OA lE TIME G U ? 2. LOCATION . 3. :otmcE 5. LENGTH OF 0:3ScRVATION 75 s~conds 6. Tl'PE OF OBSC.~VATION Gr-our:d Visue.l 9. PH Y S I CAL E V: :, =:'iCE ;roodberry For~st 10. CONCLUSION Aircraft(possible) 11. BRIEF SUtA.~ARY AND ANALYSIS Cb~;!ryers v1ere lookin~ out a \lindovr \'lhen the y noticed a gre::!nis h Hhite li~ht traveling toward the southern ~ky. It dirr:.;e d irregularly and chanc~ed c ours e t.evera l tim~s, but al".;ays continut!d in the s ame direction. Jus t before it d i s:1ppeared over the trees, there was a bright flash like a f1.are \th~!re the object di~apJ:earcd. A second objcc::. a~pc0r~d in th:! same position as t h e firs t but it H=13 '::':'.'.,.~line f:lst ~r tha n the first. Th i s obj ect Has lovJ in ;_2_:.it.ljc tha t the firs t a nd moved in t he Op}:osite dir- Sir.;:~ only lieht~ \n~re obs~rvcd it i s possible th3.t air- cr~f:. He!'e. responsible for tho ob!1crva t ion. FTD S C ? 63 0-3~9 (TDE) Prevloua od!tlonJ ;)! !hts form llH\Y bo used. DEPARTMENT OF THE AIR FORCE HEADQUARTERS "'OREIGN TECHNOLOGY DIVISION ( AFSC) WftiOHT-PATTIEASON Alft ... OftCIE IIASIE. OHIO 45433 UFO Observation, 15 Feb 67 ~-:ccd')~r ... -y. .. ibrect. School T"'coj_':;~rl'Y l'ore1;t ~ ttirglnia 2~989 Ref2rence your unide:1tified observation. The information which we t ave received is not sufficient for a scientific evaluation. Req....:eat you complete t he attached FTD Form 164 and return it in the envelope provL:l~d. Tha.nk you for reporting your observation t o t he Air Force. MANATr, Colc~-21, USAF of Technology and Subsystems FTD Form 164 w/envelope U.S. AIR FORCE TECHNICAl. INFORMATICa~ Thia questionnaire hat been prepared 10 that you can give the U.S. Air Force a1 mu~h information as poasible concerning the unidentified aerial phenonenon that you ht1vo oLservei. Please try to answer aa many queatlona as you possibly con. The Information that yCJu give witl usd for reaeorch purposes. Your nome will not be used In connettion with any st~te"teni~, condus ions, or publications without you; permission. We request this personal Information 1e that if it is deemed necessary, we may contact you for further details. 1. When did you see the obiect? (Circle One): 3. Time Zone: (C lrc/e One}: b. Central c. Mou,toin d. Pac:if:~ (Circl" L1ne): a, Ooyli9ht Sodno b. Star,dard 4. Wh&r were y :J4J when you sow the ob l"et? City or Town S. How long w:J object in aJght? (Tot~l Dvrotlon) o. Certain .' b. Fo irly certain Was ob!eet ;~ s i-ght contlnuausfy? 6. What waa th :o~:::dion of the sky? Hour a Minute a c. Not very sure d. Just o guess (bJ Cloudy .... 1. IF you saw th obiect during DAYLIGHT, where was the SUN located as you loc,keocJ at the obie~t? (Circle One): o. In front of you b. In boclc of you c. To your rlg,t d. To your left e. Overhead f. Don't remember FTO OCT 62 164 Thl fc.M upd .. PTD 164, Jul 61, whlch le obult. 8. IF ynlt sow the oLtect ot NIGttT, whot did you noteco concerning the STARS and MOON? 8.1 S 1 Akf_, (C. ~rcle One): 8.2 MOON (Circle One): Bri_ght moonlight Dull moonlight No _moonlight -pitch doric d. Don't rmembe~ Don remember 9. What """'& t ~other c:ond1tiont ot the th"you taw the obie~t? CLOUDS (.: rdo One): a. Clonf aky ( h. ti\Uy c. Scott~:-{, clovd s WEATHER (Circle One): ~. Fog, mist, Of' leuht ralu c. Moderate or heo-yy rain e. Don't remember 10. Th~ obi"~' J;)ptt\lred; (Circle One). ~ .. At o light e . Don t remember b. Trorapi"'Jt en t I 11. 1f it oppeontc 01 a light, waa It brighter t~::.~n th brightat stan? (Circlo One): t. About the 'ame d. Don't tcnow 11. 1 Com~or ~ightneaa to aome eom~on oblct: 12. The od~s o~ n object were: \l. Like a bri~t s t or c.. Sharply ovtt ind ~. Don't remem~r (Circle Ono few eoch quoatlon) Appear b 1t-:1~d still ot any tim.? Don't know Sudd~tnlt 'P"e~ up and ruah away at any time? Don't &cnow Break up mto parts or explode? Don't lcnaw Give off smoke? Don't lcnow Chanoe brig,tnesa? Don't lcnow Change a hope? Yea Don't lcnow flaah Of flicker? Don't lcnow Oiaappeor and reappear? Don't lcoow 20. Do you thinlc you can estimate the speed of the obier:t? (C ire le One} IF you an$wered YES, then what speed would you estin-.ate'f --------.. 21. Do you think you can estimate how far away from you the obiect was? (Ci rcle One) IF you an)wertd YES, then how for away would you soy it was?------ _ 22. Where wer yov locohtd when ~ou sow the oblect? (Circle On ): lnsid o building -Win J f)'(/ , ,y i).J b. In a cor - c. Outdoors d. In on o i .. :>lane (type) 23. Were you (Cirdo One) a. iri the business section of a city? b. lr. th~ residential S\)Cfivll vi o city? In op"n country~ide? d. Near an airfield? e. Flying over o city? f. Fly;nQ over open country? 24. IF yo'C--wtt V.OVING IN AN AUTOM03JLE or other vehicle at the time, then complete the followit'4Q queationa: 24.1 What ~too._,_were you .,ovin;? (Circle One) b. N :,rtheo st "}.' ....Southeast 2.4.2 How f~st were you moving? --~ f. Southwest me les. per hour. Did y~u stop at any time while you were looli'in.g at the obioct? (C ire /e One J Yea 25. Old you o~srv th e object throu;h ony of the following? Eye~ I-:' Jat Binoculars f. Telescope Theodolite Wind~""' c '.:ss Yes No ' 26. In order that you con give as clear a picture aa possi~le of what you saw, describe in yolr own worcla a COfnmOft I obiect or obiecta which, when placed up In the alcy, would give tho soma appearance as the obiect whlclt ) ' OU 1ow 14. Did the obiect disappear while you wcr~ latching it? If so, how? 15. Did the obje c t move behind som~thng at any time, porticuhuly a cloud'? Don't Know. IF you .:mswered Yf2~,, them tdH what it mov e d behind: 16. Did tho o hja:t move in front of methtng at any time, particularly a clo\Jd? (Circle One): ,. Yes No Dont Know. IF you answered Yl..:~. th"!)'' ~+!tl wii''Jt 17 . Tell in a f.e,., words the following things about the obiect: We w ish to know the angular size. Hold o match stick at arm $ length in lin~ with a known ubio:t one' ':! much of the ebject is covered by thrJ haod of the match. If you had performed this ex~eriment at the, tir:v.: .,~t ;1.1.'! sighting, how much of the object would have been covered by the match head? 1. 19. Drow a pi:tu~e thot w ill ahow the sho;J~ of the object or obiects. Label and include in your sketch any dettli lt. of the obi&et r t you sow such as -wings, protru5ions, etc., and especially exhaust trailt or vapor trails. Place on or row ~si~e the drawing to show the direction the obiect was moving. '" the followhtt a ketch, lmotlrw that you ore ot the point thown. Ple~e on ., A'' on tht r:urv: I mt. to thow ho._ high the oblct WCII abOe the horizon (t~yllne) when yeN llr1t sow lt. Ploe 'l "8" on the a:ame cur\'ed line h' ehow how hl;h the oblct wa1 above the horizon (t~yllne) when ynu lost fluw it. Place -:sn A'' on the (Ompost when you ''"'sow It, Place a "B" on tha compo11 whre you /oJt eow tt.e ohtect. 28 . . Drow o ? i: t ..sr that will ehow the motl~n that th" obiect or obiects mad(). Place on "A'' at tho boglnn1~1g oto ~ha pern, o " 6 '' ~ the end of the poth, end Jhow ony changes in direction during the ~ourae, 29, IF thr wcs :.noRE THAN ONE objtct, then how many wer thre? : 0- Orow o pl:hu Qf hQw they wtr orr~:"lgtd, and put an orrow to ahow the direction that thoy wer" trovulin~ If ao give date or dot end locotion. Hove you ever n thia, or a aimilar obiect ~f 31. Wos onyont Is with you at the time you saw th obi~c:t? (Circle One) 31.1 IF 1 :-.; :snswerd YES, did thty e the obiect too? (Circle One) 31.2 P 1~ I iat their 32. P l.o 1 ; i~ the follow I~ lnfmotl"n a~out youraelf: TELE?M~E NUMBER-------- 33. Wh'ln end to whom di~ you r port thot you had n th object? 34. Date you complted this questionnaire: 35. lnfortttation whi~h you feel pertinent and which Is not adequottly covered in the apeclflc polntl of the queatlonnair C!f o narrative explanation of your sighting. cJiuw-.--1/-U( crz.e-a./Le_{l ovt:A ~< -m0 J