U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you con give tho U.S. Air Force as much in f cr ;r-.:ri on as possible concerning the unidentified aerial phenomenon tha t you have observed. P le:se .. ry to answer os many questions as you possibly can. The information that you give will be !!tj for research purposes. Your name will not be used in conn.,ction with any statements, conc'...~sions, or publications without your permission. We request this personal information so tha t if it is deemed necessary we may contact you for further detai Is. 1. When d id you see the object? (Circle On~): 3. Time Zone: (Circle One): ra.~ -'Easte b. Cen~r~: c. Moun: a ;n d. Paciric (Circle On,.,): a. l)qyli ght Savin g ( h. ~ Stand arE_-.. 4. Wht-re we~e you when you saw t he c:;ject? City or Town Stott or County 5. How ic~g w:s object in sight? rr c: Dura tion) Minutes Seconds .:. Certain '\ c. Not very suro : . Fcidy certc in d. Just a guess 6. What was th e c-Jndi~ion of the sk1? a . Bright rb. Cloudy, 7. IF you saw the objilct during DAYLIGHT where wus the. SIJN locat"d O!l you looke d at tho object? a. In front of you b. In back of you c. To your right To your loft e. Q,~rhflod f. Don't r,m~tmbr (Circle Ona): FTD OCT 62 164 8. IF you sow the object at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One): Don~t remember 8.2 MOON (Circle One): a. BrighLmoonl ight \.. b. Dull moonlight J c.- No- mbonlig11t -pitch dark d. Don't remember 9. What wer~ the weather conditions at tho time you saw the object? CLOUDS (Crrr:/e One): WEATHER (Circle One): a. Clear sky b:-FC;'g, mist, or I ight rain cr'c. Scattered clouds) d. T h kk or i-:eavy clouds c. Moderate or heavy rain e. Don't remember 10. Th~ object c;:~ared: (Circle One): c Y:oor 11. If if Ci)pecr.!d :sa light, was it brig~r~r than the brightest stars? (Circle One): c. About the same d. Don't know 11.1 Com~;::r~ Srightn~ss to some c~rn.-0n obioct: 12. The ed s ~; ~:ie ~bject wera: c :-sharply ~t I i!ied ~. on t rcrr:e :n.)er 13. Did the object: (Circle One for each question) Appaor to stand still at any time? Don't know Sudd"nly s~"d up and rush away at any time? Don't know Br~ol< up in to parts or explod~? Don't know d. Give off smoke? Don't know Don't know/: Change brightness? f. Change shape? Don't know g. Flash or flicker? Don't know Disappear and reappear? Yes Don't know .. 14. Did the obiect disappear while you were watching it? If so, how? 15. Did th~ object move behind something ot'any time, particularly o cloud? Yes Don't Know. IF you answered YES, then tell what 16. Did the object move in front of something at any time, particularly a cloud? (C i:-:le One): Yes_ (N5 Don't Know. IF you answered YES, then tell what 17. Tell in a few words the following things about the obiect: 18. W-e w is'": to know the angular si~e. Hold a match stick at arm's length in line with a known obioct and note how mueh ~f ~he object is covered by the hood of tho match. If you hod performed this oxperiment at the time of the how much of the obi~ct would hove been covered by the match~ head? . 19. Drc-~ o o i; t.J:-' that will show th~ shape of the obiect or obiects. Label and include in your sketch any details of the ob;~c: t!-I:Jt you saw s uc h o s wings, protrusions, etc., and especiatly exhaust trails or vapor trails Plac e c~; c .. :;;w beside the dro-Nin g to show the direction the obiect was moving. 20. Do you think you can estimate th., speed of the obioct? (C ire /e One) IF you answered YES, then what speed would you ostimott9? ..,ollpsr_t r t 21. Do you think yo&J can estimate how for away from you the object was? (Circle One) Yes .. } IF you cns';oof~red YES, then how for away would you soy it was? _-_ J_._' _' _'_(_ _{._,. _r_._) " -' 22. Where w~r~ y::~ located when you saw the obiect? (Circle On'): '-.5!!_1nside o bvtL1in~'"::~ b. In o car c. Outdoors d. In on a ir;-!:lne (type) 23. Were you (Circle One) o. In the. business section of a city? , b: In tho reside~tial st,ction of'a -city? ; c. In open countryside? d. Ncar an airfield? e. Flying over a city? f. Flying over open country? 24. IF you""'"$ J...~VING IN AN AUTOMOcl LE or other vehicle at the time, then complete the following questions: 24. i What dir tion were you moving? (Cirdo On&) c. Ec~r e. South b. Norr est d. So.;tn~ast f. Southwest h. Northwast 24.2 How fos~ Nere you moving? mil~s per hour. 24.3 0 i d yov ! op at any time wh i Is y~u wero looking at the object? (Citc.'e One) No 25. Did you ob v~ th~ object through c,y or th" following? a. Eyeglc .,~ e S v e. Binoculars . Yes No b. Sun gl: s!.,! Yes Ko f. Teloscop" Yos No c. Windsn;~:~ Ytts N~ g. Theodolite Yes No d. Wind~w .: I:;~ (y~ "; No h. Other t:..tr-r L _r h 1 26. In order that you c:n give as clear o picture as p(')ssible of what you sow, describe in your own words a common obiect or objects wn i :h, when placed up in the sky, would give the some appearance as the obi act which y ou sow. 27. In tho following sketch, imagine that you om at the point shown. Pla c e Cln p_" on the c urvod line to show how high the object was above the horizon (skylina) when you first s ow it. Place a "13" on the same curvP-d line t o show how h igh the object was above the horizon (skyline) when you /a:;t sow it. Ploc~ <.m "A" on the campos~ when you fir.;t sow it. Place a "B" 0 11 th e compc1ss whe re you /a:;;t saw tht1 obje ct. 0:--:w c r;i:.;~e that will show the rnotbn that the object or objects made. Ploce on ,.A, at the beginning of the pc~h, c " S n ot the end of the path, o:~d show any changes in direction during the course. Drew o p: cn:r~ :>f h ow they wer~ cr~:J.,ged, and put on cur ow to show tha Jirot: t io11 that the y wore t raveling. ~ 30. Have you ever seen this, or a similar object before. If so givo date or dates and location. 31. Was onycr.e ~: s' with you at the time you saw the object? (Circle One) 31.1 IF y-:>u .:nswered YES, did they see the object too? (Circle One) 31.2 P leo$e ! i st their names a addresses: 32. P lease 9 iv e tne following information obout yourself: TE LE PHO~= NUM 11\dicot~ ~ny -;;dditional information eSo,Jt yourself, including any special experience, which might be pertinent. When and to whom did you report that you hod sean the object? Month Year 34. Date you completed this questionnair": 35. Information which you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting.