I 1. OA ~E "!"IME GROUP 2. LOCATION 3. :~,'lur:rt: 10. CONCLUSION Possible ( A:il\CAAI='..,' ) t. NUt~E\E R OF OBJECTS I... LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS Observers stated that the object appeared as e. light. Ed.6eG T't'PE OF OBSERVATION of the object were :fuzzy and blurred. Observers stated tr.~ f obJect vould seec to land in sane trees. Objact had :io't. ; any distinct noise ot its om. Color: red., green, and wr.ic I~. PttOTOS f 9. PtiVSICAL EVIDENCE f-TO se p 6 3 0-3 (TOE) Pre.,lou edlUoA ol dab lUi& .. Fa.. ...... 20. Do you think you can estimate the speed of the obiect? l=" (Circle One) Yes ~ bV 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? 23. Were you (Circle One) (C ire le One): a. In the business section ofa city? b. In the residential section of a city? c. ~-~J;n c~;h;-sidel} d. Near an airfield? a. Inside a building c. Outdoors 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 we~ you moving? (Circle One) I \A. t\ ;J fC c ( R R. 0 1..-L JJ d "A :'jl f'.:~ a. -North j b. Northeast d. Southeast f. Southwest h. Northwest 24.2 How fast were you mewing? ;/ t:-/-/.)-miles per hour. 24.3 Did you stop at any time while you were looking at the obiect? (Circle One) ~.// No 25. Did you observe the obiect through any of the following? Eyeglasses Binoculars b. Sun glasses f. Telescope Windshield g. Theodolite d. Window gloss 26. In order that you can give as clear a picture as possible of what you sow, describe in your own words a common obiect or obiects which, when placed up in the sky, would give the same appearance as the obiect which you saw. In the following slcetch, imagine that you are at the point shown. Place an "A" on the curved I ine to show how high the obiect woa abcwe the horizon (alcyline) when you lirst saw it. Place a .. 8 .. on the same curveclline to show how high the obiect was above the horizon (slcyline) whett you last saw ft. Place an " A" on the compass you lirst saw it. Place a "8 .. on the compass where you last saw the obiect. Draw a picture that wi II show the motion that the obiect or obiects made. Place an "A" at the beginning of the ~ path, a "B" at the encl of the path, and shu~ ~ny changes in directipn during the course. . ~ IF there was MORE THAN ONE obittet, then how ntany were there? ----------- Draw a picture of how they were arranged, and put an 01row to show the direction t t1at they were traveling. 30. Have you ever s"n 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) 31.1 IF you answered YES, did they SH the obiect too? (Circle One) 31.2 Please list their names and addresses: 32. Please give the following information about yourself: Last Name First Name Indicate any additional information about yourself, including any special experience, which might be pertinent 33. When and to whom did you report that you had seen the object? ~. Date you completed this questionnaire: 35. ion which you feel peatinent ancl which is not adequately coverecf in the specific points of the questionnaire or a narrative explanation of your sighting. dcreA-4-vY ..t!"Yl<:~ 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 conceming the unidentified aerial phenomenon that you have observed. Please try to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your name will DOt be used in connection with any staten\ents, conclusions, or publications without your permission. We request this personal information so that if it is deemed necessary, we may contact you for further details. . . . . 1. When did you s .. the obiect? //!c!ca.L (Circle One): Month Year 3. Time Zone: (Circle One): a. EasJ~1!! c:-Mountain d. Pacific 4. Where were you when you saw the obiect? (Circle One): a. Day I ight Saving C} Standard City or Town State ot County S. How long was obiect in sigh~? (Total DtWatton) Hours Minutes a. Certain c. Not very sure b. Fairly certain (d.'" J~!.! -~-~:- 5.2 Was object in sight continuously? Yes No ('~ 6. What was the condition of the sky? '-ti:' Cloudy 7. IF you saw the object during DAYLIGHT, where was the SUN located os you looked at the obiect? (Circle One): a. In front of you b. In back of you d. To your left e. Overhead c. To your r ight f. Don't remember FTD OCT 62 164 Thla form au~ndee FTn 164, Jul 61, whle~ ia obaolete a. IF you lOW the object at NIGHT, what did you notice CO"":C:e'rning the STARS and MOON? 8.1 STARS (Circle One): 8.2 MOON (Circle One): a. Bright moon I ight b. Dull moon I ight c. -~OO"! t -pitch dark 9. What were the weather c:~cfiti~s at the time you saw ff..~ obiect? CLOUDS (Circle Ontt ): ~ a. ~lear slcy c. Scattered c I oud !!' d. Thick or heavy cfouds WEATHE~ (Circle One): Fog, ni :at, or I ight rain c. Modernt"" or heavy rain e. Don'~ re"'tember 10. The obiect appeared: (Circ:le One): b. Transparent e:-E>on t remember 11. If it appeared as a light, was it brighter than the brightelit !tors? (Circle One): a. Brighter c. About the sa-nto d. Don't know Compare brightn SS to some common obiect: 12. The edges of me obiect were: (Cirde One}: c:(~ Fuzzy or blurrea::;, 13. Did the obiect: b. L ikl! c 6iiynt star c:. Sh a,.p ly out I i ned d. o~n't remember a. Appear to stand sti II nt any t ime? b. Suddenly speed up and rush away at any time? c. Break up into parts !),. exDiode? d. Give off smok-,~ e. Change bright.,~ss? f. Change shape? g. Flash or flicker? h .. Oisapo"!or or.d r,.O;:>Decr? (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 Don't know 14. Did the obiect disapoear while you were watching it? If so, how? 15. Did the obiect move behi"d something at any time, particularly a cloud? (Circle One): it moved behind: No Don't Know. IF you answered YES, then tell what Did the obiect move in front of something at any time, particularly a cloud? (Circle One):-Yes No' . Don't Know. IF you answered YES, then tell what 17. Tell in a few words the following things about the object: 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 much of the object is covered by the head of the match. If you had performed this experiment at the time of the sighttng, how much of the obtect would hove been covered by the match head? 19. Draw a picture th"t will show the shope of the object or objects. Label and include in your sketch any details of the object 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 object was moving. 20. Do you think you can estimate the speed of theobiect? (Circle One) IF you answered YES, then what speed would you estimate? _:_. 21. Do you think you can estimate how far away from you the obiect was? (C irc:le One) IF you answered YES, then how for away would you soy it was? fi,a_;J~. / t2tJ -/ ...f"C y.:J.s~ 22. Where were you located when you saw the object? (Circle One): a. Inside a building c. Outdoors In an airplane (type} 23. Were you (Circle One) a. In the business section of a city? b. In the residential section of a city? @In open countryside? d. Near an airfield? 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) 24.3 Did you stop at any time while you were looking at the obieet? (Circle One) 25. Did you observe the obiec:t through any of the following? Eyeglasses Yes No e. Binoculars b. Sun glasses f. Telescope c. Windshield C:Yes ) g. Theodolite Yes Window gloss 26. In order that you can give as clear a picture os possible of what you saw, describe in your own words a common obiect or objects which, when placed up in the sky, would give the some appearance as the object which you saw. 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) 31.1 IF you answered YES, did they SH the obiect too? (Circle One) 31.2 Please list their names and addresses: 32. Please give the following information about yourself: Middle Nome Zone State TELEPHONE NUMBE Indicate any additional information about yourself, including any special experience, which might be pertinent 33. When and to whom did you report that you had seen the object? Doy Month Year UNCWSIFIED ACTION: RDC-4 INIU: XDP-1 XOPX,..2, SAnl5-3, NIN-7, DIA/JCs-1, (19) . . . ADV CY DIA SMB B 15 IJVO ~9 7 PTTU JAW R tiiTEMA 179' 18122 1':-UWlJ-~ LEOHQA. z Nt uuuuu P 2122ell MAR sr FM J2FTRWG R ICHMOS GEBA\R AFB MO TO RUIMFVA/ADC RUEDFIF/fORE IGH TECH 0 IV WPAFB OHIO R UEO HQA/CSAF R-l0 HQA/OSAF VI ASH 0 C RUCISKA/31 AIR 0 IV SIOUX CITY MUNI APRT IOWA INFO ZENI11AF R I CHARD S GEBAlR AFB MO ZEN/UNIVERSITY OF OOLORADO BOtLOER COLO f(R ADO IN, TDETR, AfROC, SAF-Q f, 3111 N. INFO: 11) IN & OR CONlON AT U OF OOLO. SlBJ: lfO REPORT I M;. All PAR A N\NBERS REFER TO AFR 81-17 . PARA 11.A. C1> ROUNl WITH sr.tM..LER ROUNl TOP. (2) BOTTOM ABOUf THE SIZE OF AN ARMY TANK WITH A SMALLER DOME LIKE TOP. CJ> N> VI SABLE COLOR. C4> NO IDENr IF I CAT ION Nu.tBER VISIBLE. ON. Y ONE OBJECT. (5) N/A UNCLASSIFIED 34. Date you completecl thi1 queationnaire: 35. I ion which you feel perti,.nt ancl which is nat adequately ccwerecl in the specific point of the . .,eetioti."'MMire or a narrative explanation of your sighting. UNCWSIFIED DIPAIT.. Of nil All FOICI Slllf ... lUlGI UKOMIII MISSAII . <6> TWO WHITE SPOT LIGtfS ON TOP, ON BOTTOM HALF ONE ROW Of RED L IGHfS, BELOI THAT A ROW OF GREEN LIGHTS, AN) BELOW SECONl ROW OF LIGHTS A StllRTER ROW OF GREEN LIGHTS. <7> N) TAIL, TRAIL, OR EXHAUST. PAGE 2 R llfTEMA 179' UNQ.AS <a> .OBSERVERS ROLLED DOWN CAR WINJOWS TO SEE IF THEY COlLO HEAR ANY SOUNl S -~ SO 00 HEMO. <9>. NJ ~. B. ( 1> A ROW OF" REO LIGHTS WITH T\0 SPOT L IGt-fTS ABOVE ROW OF LIGHTS ON ROAD IN FRONT Of AUTOMOBILE. C2> T~EE HUNlREO TO FIVE HUNlREO FT ABOVE GROUNl. DIRECTLY IN FRONI' OF AUTOMOBILE. CJ> RIGHT ANiLE TO AUTO, 111 YOSOUT IN FIELD AP~OX IMATEL Y 391 FT ABOVE GROUNl. C4> OBSERVED IN F IELO TtN 0 ISAPPEARED BEHfNl TREES THEN REAPPEARED ALONi -SIDE OF AUTO, OBSERVED ABOUT 0~ M INUfE TtN ANlTHER AUTO APPEARED FROM 0TtR 0 IRECT ION STOPPED THEN OBJECT 0 I SAPPEARED. C5> INSTANT ANEO USL Y WtN SECONl AUTO STOPPED TO OBSERVE. C 6> T~EE MINUTES. C. < 1> GRO U~ VISUAL. C2> ~OPTICAL AIDS. <J> NIA. D. <1> llt38-I'J't5 ZULU ~S, 18 MARCH 1961. <2> NIGHT E. TtfiEE MILES OOUTH OF. HIGKIAY 58 ON HOMES ROAD. F" ( 1> C IV Ill ANS NSAS CITY, M I SSOLR I, ARMCO STEEL, A C 1> CLEAR. AHl CALM. C2><A> 58 DEGREES AT 2 K~TS,CB> 030 AT 19K(C)311 AT 30K, UNCLASSIFIED UNCLASSIFIED (') 11 NILES. (5) OVERCAST AT H. NO~. I. tDtt:. J. tGt. K. ACT lNG II Ni INTELLIGENCE OFFICER LEE M. MAOURDO, CAPTAIN USAF, HQ 328 fIGHTER WIN; PAGE 3 RUYTEMA179-UNQ..AS R I r.HARO S-GEBA lR AFB, M I SSO lR I EXT 5 81 OFF Pf()~. 816 AREA CODE. 0 I 5 ''II AFHQ Mtee 0-309C UNCLASSIFIED DK~A"TMKNT 0~ THK AIR P'OftC. HKAOQUA .. TK"e I'O ... ION TECHNOLOGY DIVISION f AI'8C W"IOHT.ftATTKR.ON AIR I'O .. C& 8A81. OHIO aa UP~ Observatio~ 18 March 1967 Reference your un14eDt1tle4 observation. The i ion vhich we have received is not auft1c1ent tor a aeient1t1c evaluation. Request you complete the attached F~D Form 164