1. OAlF. TIME GROUP 2. LOCATION Dec 66 o4ooz Philadelphi<:. 3. ~ifllH~Ct: -1. NU BCR OF OBJECTS 10. CONCLUSION INSUF'li'ICIENT D.\': .. r lH i~U\LUATION !i. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANA.L Y:>l5 None Noted t.. TYPE OF OASERVATION Ground Visual None Noted l SJ, PHOTOS I" f'HYSICAL EVID!NCE FTD Sf.P 63 0-329 (TOE) p,.vloae edlUOfte of 'hh foaa aay be'ueed. U.S. AIR FORCE TECHNICAl. IH FORMA II0-1 Thia questionnaire hat b.en prepared to that you can yive the U.S. Air Force aa much information os possible concerning the unidentified aerial pheno.nenon that you hnvu oL8erveti. Pleote try to answer as many questions at you pc-ssibly con. The information that ye;u iive w it! be uaed for reaeorch purposes. Your nome will not be used in conne(;tion with any st~tentenS~, conc:lusions, or publications without your permission. We request this personal inform~tiQn 1c that if it is deemed neceatory, we may contact you far further detai Is. 1. When did you e the obiect? 'i. Tim~ of rlc.r Ooy Month Y eur 3. Time Zone: (C irde OneJ;,.-- Eastern y c. ountarn d. Pacific (Circlt' ()ne): o. Daylight Sod nH b. Sto'ldard Where were yrN when you saw the object? Neareat Paatal Addr City or Town Srot ~ CoJ"~t; S. How long waa obiect in sight? (Total Duration) Minute& Second Certain c. Not very sure b. Fairly certain d. Justo guess How was time In sight determined? Was object in sight continuously? What waa the condition of the slcy? a. Bright Dright a. b. Cloudy b. Cloudy 7. IF you taw the objact during DAYLIGHT, where was the SUN located as you lockPd at the o':;e~t? ( C lrclo One): a, In front of you b. In bock of ycu c. To your ri~t d. To your left e. Overhead f. Don't remember FTO OCT 62 16. Thle fo.lft up .... dee PTD 164 whlch l obDiete. 8. IF ynv sow the obtect ot NIGtiT, what did you notece concerning the STARS and MOON? 8.1 S 1 Akf.. (C ,cJe One): 8.2 MOON (C..rc/e One): a. Bri~t moonleght b. Dull moonlight c. No moonlight - pitch darlc a...._ None d. Don't remember d. Don't remember 9. What .,._.,. tne ..... ather c:ond1tion ot the time you aaw the object? CLOUDS (Cttle One): I a_y Clear aky c. Scatter .. d e h~d s d. Th tc ~ c>4 he\l.y cf~,h WEATHER (Circle One): b. fog, mtsr, ~ leyht ro6u c. Moderate OJ heavy rain e. Don't renaember 10. The obj.-ct appeared: (Circle One); d. A I ll light b. Troupont e. Den 't rerttember 11. If it appeared oa a light, waa it btighter than the brighteat atars? (Circle One): (!) Brighter c. About the same b-Oimm1r d. Don't ~now 11. 1 Compare brightneaa to IOflte common o~Ject: 12. Th edge of me obiect were: Fuzzy or blutred Like a bright star Sharply outlined d. Dont remember 13. Did the obtect: a. Appear to stand atill at any tim1? b. Suddel\ly speed up and ruah away at any time? .. c. Break up into parta Ot explode? d. Gave off smoke? e. Changoe bri~tnest? f. Change thape? g. f laah or fl iclcer? h. Disappear and reappear? (Circle One for each question) Don't lcnow Don't &cnow Don't lcnow Don't lcnow Don't &cnow Don't know Don't lmow Don't know 14. Did the object disappeot whild you wert. ' otch.ng at? tl ~o, how? 15. Did the obiect move behind som.,thang at any time, particukarly a cloucl~ (Circle One): No Don't Know. it moved behind: . 16. Did the objeet move in front of ~l)merhing at any time, particularly a cloud? (Circle One): Yes No o~n't Kno~. IF you answered YES. th~ ttlU wj,.lt 17 . Tell in a few warda the following things about the obittct: -j 18. We wish to know the angular size. Hold a match stick at arm~ length in lintt with a lmown ubioct ant4 t~"/J ' j N much of the obiect is covered by the head of the match. If you had pttrforme.:J this experiment ot th tir.'V; ..t :.~ sighting, haw much of the object would hove been covered by the match head? . 19. Draw a picture that will ahow the shape of the obiect or obiects. Label and include in your ketch ony detc:ail of the obiect that you saw such as wings, protru1ions, tc., and especially exhaust trailt or vopor traila Place an arrow beside the drawing to show the direction the obiect was moving 20. Do you thinlc you can estimate the speed of the object? (C ire le One) IF you answered YES, then what speed would you estirr.ate'f ------. - 21. Do you thinlc you can estimate how far away from you tho obiect w12s? (Circle One) IF you answered YES, then how for away would you say it was?----------- 22. Where were you locotd when yrN aaw the ob{ect? (C irc/e One): o. Ins ide o bui I ding b. In o car c. Outdoors d. In an airplane (type) 23. Were you (Cirdu Omt) a. In the business section of a city? b. 1r. rh<r residential S\tctic,et "i G city? c. lr: opttn country~ide? d. N"ar an airfield? e. Fl) ing over a city? f. Fly ;nv o..,., open country'! 2~. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete t~et followir.g queatiC~ts: 24.1 What direction were you ~noving? (Circle One) a. North c. East b. Northeast d. Southeast 24.2 How fast were you moving? .mils per hour 24.3 Did you atop at any time while you were loolcing at the object? (Circle One) Old you obaerve the obiect through any of the following? a. Eyeglaaaea Yea No Binoculars b. Sun gloasea Yea No Windshield Yea No Theodolite Window glaaa h. Northweat 26. In order that you con give as clear a picture as possible of what you saw, describe in your own won:la o cocunOf' obiect or obiects which, when placed up In the sky, would giv tne soma appearance as the obict whlcl, )'~ IOV~1 11 tn foJJ~wint JM.fCrt lttt<ttfn that you 011 If tht point t:-,OWn, ?ieee (JM ' 'J.." OM \he t:IJtvl': ftr~ tO 1how n0 high the oitect was abcwe tnt horizon (s~yllnt) when y~ llrat sow lt. Ploc:t1,.. "B" on the a.2ma c;Uf~d line,('. how high the obiect was obove the horizon (slcyllne) when ynu lost ~uw it. Ploco ~n 'f..' on the tomptJif -hen you ''"' aow lt. Place a "8" on the com.- where you lot sow th of-.tett. 28 . Draw a picture that will show the motion that the obiact or obiects mado. Place an ''A' ar rhet beglnni:lg ot the path, o ,.9" at the end of the path, and show any changes in direction during the ~ours.e 29. IF there was MORE THAN ONE ol.iKt, then how many were there? _ Draw a picture of how they were arranged, ond put on orrow to ahow the dire,tion that they were traveling :o. Hov~ yo-J ,..,., n tni,, 01 a aimilcr objact b.for~. If so g ive datJ or dor~.s and locoH~,. 31. Was anyone alae with you at ftle time you saw the object? (Circle One) 31.1 IF you answered YES, did they aee the obiect too? (Circle One) 31.2 Please list their names end oddresaea: 32. Pleaae give the following lnfematlon about youraelf: TELEPHONe NUMB l"cUcate any odclltlonal lnfor,.tlon about youraelf, lnclucllng any apeclal experience, which might be pertlnenY 33. When and to whoa1t dtd you that you hacl teen the objct? 3.6. Date you complted this questionnaire: 35. Information which you feel pertinent and which Ia not adequately covered in the specific points of th. qustlonnalre or a narrative explanation of your alghtlng. Jt:lu' ( j DEPARTM!!NT OF TH AIR FO~CE HEADQUA,.TERS FO"EIGN TECHNOLOGY DIVISION r AFSC) W"IGHT-PATTE"SON AI" JrO"Ca BASK. OHIO A5A33 ftlfi'LY TQ TDET/UFO UFO Observation Philacelphia, Penneylvunia 19131 Reference your unidentified observation. The information ~hich we have received is not sufficient for a scientific evaluation. Request you complete the attached FTD Form 164 and return it in the envelope provid~d. Thank you for reporting your observation to the Air Force ..... , S C. MANATI', Colonel, USAF '~-"!"'U rector of Technology and Subsystems F~D Form 164 w/envelope