I. i'<~lt':'.ER OF 03JECTS .... leNGTH OF OBSE~VA TION 'f?E OF OBSERVAiiON 7 . COURSE i'nYSICAL EVIDENCE Oosc::-vvr U.S. AIR FORCE TcCHI-IICA1. INFORMATI01~ Thia questionnaire ho;~ bean propor"d s o that y ou con yive the U.S. Air Forc e os mudl informat ion as possible concerning the unidentifie d oo110 I phonooi'I.H'IOrt thot you l.llvu ol.nerv&.i. Please try t o answer os mony quo:stlon.s os you pC'Issibly con, Tho in forma tion that ~t:u s:ve w:ll b:t usod fOf r~seorch purpo:sa:s. Your norr_. wi II not be us~d in conn..,c..IH>rl with a ny 5t~ton.eni:;, conclusions, or publicat ions without y our permissior.. Wa rl)quesl this per!loncl lnformot ion ~c thor if it i~ deemed necolSory, w.:~ may c ontact you for i!Jrther datoi Is. 1. Whan did you see th~ obr., c r? 'i. rir.1e of r!r. . Mi nut"f s 3. Tim., Zone: (Circl One): a. Easter.(' o.-Central c , Movntoin d. Pacific 4. 'hh"ro w~re yeN wh'n you s ow t he obj,ct? iC.rc/e One): (Circl<' L) n e}: a.:,_ D$i ~tfc mi) I,. Sfo., or Cit y or To .. n 5. How lon9 was object in sight? (Total Ourotlon) o, Certain c . t Jo t very sure ~a~rly c-~-rt-o~ln---_. d. J ust o gu"" 5.2 Wo~ obj8ct In sight contin uously? 6 . What woa the conditi on of t he alty? a . Br iGht ~B_r_i_glu-' 7. IF y ou 3aw th obj~ct dur ing DAYLIGHT, where~ WOJ th" SUN locoto d Ol yov loc.keJ c: tho ot:1~:: t? (Circl.l One): o. In front of you d. To your ltlft In bock of you T o y our r i!;ht f. Don't reme mber Thl<> t,.,.,m ou p ouod YTD 16 -' , jut Ill, 9Whlc h l o oba ntot ... 8. If" you ~uw the obJect or NIGIH, whul d1d yoo noltcc concemmg th .. STARS and MOCt-1? 8.2 MOON ((,cfc Or.-o): a. Br1~t mooolt ght b. Dull moonlight a . Nooo d . Don't rem~tmber c . N.2. moon I isJh _.!_ -::._P i rch datk 9. What .... ero tiut ~;.eother c.oodttions ot tha tim~ yoo .aow th e objoct ? CLOUDS (Ctrda One): WEATHER ( C ire/~ Omt): '--t:-tog, mt:SI Of lts,;ht r0111 c. Scofte: .. tl clov.~ c. Moderato o r heavy rain e. Don't rei'Tlember 10. Th~ obtfiCt appe<lred; (Circle On~). A.a :: light_.... o , on f romember b. Trou~pm"nt c . Voplr ) 11. If 1t appeared o a a li ght, wa a it bright, than th.t brignt~JI a t a r:s? (Circb Qn., ): a. Bright3 r c. About th 3omo 12 . Th e ed~a of th~t object WtJr-t~: ((,,,It>,,,.,) a. Fu::zy or blurred h. Like o brlynt s tar c Sharply cwt lineci d. Don't rem'lmber d. Don' t know o. Appear to arond ::.till ot any t l"""'? b. Svddflnly ape~ up and r ush away at a ny tim? c. ~hook up m t o part:l or l'tXplod? d. Grv:t ofi 11mo~e? o . ChanQ'4) brig,tnasJ ? f. Change .ahope? O flash Of fliclcer? h. CilllOpJ>4iOr and r~oppear? (CircltJ One fOf ooch q uatlon) i Cv~v N~" Don't bow ~ Y~s (No_) Oan' t know \ Yes (No, D0t1' t know f Yen Q~ Don' t !cnow ~ Y~ ( No J O;;n ' t kno'JIII Cio/ 'Jio o~t know Yttll ~o) Dcn't k,.,ow 15. D id tn e object movet behind somethnq ot any t ime, port cul\lrly o c loud? ( C lfclfJ On~): it moved bahind: Don't Know. IF y.:.u Jo1Swered Yf:.;,, lht'lll t:sll ..-h ot 16. Did the ohjot.:t move in front of GJ.)metfnng a t any 1 1me , pl'lrl ic u lo r ly a cloud? .. w Yo s ( . _ ~ ~ IF you onsw.eren YES, th'"!,, -sH w,. JI 17. Toll in a few word& the fo llowing tn1ngs about the object : 18. We wish t o know the angular siB. Hold a mat c h s tick a t a rm''> length in l int; w i th a lct~t>vtn t.~bj0~t one' t:':' .. J,.. much of th ooject iJ cover~d by t h o head o f the mat ch. If you had perfor med t h is o xperimon t o t thtt ti.~o ,i : ~ siohtin~, how much of t h e object would hov" been covered by the match head? 19. Draw o p icture tha t will ahow t h e :~hope o f t h o obj~ct or o bjects. Lobel a nd include in yvu1 s ketch a ny det<:>il~ of t h ' objec t that you s ow such O ll wings, protr usions, etc., a nd eapeciolly e xhaust t roilt o r vopOt' tr'lila. Ploco on arrow beside th e dro.,.,ing to :~how t h e d irec tion the object w o!. moving. u-s 1 a ld IUlft c. us 1 r u 1 ;0. Do you th rn !< y ou c on ust~rnotc thlt ::.peen of th., cbj.,cr? (Circle One) IF yoo onsw!r3d YES, rh,n whot spaed would you oJtin,ot.,~ ------- 21. Do you thin!< you con e s timate how for away from you thn object w'ls? (Circle On~) you answered YES, then ho.,.,. fa r owoy would you s oy i t was?------- ----- 22. Where ware yoo locotttd when 'JOO :sow th~ object? ( C trclo One): Were you (Ctrcld One) o. Inside o bui ld ing b. In a cor (!'; O utdoors a. In on airplane (type) a. lr the busine:;:. section of a crty? \~ GJ lr. rl:~ residentia l s..,o.::ric. vi c city?r.Y>''""" c. lr: o ptm country~ide? d. Near on airfield? e . Fl)'ing over a ci)y? f. Fly.n~ C't'or open coc;n t ry '! 2-l. IF you wera MOVING IN AN AUTOMOBILE or o ther v.,hicle at th., t rrr.e, the, complet~ tho:t followi9 qunti~: 24. 1 What dirt~tction were you ..,oving? (Circ/., One) o . North c. Ea5t e . South b . N~theost d . Southeolt f. Southwest h. Northweat 24. 2 How folt were you moving? _ -----'niles per hour. 24.3 Old you atop at a ny time whil y ou w~re looking ot t ho obje c t? (Circle One) No D id you obnrv e the object through any of th' following? Binoculars b. Sun glouel Yes f. Telescope Y e:. Windshield Yos No g. Theodolite Yos Window olo.a :~ Yos No h. O th e r 26. In ord, that you con g ive as clear a pict ure o s possible of what you s o w, dl'lscribc in your own wotds o common objact or object.a which, whn p laced up in th~ aky , would givs th e some appearance a ' the ob ject which )OU aa"' high lh~ obj~ct wou obov~ ?h hodz()(l (~lcyllnt} wha n y w flr.st ~ow it. P l.,cu., "B" or th:t ;1,:::~ c.urud li ne:(' show how hig h th., objGc t was ohov.t th::t h ori1on (s!cy llntt) whan you las t '\uw rt. Ploco .:1n ' .A.' on tho tompo.1: wh;,n you llr~t aaw it. P l oco o " B " on tho compou wh~tr y ou loJt Gow rho oh1oct . 23 . Draw a pic ture that wi ll s how the mot ion tnot t he obje c t or obje cts modo. P loco on ' ' A ' aT rho ~ulntai .1R u 1 path, oJ "S" a t t h11 ond llf the path, and ~how any cha nges in dire c t io n during the c.::>Jt~:t. 29. IF th,,., w-;sa MORE THAN ONE obict, t hn how mony wro th ere? -------------- Dra w a pl<:tvr11 of how thy Wr8 orronged, and put on arrow to 1how t ho d iro c r1on t hat thoy we r" trcvcllfl~. I p t I -I 31. Wo~ myon-~ eln with you at ~e t ime you sow the objoct? (Circle Ono) 31.1 IF you onsw11r-.d YeS, did t h11y sae the obj11ct too? (Circlu On:,) 31.2 Plc:~a,. lis~ their nomu ~nd oddr~nu: 32. Pleou giv th following lnfmatlon about y ournlf: TELEPHONE NUMBE ZoM St Clto lndko~ ony additional lnfOf'mltlon obout yournH, Including ohy a~Kiol ex;,.rlnc, whleh might b. po~rtl~nro 330 Wht~n and to whom did yoo re;::acrt that y ou ),od oun the object? 1 :W. Ollt y cv compl-.tt~d ?ni o c;uutlonnolr~: lnfotmatlen which y~ bel prtinent and whicl1 is not od'tquot~ly cov,~d in the ~p.telflc poli1h o f tho. qu:lt ionnoir3 oro n a rrotiv explanation of your alohting. OC:? At=l'rMENT 07 THZ P.l~ F'O"!lC~ WRICHT-PATT!::R30N AIR FO;tCt: t:A;,'!, OHIO -'"'.33 UFO Observation, 3 Ap~ 67 Reference y .. :>ur unidentified observation. 'Ii'le inforiT!.!!ti on vhich we have recelved is not sufficient for a scientific evaluation Request you complete the attached FTD Fort:1 164 and return it in the envelope provided. Thank you for reporting your observ e.tio:-1 t o the Ai r Force. Jr'IJ1ES C. MANATI', Colonel , USAF Director of Technology and Subsystems F'i'D ?orm 16!,. 4 e nvelope U.S. AIR rORCE T ECHJ'IIICAL INFORMATION This questionnaire has been p r:!pared s o that you can give the U. S. Air Fore_, as much information a s possible concerning the unidentifie d o~riol phenom-.,non that y oll have observed . Ploose try t o answer as many questrons as you possibly con. The informatio n that fOU give will bd used for research purpos~s. Your nome will Dot be used in connection with any stot~m~nts, conclusions, or publications w ithout your permission. We request this personal information so that if it is deemed necessary, we may contact you f or further details. l. When did you see the object ? Month Yoar 3. Time Zone: (Circle One): l.C!."' Eastern b. Central c. Mountain d. Pacific 4. Whera were you when you saw the object ? 2. Time of day: j_- (Circle One): (Circle One): a. Daylight Saving b. Standa rd City o r To w n Sto: ~ o r County 5. How long was object in sight? ( T o tal Duration ) Hours M[nutes Soc:!!nds a. Certain c . Not very sure b . Fairly cartain d. Just a guess 5 . 2 'Was object in ~ight continuously? 6 . Wh a t was the condition of the sky ? b . Cloudy .s- Br i nh t b . ClouJy 7. 1c you sow the o bj ct during DAYLIGHT, where was the !)UN located a s you looked at th., obi ct? (Cirde One}: a . In front of you b. In beck o f you c. To your ri~ht d . Toyourleft t r:>memb e r a. IF you sow the object at NIGHT, what d id >ou notice concerning the STARS and MOON? 8 . 1 STARS(Circ/eOne): 8.2 MOON (Circle One): Bright "moon I ight a . ull moonlight c . No moonlight -pitch dar k d . Do n ' t Do n ' t remember 9 . What were the weather c onditions at the time you saw the object? CLOUDS (Circle One): & Clea r sky c. Scattered clouds d. Thick or heavy clouds WEATHER (Circle One): b. Fog, mist, o r light roin c . Moderate o r heavy rain e. Don't rememb~r 10. T he object appeared: (Circle Onej: b. T ronsporent e . Don't remember A s a light 11. If it oopeored as a light, was it brighter than the brightest stars? ( Circle One): (_?/ Brighter b. Dimme r c . About the some d . Don't know 11. 1 Compare brightnes s to some common object : 12. The ~dges o f the object were : (Circle One): a . Funy or blurred Like a bright stcr c . Sharply outline d d . Don't remember 13. Did th e object: (Circle One for eoc:h question) a . A ppear to stand sti l l at any ti me? No Don't know Sud:ienly speed up and rush away at a ny time? Don' t know Br!!al< up into parts or explo<ie? on' t know d . Giv e off smob? Change brightnec;s? Don't know f. Change sh:~pe? Yes {No Don't know F l:uh o r flicker? Don' t know Discppeor and r~appear? Don't know 14. Did tho} obj.,ct disappt>cr whii'J you Wl':ro watching i t? If :.o, how? I 15. Did tr.e object move behind something a t any time, particularly a cloud? it moved behind: _ 16. Did th e object move in front of something at any t ime, particularly a cloud? (Circle One): Do n ' t Knew. IF you ans..-ere-:1 YES, ,h.,n :e : rlna~ Yes 17, T~f f in a f9W 'ords the following things obour the object; a. Sound _ ' ''(:! wish to know tin angula r size . Hold a match stick at c rm's length 1n line with a known oo:-:ct ond note h...,., mJch o f the object is covered by the head of the match. If you ha d performed this e~peri:r.-,rt ;t th ~ t1me o~ .h~ f sighting, how much of the object would have been covered by the match !-cod? /., I r - I ' I I I I C'row o picture that will show the shape of t h e object or objects. Lebel and include in your skerch cny dOJtcd s o~ the object that you saw such as wings, protrusions, etc. , and especiolly exhaust trails o r vapor trail;. Place en a rrow be.iid~ the drawing to sno' the dir:ction t'-1~ object was moving.