JUd~ WEATHER (Circ;le One): b. Fog, mist, Of leght roiu c. Moderate or heavy rain Don't remember 10. The object appe.,red; (Circle 0,.); Tronapment c. Vap~-.r d. As c light e . Don't reew:ember 11. If it appeored os a light, was it brightr than the brighteat atars? (Circle One): a. Brighter c. About the same b. Oimn:er 11.1 Compare brightn to some common oblect: 12. The edges of the obiect were: (C i,f lo (;ne ) a. Fuzzy Ot blurred b. Like a bright star Sharply outlined Don't remmber 13. Did the obaect: (Circle One for each queati~n) a. Appear to stand atill at any time? Yes Don't lcnow b. Suddenly speed up and rush away at any time? Yes Don't ltnow Don't know c. Break up into porta explode? d. Give off smoke? Don't lcnow e. Chan~ bris#1tneaa? Dm't lcnow f. Change 1hape? Yes Don't know Yes Don't ltnow Don't know g. floah or flicker? h. Oiaap~ar and reappear? U.S. AIR FORCE TECHNICAl IHFORMATIOf~ Thia questionnaire hat been prepared ao that you can yive the U.S. Air Force at much information as poasible concerning the unidentified aerial pheno.nenon that you hravu olfte"'d. Pleaae try to onswer as many question at you possibly can. The information that y~u iive witt be uted for retearch purpoaes. Your name will not be used in connec.tion with any st~trreni:;, conclusion, or publications without your permiasior.. We request this personal information ~Je that if it is deemed necessary, we may contact you for further details. 1. When did you aee the obiec:t? ( ( 1rde One): 3. Time Zone: (C lrcle One): a. Eastern ( Circl ' L)ne): Oayli9ht Sa: i"O b. Central c. Mountain d. Pacific 4. Where were you when you sow the object? Neoreat Poatal Adclr City or Town S. How long was oblect in sight? (Total Duration) o. Certain c. Not very sure b. Fairly certain d. Just a guess 5.1 How was time In sight determined? ------------------- 5.2 Was obiect in aight continuously? 6. What was the condition of the sky? a. Bright a. Bright b. Cloudy b. Cloudy 7. IF you saw the object during DAYLIGHT, where was the SUN located as yo\J loc;,k~d a: the ob;e:t? (Circle One): d. To yoor left e. Overheod f. Don't remember a. In front of you b. In bock of yt:XJ c. To your rig,t 8. IF ynlt ~uw tho obJect ot NIGHT, what did y04J notec.e concerning th STARS and MOON? 8.1 S 1 A f.<~, l'C ~rcle One I: 8.2 MOON (C.~rcle One): Bra"'t moonltght Dull moonlight No moonlight -pitch dark d. Don't remember Don't remember 9. What .... ere tne ~other c:ondtiont at the time you aow the object? CLOUDS (C'~rde One): a. Clear aky c. Scarte: .. d clo\.I.U d. T~ I< k o f he\Jty cl~d' WEATHER (Circle One): b. fog, mtst, Of ltyht roiu c. Moderate or hea-,y rain e. Don't remember 10. The obitt<t appe"red: (Circle One); d. As n light b. Trotupment e . Don't relltember c. Vap~olr 11. If it appttared as a light, was It brighter than the brightest atars? (Circle One): a. Brighter ~. About the same cl. Don't lcnow 11. I Compare briohtnesa to aome common oltieet: 12. Th edge oi the obiect were: ( C ,-/~ (;ttfJ) a. f u11y 0t blurred b. Lilce a bright star c.. Sharply outlined d. Don't remember 13. Did the ob1ec:t: (Circle One foo each queatlon) l a. Appear to stand atill at any tln1e? Yes No Don't lcnow , b. Suddenly speed up and rush away at any time? Yes No Don't "now c. Break up into porta ot explode? Yes No Don't know d. Give off smo~e? Yea No Don't lcnow e. Change bri~tness? Y No Don't lcncw f. Change shape? . Y No Don't ~now SJ r laah or fl idcer? Yes No Don't know h. OiJoppear and reappear? Yes No Don't know 14. Did the ODjOCt di.sappcHJr whilu y ou were. 1atching at? II so, how? 15. Did tho object move behind tiom.,ttH"g at any time, porticull.lrly o cloud'! (Circle Ontt ); it moved behind: ((Jes) No Don't Know. IF you .111Swered '([~,, thtm tatH "'ihat 16. Did tho obieet move in front of ~pmething at any time, pmt icularly a cloud? (C ire /e One): Don't Know. 17 . Tell in a few words the following things about the obiect: J 18. We wish to know the angular size. Hold a match stick at arms length in lintt with a luaown '-'bio:t and w : J ' j l'f much of the object is covered by tho head of the match. If you had performed this ox~eriment at ther tir.-...,; . i >Le sightin~, how much of the ob;ect would hove bee11 covered by the match head? Draw o picture that will show the shnpe of the object or objects. Label and include in your sketch ony det~;l of the object that you saw such as wings, protrusions, etc., on~ especially exhaust trails or vapor trails Place on arrow beside the drawing to show the direction the object was moving ~. Do you th ink you con estimate the speed of the object? (Circle One) IF you answered YES, then what speed would you estin.ote'f .. ------ -.. - 21. Do you think you can estimate how far away from you thtt object was? (C irde One) t_e~ No IF you answereo YES, then how far awoy would you say if was? ()11J~{~ t'!l!..r! /J;t;j., OIJAJf: 22. Where were you located when you 1aw the obiect? (Circle One): o. Inside o building {)Outdoors d . In on airplane (type) 2:4. Were yo"' (Circlo One) ir; the business section of a city? lr. rhQ residential s.-cfic.e v i G city? In opc.n country~ide? d. N"ar on airfield? Fl)ing over a city? Fly;n~ over open country'/ 24. IF you were ~OVING IN AN AUTOMOBILE or other vehicle at the time, then complete t~e foltowia.g queati\)ftl: 24.1 What direction were you '"oving? (Circle One) c. East e. South d. Southeast f. Southwest 24.2 How fast were you moving? -------Jmiles per hour 24.3 Did you stop at any time while you were looking at the object? (Circle One) 25. Old you observe the obiect through any of the following? a. Eyegla1sea 6) e Blnoeulars f. Telescope Wind1hield Theodolite h. Northwest d. Window gla1s 26. In order that you con give aa clear a picture as possible of what you aow, describe in your own worcb a catrul'\ort object or object which, when placed up In the aky, would giv~ the so~ ~pearonce aa the object which ) "OU -: In the follolng alcetch, lt~toglne thCJt you are at t>- poi"t ahown. PI~<: u;' J.." on \he r.urv.,,.: ltrc. to sho_, ho.._ high the oblect woa abcwe the horl1on (tlcyllne) when yw llrst aow It, Ploct~ 'l "8" on the 1.1rne cur~d line ,c. ahow how high the obiect was above th horizon (a\cyline) when ynu lost ~u.-~ it. Place ''n 'J.: on the tompost whe" you ''"' aow It, Ploc o "B" on the compost where ~ou lost aaw the ohict. 28 . Draw o picture thot will ahow the motion that the obict or obiects mado. P.loce on .. A' ar tha ~gJnni:1g at ~ne path, a .. B .. ot the end of the path, and show any changes in direction during the 'oune, 29. IF there waa MORE THAN ONE oblect, then how many were there? _ Draw a plctur of how th~ wr arranged, and put on arrow to ahow the direction that tho)' were traveling 31. Waa anyone elae with you at tt.e time you saw the object? (Circle One) 31.1 tF you answered YES, djd they see the obiect too? (Circle One) 31.2 PleM llat their names end addreaaea: 32. Pleaae give the fellow TE LE PMONE NUMBE uullca'-Clfty edtlitlonol lnformltlon about yourelf, Including any apeclol xperlence, which '"ight be pertlnenr . 33. Wh,, and te wh did you reJ*t thot yo had n the obtect?