1. nA ~F . TIM!! GROUP 2. LOCATION PROJeCT 10073 RECORD ! Civil iar. t t. Nl,H\ER OF OBJECTS 1 l'PE OF OBSERVATION liround Vi::lUlll ~. F'tiOTOS f9. PHYSICAL EVIDENCE 1 1. BRIEF SUMMARY AND ANALYSIS Uboerver Rlat~d there w~r~ li~ht. C0lore: e~e ed to un or down or acc~lernted. Just a bright 27. In the following slcetch, imagine that you are at the point shown. Place an "A" on the curved line to show how high the obiect was above the horizon (slcyline) when you lirst saw it. Place a "B" on the same curved line to show how high the obiect was above the horizon (slcyline) when you last saw it. Place an .. A" on the compass when you lirst saw it. Place a "8" on the compass where you lost saw the object. path, a "B" at the end of the path, and show any chan 1rection during the course. ~ o t.C-t h we.s-c 29. IF there was MORE THAN ONE object, then how many were there?------------ Draw a picture of how they were arranged, and put an arrow to show the direction that they were traveling. 30. Have you ever seen this, or a similar obiect before. If so give date or dates and location. 31. Was anyone else with you at the time you saw the obiect? (Circle One) No 31.1 IF you answered YES, did they SH the obiect too? (Circle One) No 31.2 Please list their names and address L 32. Please give the following information about yourself: ...S L_ast Nome Middle Name S9 -ft/a le_ T~LEPHONE NUMBER Indicate any additional information about yourself, including any special experience, which mig~t be pertinent. When and to whom did you report that you hod seen the obiect? 34. Dote you completed this questionnaire: lnfor1nat which you fHI pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sightinq "UFO" Reportinl Data ( contiDuecl) (1).. Use one or 1"7 combination ot the tollowin& items: Ground-visual, .11'-~ , psound-electronic, (It electronic, specit7 tJPe of radar.) Ground--visual. (2) Stat .. t as to optical aida (teleacopea, bizloculara, etc.) used deaeriptioa taereot .. (.3) U the ailbtiDI occwTed wldle air-borne, give t)'pe ot aireratt, identification n'mber, altitude, headins, speed, and home station. d. TIME AND DATE OF SIGHTING: conditions. dawn, dusk. (Use one or the tollowin& te1ns: n:tsllt, dq, latitude and longitude of eaca e. LOCATION OF OBSERVER(s). Give exact observer, and/or geo1raphical position. Indoors, watching through window on west side of house. House located in Delta county, address Gladstone, Hichigal"l Route d 1 . ot reliabilit7. -Name, age, mailing address, occupation, and estimate age 39 Brcklayer Gladstone, Michigan 49837 age 33 homemaker , t'tl..L. t" e n (2) M:llitar.y-Name, grade, organization, duty and estimate ot reliabil:lt7. ADC-1 Cmbt Spt Gp-CDC Se) fr!.2.e AFB TD'E:r/UFO DEfiA.-TMKNT Ofl" THI! AI" fi"O.-CE /)-z- HIAOQUA"Ta.-e 'OIItiiGN TECHNOL.OQY DIVIIION f A,Sf;) w.-IGHT~ATTI.-eON AUt ,O,.CI 8AII. OHIO 41.11 IC41oo Jc. UFO Obaervat1op8 Mu-G1 Reference your \ID14eDtlt1ecl o'baervation. 'lbe intounation vh1ch we have received 1a not autt1c1ent tc~ a acient1t1c evaluation. Request you complete the attachecl F'l'D 164 and return 1 t in the envelope provided. Thank you for reporting your observation to the Air Force. -/tiMEs C. MANATT, Colonel, USAF /,Director of Technology and Subsystems FTD Form 164 w/envelope Return to: Reportiaa Data: 1st Fighter \-Jing ( J\DC) Selfridge AFB, Hich 48045 (2) Sise to a mown object (uae one ot the tollowinl t Head of a pill, , dime, nickel, ~rapetrait, or baalCet ) , halt , aUver , held iD the hand at a~ut arm' I Larger than a basketball. H~ Single object. see number nine (9) (7) TaU, trailritl or , illoludinc aise ot ot object(s) "_ (8) SoUDd; it heard, describe sound none watchj.ng frorr. indoors. Red.glowing colqr appearing (9) Other features beneath object also a green flickering color beneath object. (1) What first the atteatioD or obaerwer(a) to the object(s)? Family dog Skippy, excited barking~ (2) An,l or elewation and azimuth or object(s) wh tirst o . Descdnding very rapidly towards earth from a southwesterly direction (J) Anal or el~vation and azimuth ot object(s) upon disappearuce. Rising intm the northwestern sky. I (4) Description ot t111ht path aad mneuYere ot object(s). DtJscendad vary r .1 pidly to,...Ja!"d 3 earth. A ppe~r'3d tl.)' hoV('!~ a bo..re Ri~i and falli motumons while risin~ in a appear o veer to the right twice. (5) How did the object(s) disappear? Instantaneoual.7 to the North, Rising to tha northwest out of sight. (6) How lone were the objects(s ) visible? (Be speeitic, 5 minutes} U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force as much information as possible concernin' the unidentified al phenomenon that you have obHrved. Pleas try to answer as many questions as you ltOSslbly can. The information that you give will be used for research purposes. Your naiiW will DOt be used in connection with any statements, conclusions, or publications without your permission. We requst this personal Information so that If it is deemed necessary, we may contact you for further details. 1. When did you see the obiect? 3. Time Zone: (Circle One): a. Eastern c. Mountain d. Pacific 4. W!,erA were you when you saw the obiect? Nearest Postal Address S. How long was obiect in sight? (Total Duration) (n. Certain "&:-a1r y certain 5.2 Was obiect in sight continuously? 6. What was the condition of the sky? 2. Time of day: (Circle One): (Circle One): a. Daylight Saving b. Standard City or To~ State or County Minutes Seconds c. Not very sure d. Just a guess 7. IF you saw the obiect during DAYLIGHT, Where was the SUN located as you looked at the obiect? (Circle One): a. In front of you b. In back of you c. To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thla form auperaed FTD 164, Ju1 61, which la obeolete. 8. IF you saw the ob;ect at NIGHT, what did you notice concerning the STARS and MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle One): a. Bright moon I ight b. Dull moonlight ([Mlj,,.an'~ d. uon't rememl.r c. No moonlight -pitch dark {;) Don't remember 9. What were the weather conditions at the time you saw the obiect? CLOUDS (Circle One): Clear slcy.,~ c. Scattered clouds d. Thiele or heavy clouds 10. The obi ect appeared: (Circle O:..n:,:e.:..;.)::....----"""1 (d: As a light b. Transparent WEATHER (Circle One): 'b. rog, mist, or I ight rain c. Moderate or heavy rain e. Don' t rensember 11. If it appeared as a light, was it brighter than the brightest stars? (Circle One): ~ a. Bright~ c. About the some ... b. Uimn:er d. Don't know 11.1 Compare brightness to some common object: 12. The edges of the obiact were: (Circle One): a. Fuzzy or blurred (9 Like a bright star c. Sharply outlined d. Don't remember 13. Did the obiect: a. A!)pear to stand still at any time? b. Suddenly speed up and rush away at any time? c. Brealc up into parts or explode? d. Give off smolce? e. Change brightness? f. Change shape? g. Flash or flicker? h. Disappear and reappear? (Circle One for each question) . Don't know Don't know Don't know Don't know Don't know Don't know Don't know Doo't know 14. Did the obiect disappear while you were atch ing it? If so, how? 15. Did the obiect 1110~ behind something at any tinoe, particularly a cloucl? (Circle One): Yes Don't Know. IF'you answered YES, then tell what 16. Did the obiect mcwe in front of something at any time, particularly a cloud? (Circle One): Yes Don't Know. IF you answered YES, then tell what 17. Tell in a few words the following things about the obiect: 18. We wish to know the angular size. Hold a match stick at arm's length in line with a known obiect and note how the obiect is covered by the head of the match. If you had performed this experiment at the time of the 1 sighting, how much of the obiect would have been covered by the match head? I 19. Draw a picture that will show the shape of the obiect or obiects. Label and include in your sketch any details of the obiect that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on a"ow beside the drawing to show the direction the obiect was moving. 20. Do you thinlc you can estimate the speed of the obiect? (Circle One) Yes IF you answered YES, then what speed would you estimate?------- 21. Do you thinlc you can estimate how far away from you the obiect was? (Circle One) IF you answered YES, then how far away would you say it was? 22. Where were you located when you saw the obiect? (Circle One): 23. Were you (Circle One) a. In the business section of a city? @ Inside a building b. In the residential section of a city? b. In a car @ In open countryside? c. Outdoors d. Near an airfield? d. In an airplane (type) e. Flying over a city? f. Flying over open country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24.1 What direction were you moving? (Circle One) r.t. Nor~ c. East e. South b. Northeast d. Southeast f. Southwest 24.2 How fast were you moving? miles per hour. 24.3 Did you stop at any time while you were loolcing at the obiect? (Circle One) Did you observe the obiect through any of the following? Eyeglasses Binoculars b. Sun glasses f. Telescope Windshield Theodolite Window glass In order that you can give as clear a picture as possible of what you saw, describe in your own wnrds o common obiect or objects which, when placed up in the slcy, would give the same appearance as the object which you saw If so, how? 15. Did the obiect mcwe behind something at any time, particularly a cloud? (Circle One}: Yes Don't Know. IF' you answered YES, then tell what 16. Did the obiect move in front of something at any time, particularly a cloud? (Circle One): Yes Don't Know. IF you answered YES, then tell what 17 . Tell in a few words the following things about the object: We wish to know the angular size. Hold a match stick at arm's length in line with a known obiect and note how the object is covered by the head of the match. If you had performed this experiment at the time of the sighting, how much of the ob;ect would have been covered by the match head? 19. Draw a picture that will show the shape of the object or obiects. Label and include in your sketch any details of the obiect that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing to show the direction the obiect was moving.