PROJECT 10073 ReCORD c:;.ou? LOCATION .. N~it?C:R Or O~JcCTS 10 CO.~CL US JON PriYSICAL EVI:>c"-:~ 11. BRIEF SUMMARY AND ANALYSIS ftiii'LV TO DEPARTMENT OF THE AIR FORCE HEADQUA .. TE"S FOREIGN TECHNOLOGY DIVISION ( AfPSC) WRIGHT-PATTERSON AUt FOACI BASil. OHIO 4!5433 i 7 February 1967 UFO Observation , 15 Feb S? Cl:=i~tinnsburg, 0~1io h 3012 Referen~e your unidentified observation. The information which have received is not sufficient for a scientific evaluation. Re:;~;st you complete the attached FTD Form 164 and return it in the envelope provid~d. '.rha.nk you for reporting your observation to ~he Air Force. MANATr, Colo::el, USAF of Technology and Subsystems F~D Form 164 w/envelope U.S. AIR FORCE TECHNICAl. IHFORMATIO~ Thia questionnaire has been prepared so that you can yive the U.S. Air Force as much in format ion as possible concerning the unidentified oe.-ial phenornenon that you hnvu oLserveti. Plea try to answer as many question as you possibly con. The information that ye:u give wiU be uad fQf research purposes. Your norM will not be used in conn!tc;tion with ony st~tentent~, conelus ions, or publications without your permissior.. We request this personal Information 1e that ;f '' is deemed neceaaary, we may contact you fur further details. 1. When did yo1.. see the obioct? 3. T ime Zoi\8: (Circle One):-70 . c. Mountoin d. Pacific (Circl'-' L)ne); a. Ooyli9ht So'doo ,~:, Sto11dard 4. Where wer y-:N when you sow the object? City or Town S. How lon~ w=s -o:ject in sight? (Tot:~! Dvrotlon) Hours Minutes a. Certoin c. Not very sure /b.-Foirly certain d. Just o guess 5.1 How wes , ;r.-:e in sight determined? ------------------- 5.2 Was obj-tct ir. ~i;ht contlnu~usly? 6. What waa tn-t:~:'!= t:~n of the sky? 7. IF you aow the object during DAYLIGHT, whare was the SUN located os you lovk~d at th ob;fJ~t? (Circle One): o, In front of you b. In bode of you c. To your rig,t d. To your left e. Overhead f. Don't remember FTO OCT 62 16~ Thle form eupereedn PTD 164. Jul ta, which le ottaDIt. 8. IF yov sow the oLtect of NIGttl, what did you nottce concerning the STARS and MOON? 8.1 Sl Ak~' fC,c/e One): ~C.'-'IA H ,;-{-8.2 MOON (Circle One): l~'l'~-"Jt~f '-'"-" a. Hre~t moonlight b. Dull moonlight c. No moonlight - pitch doric d. Don't remember d. Don't rtmember 9. What 'l'tere ,;, .-.eother ,ondetiont Gt the time you aaw the obi~rt? CLOUDS ! C '' ' le One): WEATHER (Circle One): a. C lenr ~Icy a. Dry (~-Fog, mlt, OC' le~t raha c. Scaue~*C eft)U,JS c. Moderate or heavy roin (dj Th !C: lo 1;.; n e\l-.y cl~u&h Don't renaomber 10. Th~ ob j,.ct appeared; (Circle One}; Tronspm etllt <.'[~; A.s :l light e . Don't rernemb.r \ 1. If i t oppeer<Jc 01 a light, wa it bri~htr than th brighteat stars? (Circle One}: o. Sri~ter c. About the tame d. oont know o. Fuzzyorbturrd b . Li~e a bri~t sror j,/ Sharply out I ind -l. Do;, t reme,ber a. Appear t o uond ati II at any time? b. Suddenly s;.oeed up and rush away at any time? c. Bteak up into parta or xplod? d. Give off smoke? e. Chang. br ig,tness? (Circle One fOf ecch qyeatlon) oont know Dent know Don't know Don't lcnow , t / 0 Don't know v 1 , f. Change shope? g. <f1Qil\ 01 fl idcer? h. Oiaoppear and reappear? 15. Did the obiec:t move behind ttome~hing ot any time, particul..uly a cloud'? (Circle One): Don't Know. IF you ,J,'\swerod Yf.~,, thttn t_.U ,,.-hat it moved behind: 16. Did tho objer move in front of !$Qmerhing at any time, prnt icu larly a cloud? (Circle o..,~): Yes Don't Know. 17 . Tell in a f,., words the following things about the obiect: o. Sound j) 18. We wish to k~ow the angular size. h vl d c match stick at arm'5 length in line with a known ubiett and 1 t:'r much of th o;,ject is covered by th e head of tho match. If you hod p~rformed this experiment c;t th& ti.-..; sighting, h~..,. much,of,'he object woul~. hove been cove~ed by the match head! ~ 19. Draw a l)lc+vr thot will show th& shope of the obiect or objects. Label and include in you.-ketch any detc.i 1,. of the obje' !h.: t y ou saw aueh os wings, protru&ions, etc., and especially exhaust trails or vapor trail a. Ploc on orr~w besid the drawing to show the direction the obiect was moving 20._ Do you th inlc you can estimate the speed of t41e obiect? (Circle One) IF you answered YES, then what speed would you estin.ote"f ------.. -- 21. Do you thin~ you can estimate how far away from you thft obiect wos? (C i rele One) No IF you ans.,red YES, then how for away would you say it was? ;;. 22. Where wer 'I':>V located when you sow the obiect? (C ire /e On e ) . & Inside a t.vilding b. In a car c. Outdoors d. In an a ir? lone (type) 23. Were you (Citc-lo One) a. iri tho business section of a city? b. lr r~<: residential s"cfiC#II vi a city? @ Itt oplln country~ide? d. Near an airfi~ld? e. Flying over o city? f. Fly ;n\i over open ~ountry't 24. IF yo'J wer V.OVING IN AN AUTOMOBILE or other vehicle at the time, then complete t~e followie.g questions: 24.1 What ci&rction were you "'oving? (Circle Ona) b. Nor~heost d. Southeast f. Southwest h. Northweat 24.2 How ~<a' were you moving? miles per hour 24.3 Did y;,u 1top at any time whil you wera looking at tho obiect? (Ci,.cle One) No 25. Did you obaave the obiect through c:1y of the following? a. Eyt;b,s b. Sun ; loa1s e. 8 lnocu Iars f. Telescope g. Theodolite ~- 't(,1-w ttLc-~-t.ff ti1~t..ss. In order that you eon give as clear a picture aa ~6sai.ble of what you saw, describe in your own wotda a con,.mon obioct ot obieett which, when placed up In the alcy, would give the same ap~aronce os the object which ) 'OU 10"' 27 .... '" the followl"t a ketch, lmotlrte that you ore at the point thown. Plac on J.." on 'h r:vrv,.: line. to a how ho- hlgh the oblect woa above the horl1on (skyline) when yc,u llrst aaw ft. Ploe8, "6" un the 101me cur~d line 'c ahow how hl;h the obiect waa abov the horizon (skyline) when ynu lost ~uw it. Place un ''/A.' on the tompCllf when you ''''' ''w lt. Ploce o "B" on the comp011 whr you /ot eaw the ohict, ' ~3 . Dr~w : p i:t-...a that will show the motio~ thot tho obiect or objects modo. Pluce on "A ' at the. boginrai:1g ot ~ho pot~, o "S., ct the end of the path, o ~d lhow any changes in direction during the ~our!.e, IF th"' wca MO~E THAN ON! o)f thtn how n~ny were there? v~r -- Drow a pl:tvr ~f nQW thty wer or~e d, and put on arrow to ahow the dire'ttion that tht~y werrt travvling 30t Hove you ever seen thia, 01 a aimilar object before. If ao give dote or dote and locotlon 31. Wos anyo,. elae with you at ttl. time you sow the object? (Circle OneJ 31.1 IF y~ ~nswertd YES, did they the obiect too? (Circle OnJ 31.2 Ptt,a liat their nomea end addreaaea: TELEPHOI"E NUMBER Mlcl .. le Name lndJ~at o"y odditlonol lnform~tlo, :~:,Out youraelf, Including any apeclol experlene, which might b. p&rtlnnT. j 33. Whn on.d to whom did you report that you had seen the obiect? 34. Oat you complted this queatlonnalre: 35. Information which y04J fHI pertinent and which 11 not adquotely eoverd in the lp4tctflc polnta of the questionnaire 01 o norrotlv explanation of your lighting.