1. OA IE il:~EGKOUP NUMBER CF 03JECTS CONCLUSION trc;..veli~g 5. LENGTH OF OBSERVATION TYPE OF OBSERVATION :}rour.d VisuG~.l 9. PHYSICAL EVlDENCE 11. BRieF SU~A.\~ARY AND ANALYSI S OOJ ec:. :J.:i t o tr . .J.t as l~.. s ~ov1~1 across s~y. o:>jcc7. .i'=..ried fro:-:-. vi~.; 'ot:.t c~e obs~rv~tio:1. Pr~vlou'l crllt',.,.-:~ nf thl ::1 ft'~ M~V h~ ; '.l'ld, U.S. AIR FORCE TECHNICAL. INFO RMA liO'~ Thia questionnaire haa been prepared 10 that you can yive the U.S. Air Force aa much in format ion as possible concerning the unldentlf ied oer 10 I phenoanenon that you hnvu ob!"rv~tti. Pleoae try to answer as many question a a a you pos s ib 1 can. The Information that yc:u i ive w i t1 be used for reaearch purposes. Your nome will not be used in c~nnec.tion with any st~terreeni:~, conc:lualons, or publications without your permissior.. We request this personal lnformc:.tion 1e that if it i 1 deemed necessary, we may contact you fur further detoi Ia. 1. When did you tee the obiect? 'i. rime of tiar ---"-' --- i ( 1rcle One): 3. l ime Zone: (C lrde One): (Circl(l J nf!): a, c. Mountain d. Pacific 4. Whera wr yoo wh&n you sow the obfect? Neoreat Potol Addr City o/T own S. How long waa object in alght? (Total Ourotlon) Hour a Minute a, Certain c. Not very sure ~Fairly certain cl. Just o guess 5.1 How was time In sight determined?:~-~ ~.Ll~S ~are .-,r J..e~-/(A e;t;.za-fe , 5.2 Wos obiect in sight continuously? 6. What waa tne condition of the sky? @.;)Bright 7. IF you aaw th obiect during DAYLIGHT, where was the SUN located os you lookrd ;:~ the ol;;e=t? ( C lrcle One): a, In front of you b. In bock of you c. To your rig,t d. To your left Overhead f. Don't remember F TO OCT 62 164 Thla f~m aupar .. d .. P1n 16, Jul 61, whleh la obaolet. 8. IF ynv suw tho ob1ect of NIGttl', what did you not tee concerning the Sl ARS and MOON? 8.1 S l Ak~ r'C trcle One): d. Don't remember 8. 2 MOON (C. ire le One): a. Bri~t mf)Of11aght (~?1 Dull moonlight c. No moonlight -pitch dark d. Don't remember 9. What were the ""other tondttianl at the tll"e you taw the obiect? CLOUDS !Crde One): WEATHER (Circle One): @Clear aky b. fo~, meJt, Of leght roha c. Scarte: .. d cloud s c. Moderate or hea"'y rain d. Tt-.t< ~ if heu;y cbud Don't remember 10. The object appeared: (Circle One); (o~ Solici 1). T ron apJa ent d. AI 0 light Don't rertaember 11. If it appeord os a light, was it blighter than the brighteat stars? (Cirde One): @ Brighter 'c. About the ~ame d. Don't know 11.1 Compare .,ightneaa ~o Olftmon obiect: 12. The edge of the obiect were: fCau-lo (.;n,) a. Fu11y or blurred @ Lilce a ,bright star c. Sharply outlined d. Don't remember Did the ob1ect: (Circle One for each question) o. Appear to stand still at any time? Don't lcnow Suddenly a peed up and rush away at any time? Dcn't "now Break up into porta cr explode? ,"N~ Don't know d. Give off amolce? Yet Dcn't lcnow Change brigwtness? Don't know f. Chang a hope? Yes Don't know F laah or fl idcet? Don't "now Dsappear and reap~ar? Don't know p Cl Ql't J 14. Did the object disappear while you wer<. totching 1t ? If ~o. how? 15. Did the obiect move behind someth1ng at any time, parttcul1.1rly a cloud'! @. No Don't Know. IF you .:mswered Y f;~,, thftn t~tH ,_,hatfr o '"} .. (Circle One): 16. Did tho objeet move in front of 'Rmething at any tame, pt'Jrt i cu larl~ a cloud? (Circle One): Pon't Kno~. IF you answered YES. th'!!., ~ n w i; lt 19. Draw a picture that will ahow the shnpe of the obiect or ~bjecta. Lobel and include in ywr aketc