t' KUJ l:: L I IU\J/ J K t:LUi'<U 1. [)A iF. TIME GROUP 2. LOCATION 3 ?cb (;'( "j.l 2 l tiZ Ken.inct.on, l1[uylnnd ( 2 \dt.:~c:.;se::;) 10. CONCLUSION I 1. NWH\CR OF OBJECTS !J. LENGTH OF OBSERVATION 10 rninutes I ( .. T'I'PE OF OBSERVATION ~round-Vlsual 7. C.OURSE 1 Souchwest-South rg PHOTOS I?. PHYSICAL EVIDENCE rTD slP6J 0-329 (TOE) 11. BRIEF SUMMARY A ND ANALYSIS ! Observer s~t.ed thut t.he object appeured as a lign~. Oo~ec~ I had ligilts t.hat we reliKe those of a plane except for ~.r.e revolving ones which were b righter. Object t.hen .f'loa .... cu ot.. ~ of sic;ht. Color was of red and white lights. It appeaLeci co oe traveling i n a southwest-south direction. U.S. AIR FORCE TECl-11"1\CAL IH ORM. n o N This questionnaire has been prepared s o that you con give the U . S. Air Force a s much ormation as possible concerning t he unidentified aerial phenomenon thot you hove observed. Pleas e toy to onswe. os many quesHons os you possibly con. The onfoomotion that you give will be used for research purposes. Your name will not be used in connection w i th any s tatement s , conclusions, or publications w ithout your permission. We request this p:rsonol information so that if i t is deemed necessary, we may contact you for f urther detai ls . 2. Time of day 1. When did y ou see the obiect ? (Circle One): Time Zone: (Circle One):(_o. ( Ci rei e One): l~ghLSovi:1g 1\. Wh~re were you when you sow the object? Stoto or County oorest Postal Address City or T own 5. How long was obiect in s i ght? (Total Duration) o. Certain c. Not very sure b!/ Fairly certain d . just a guess 5.2 Was obiect in sight continuously? 6 . What was th e condition o f the sky? (a._ Bright_./ a . Bright \ 7 . I!' yo u sow the object dud ng DAYLIGHT, whe was the 5UN locate d as you looked o t th e object? (Circle One): a . In f ront of you d . T o y our left b. In beck of you e. Qveoheod l c . To your r ight f. D on' t remember J 3. 1:-y o u s o w th..: ob1ect ot NIGHT, wnat dtd yo u nott c e conct:rntng th e S f A f<S and MOON? 8. 1 STARS (Circle One): 8.2 MOON ( Circle One): b. A few a. Brtght moonlight b. Dullmoonlight c . No moonlight -pitch dark l d. Do n't reme mber ' t:.:.) Ma ny d . Do n't rem~mber 9. What were the weather condit ions at the time you saw the object? C LOUDS ( Circle One): WEATHER ( Circle One ): b. Fog, mist, or light rain \5' C lear s ky c. Moderate o r heavy rain c . Sr.:ottered clouds d . Thick or hea vy clouds e. Don't remember 10. T he o bject o p~ored: (Circle One ): e. Don't reme mber o . Sol id b. T ronsparent 11. If it appeared as a light, was it brighter than t he brightest s t a rs ? ( C ircle One ): c. About the some d. Do n't know 11.1 Compare brightness to some common object: I 12 . Tne edges of the object were: (Circle One ): Fuzzy or blurred Uke a bright s tar Sharply out I ined Don't rerr.ember 13 . Did th e object : Appear to stand s t i ll at any time? Suddenly speed up and rush away a t any time? Sr~ak u;:> into ports or exp looe? G ive o ff s mob? Change brightn~ss? Change shape? Flas h o r flicke r? Disappea r and reappear? ( C ircle On e fo r each question ) r, Ye_s " No Don't kno w \.....No ~ Don't know Don't kno w <.._No cgon now No 'on't know <..Q~n'J_know ) Don' t ~now No Don't kno...,. 14. D id th e objec t disappear while y ou were wn tt:hing it? If s o , how? 15. Did the object move bohind something ot any t ime, particularly o cloud? (Circle One): Yos Don't Know. IF you answered YES, then tell whet tt moved behind: 16. Did the object move in front of something at any t ime, particularly a cloud? (Circle One): in front of: Don't Know. IF you answerad YES, then tell what We wish t o know the angular size. Hold a match s tick at arm' s length in line with a known object and note h ow ch of the object is covered by the head of the match. If you hod performed this experimen t at the time o f the sighting, how much of the object would hove been covered by the match head? 19. Draw a picture that wi ll show the shape of the object or objects. Label and include in your sketch any d<!toils l of the object that you sow such as wings, protrusions, etc. , and especially exhaust trails or vapor trails. P lac'! on arrow beside the drawing to show the direction t he object was moving. l 20. Do you think y ou can estimate the speed of the object? (C ire le One) I F you answered YES, th e n what speed would you estimate?-------- l 21. Do you think you con estimate how far away from you the object was? (Circle One) IF y ou answered YES, then how for away would you Wh re were you located when you sow the object? (Circle One): o. h~ide o building b. In o cor ~Outdoors d. In on airplane (type) 23. Were you (Circle One) ("\ o. In the business section of a city? @ In the residential section of a city? c. In open countryside? d. Near on airfield? e. Flying over a city? f, Flying over open country? i 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete th~ folfowin.g que s tions: 24.1 Whot direction were you moving? (Circle One) fl. Nor11 c. East e. South b. Northeast d. Southeast f. Southwest 2d.2 How fast were you moving?--------------" iles per hour 24.3 Did you s top at any time while you were looking at the object? (Circle One) h. Northwes t 25. Did you observe the object through any of the following? Eyeglasses e . Binoculars Yes Sun glosses ~) f. Telescope Yes Windshield g. Theodolite Yes c. Window glass h . Othe r 26. In o rder that you con give as clear a picture as possible of what you sow , describe in your own words a common object or objects which, when placed up in tne sky, wou ld give the some appearance as the object which you saw. 27. In th e following sketch, imagine that you ore a t the point shown . Place on " A " on the c urved lin~ to s h o w how 1 high the obj~ct wa s above the horizon (skyline) when you first sow it. Place a "B" on the same curved line to I s ho..., how high the object wa s above the h orizon (skyline) when you los t sow it . Ploc.:: on "A" on the compo:.s wh~n you first sow it. Place o "B" on the compass where you los t sow the object. 28. Draw a picture that wi ll show t he mot ion that the object or objects mode. Plac e on "A" a t th e beginning of the 30. H CIV!) you ever suen this, or a similar object before. If :;o give date or dat!)s and location. 31. Wcs unyone else with you a t th e time you sow the object? (Circle One) No IF you answered YES, did they see the object too? (Circle One) 31.2 Please li s t their names and addresses: fV t:: vv yo R ""' Please give th e follow ing information about yourself: F irst Nomo Middle Nome T :: L EPHONE NUMB Indicate any addit ional information a bout yourself, including any s pecial exper ience, which might be pertinent . When and to whom did you report that you hod seen the object? Day Month Yo or 34 . Dot~ you completod this questionnaire: 3 5 . lnfor~otion. which you feel pertinent and whic h is not adequately covered in the specific points of the qJesttonnotre or a norroti,;e explanation of your sighting.