0ve1 YolJ l cc,, i.Ja./Plat.t7ou.rJ f, i?il ,7. COURSE I~. PnCTOS co~cc t wns r oun d und di~c1iocu u nj"\t;lcr c from o.s ".:>.:.c, c...; 'J:c:.:1ct to trw zizc oi' l.,(!e tiluon. All observe r s Gl.<:.~t.-...!~ ..,; ..: n a tail ns liKe n E.iloot.ine S\,or. FTD S f P -l' : .:29 (TDE) Pre v lou t<!':.,na o f thlo form m a y b e u .. d. U~CLASSIF D DEPAATME:atT Of THE Alit FORCf Slt\fF r~USAGE SlA>Iot INCOMJHG h\ESUGE <INVERSt.: W, 3000 TO 5000 FEET MINUS 2. 5 OEGREES/1000 ~00a TO 16e00 FEET MINUS 1o2 OEGREES/1000 FEET I o NOT Ft:AS IBLE J. COU..D \OT BE OETERM I NED LOCALLY UNCLASSif!ED the i(ccord: l Feb 67 :-::1:-::ct \'lith SP!\0,\'i.'S rcvc:jled that on 25 Jan 67 th~ce wen~ vftr~l dec2y s . The one moGt likel.y l'BU~lOn!;ible for the ::)o.H>:rve.tion .ms t;,c d~cny of obj,..ct number 265f!. and object .wr:b~r 2659. Object /12658 H & s the rocket body of Co!':r:tos 139 i:1ile object t! 2659 was aom~ arl.dH:iona l space cl~bris. SPADATS sai l that object ;f 265~ had no tir.t<~ fot rl.eca.y since it decayed :hortly aft e r lat.:_nch. 1\o definite dnLa was obt;.!in d on the 0bj1~ct since it ha.d such a short li rc. U.S. AI R FORCE TECHNICAL INFORMATION Tn1s questionnaire has been prepared so that you con give the U.S. Air Force as much in fo r mo ion os possible concerning the unidentified aerial phenomenon that you have observed. Please ~;y t o answer as many que stions as you possibly can. The infor mation that you give will be use:i for researc h purposes. Your nome will not be used in connection with any statement s , conci.:si ons, or publications without your permission. We nquest this :;-ersonal information so that if 1t is deemed necessary, we may contact you f o r further details . l. When did you s e e the object? Doy Mont h Year 3. Tire Zon'! (Circle One): a . tose., b. Centel d . Paciric 2. Tiroo o f day: (Circle One): (Circle One): a . Daylight Saving b. Standard 4. Wher~ .... ~-e ) O\.J when you sow t he =::.je:::t ? Ncoa ?oslo I A ddres:. ' Cit y o r Town Stote o r ~ou~ty ./ I 5 . how lo-9 w: s o!>ject in sight? {"ic::' :::>urotion} Minu tos Seconds c. No t very sure b. Po'dy cert ain d. Jus t a guess 6. What was the condnion of the sky? !>. C ioudy 7 . IF you saw the object during DAYLIGHT, where wos the SUN located as you looked a t the object? (Circle One): a. In front of y o u b. In bock of you c. To your right d. To your left e . Overhead f. Don' t remember FTD OCT 62 164 T hl8 form a uperacd,.s F'Tn 164, j u l 61, which In ollsole\t:. tL IF y o u sow the object at NIGHT, what did you n otice concerning th e ~TARS and MOON? 8.1 STARS(CircleOnc): b. A i e.v d . . :~n't remember 8.2 MOON (Circle One): a. Oright moonlight r~' / b . Dull moonlight moonlight -pi tch dark d. Don't remember 9. Who! wer~ ''lc weather conditions at the t ime y ou saw the object ? CLOUDS (Circle One): WEATHER (Circle One}: a. Clea r $:.;Y b. Fog, mist, or I i gh t ro in c. ScottenJ clouds c . Moderate or heavy ra in d . Thick c heavy clouds e. Don't remember I 10. The obj~.: .Jppeorcd: (Circle One): j c. Vapo r 11. I f i :l;'):;>eo~J a s a light, was it br';-,:!r rh on the brightest stars? (Circle One): c . A bout the some b. C immer d. Don't know 11. 1 Com:~.: e bri sh~ness t o som~ c o:"lmon object : 12. The e3g':!s -:.: 1~ oSj~ct were: o. F uzzy or bi .:; e:! ~. Snorp!y O\Jt 13. Did t h e o bj e::r. a . Appco; t o s.t::"'d still a t any t ime ? b. Sudde:1ly s;> d up and rush oway at any time? c. Break Uj) ;,o ports or e xplode? d . Give otf s r 1oke? e . Change bri gh tness ? f. Change s hope? ash or fl icker? h . Di soppcor and re appear? (Circle One for eoch question) Don't know on't know Don't know Don't know Don' t know Don' t know Don' t know Don't know 14. Did the object disappear while y ou were watching it? If so, how? 15. Did t~.e ~:; ' e-:1 move behind sornetning at any time , particularly a cloud? Don't Know. IF you answered YES, then tell whot it f"lOV'!'.j behind; 16. D id the move in front of something a t any time, particula rl y a cl oud? (Ctrcic: ')ne): Yes No Don't Know. IF you answered YES, then tell wha t 17. T!!!l i.,::: :~"'words the following h irgs about the object : Hi. ri-: ""' Sr ~.;now t h e angular size. -~o a match stick at arm' s length in line with a known object and note h ow mv ct, of I"'! ~bject is covered by , e r>~cd of the match. If you hod performed this experiment o t the time of the sigh tirg, h::,,.; much of the object .,..,juid h a ve been covered by the match head? 19 . Draw=:>: -~--~will s t,ow :;;~ s~-:-:e o f t h e object or objects. Lobel and include in your sketch any d etai ls =-s::~w s ... ~)-: ::;: -;~gs, protrusions, etc., and especially exhaust trails or vapor trails. Plac e c., ~ . ..,._ ;:: ~ de t'-,e drawt~; -. s~ow the direction the object was moving. 20. Do you think you con estimate t h e speed o f th e ob je ct? ( Circle One) I F y ou onsw::r d YES, then whot speed would you e s t imate ? c.on estimate ho w for away fr o m y o u the obje c t wos? . , . (C -:le One ) IF you ons.,..~:ed YES, t he n ho w for away would you soy 22. Where W'!re .-~u located when you sow the object? (C ire /e 'Jr.~ : a . lnsid~ t: :lui lding b. In o co c . O utdoor.; d . In c-. c ::d o n e (type) 23. We r e y o u (Circle One ) a. In the business se c ti o n of o city? b. In th e residential sec tion of a city ? In open countryside? d. Ncar on a i r field ? e . F lying ove r a city? f. Flying o ver open country? OVING IN AN AUTOMC~ !_t or o t he r vehicle a t the time, then comple t e t he f ollowin g q ue s t ions : '2~.1 Whc ~:e::tion were you ma v in -;? ~Circle One) b. t,.:w'1~ost d. Sowneost f. Southwest 24. 2 How k~t were y o u moving? mile s per hour. 24.3 Di d ycu ~f-'? a t any time while you were loo!dng at the objec t ? e. Binoculars f. Telescope g. Theodoli t e h. Northwes t 26. In o rd e r that y:w ccn g ive o s clear o p icture as pos:oi b le o f what y o u sow, desc ribe in your own wo rds a common object or obje~ts w:...i c h , when placed up in the sky, w ould give the some appearance as the object whic h you sow . 27. In the follow ing sketch, imagine that you are at the point shown. Place on " A " on t he curved line t o show ho w high tho object was above the horizon (skyline) when you first sow it. Place a "B" on the same curved l ine to show h ow hig:, tho object was above the horizon (skyline) when you lost sow it. Place on " A " on the compass when you frrst s o w it. Place o "B" on the compass where you las t sow tlcc object. , 'row o p i.: re that wi II show the ;-;: ion t ha t the object or object s rna de . Place on "A" at the beginning of the po!-, o "~'' o t t h e end o f the path , :::-d s how any changes in direction during the course. 29. IF tnere w :::; 'w~O?.E THAN ON~ e~ e::t, then how many were there? Dre w o p , .:r _ e :;f ~ow they were :1rr :!,..ged, an ..:I put an arrow t o show the direction t hat they were trove I i ng . 3 0. Hove you ever seen this, or o simi lor object before. If so give dote or dotes and locat ion. 3 1. Was anyo ne ;lse with you a t the time you saw the object ? (Circle One) 31.1 IF y c .. answered YES, did they see the object too? (Circle One) t Yes Pl~c;e l is t their names and addresses: 32. Please gi" ~ the f ollowing information ~bout yourself: TE LE PHON~ NUMBE F irst Nome Middle Nome Zone State lndicch ~;;y ddit ionol information :J:,Out yourself, inc lud ing any special experience, which might be pertinent. t.lt t',Jj'l When and to wh :>m did you report that you had seen the object ? 34. Dote you completed this questionnaire: Information whi:::h y ou feel pertinent and which i s not adequately covered tn the specific points of t he questionnoir!' or a narrat ive explanation of your sighting.