L.::,.,CTrl OUv ..J o . the o';)jcct Hove you ,v.,r ~6bn this, or u simi lor obj~ct l.lvf~,r~. ~e with you o t the t irno you !"Ow th!! objt~ct? (Circl& One) 31.1 IF ::. ~nswor .,d YES, did th~y ."'t: th~ o!>joct too? ( Ci1cfd One) i~t tbir names a nd cddrc.>~tU; Pleo,.~ fpv th~ follo\ling iuformolton ob~ut yourself: F ir~>t Nom't !nd~cc!~ :~-, c~:iitionol inform'=lti o., r."''lut your:;olf, i r1cluding any specia l trxp~ri-Jnce, whic h rnigl1t b ~rti,.~n~. 33. \'/lt~n and tn ... ~:::~-did you r~port thr.2t y ~u hcd :'iet:n th:1 object? 34. Dot~ you com~htbd this questi011noire: 35. lnformo!ioo '"f'"' c~ you feel p~rtinent e nd which 1s not adequately cover.,d in ,;,e specific points o f the quuti011n"" .. .;( o n:urotive explonction of y our sighting . D EPARTMENT OF THi:: Aln FO,lC2 HEAOQUARTEI't3 F'OI't~IGN TECHNOLO~'f OIVI310N C A!'":JC l WRIGHT.PATTEn30N A I R FO~CE 3A3'!. OHIO <6~.a3~ ti? .:" ::r:-2 erva tion _. ?-: .... ~:-encc y,ur unider:~ified observation. '.I"ne informe.t1on vhich ~e .. ave received is r.~:. sufficient for a scientific evaluation. ~P .-est you cor.;p1ete -:~e attacherl FTD Fori'\ 164 and return 1 t i r. ~ envelope provlj c. Thank you for reportlnc; your ob3~rvetion #:':. -.. ctor of Techno'!.:;.;: ~-:11 Subsystell\3 F':l'D Form 164 -w / e nvc lot>:. U.S. AIR FORCE TECHI'IICAL INFORMATION -'; q"'~stionnoire has been prepared so that you con give tho U.S. A ir Force as much i:-1b-: ,-c; oossible concerning th~ unid.,ntifiod ONiol phenr>menon that you hove observed. r:'!~c . ' l to answer as many questions os y o u poHibly con. The in formation that you give will be _ -; :::>r research p u rpOSt."S. Your nome will not ba used in c.onno c tion with any statements, .::"':L. ;:;,ns, or publications"' thc.ut your permission. We request this personal info rmation s o t!i.:t i IS daom~d ne:essory, W!! moy contact you for further detail s . 1. tihen Jid ~ -'CC the objec t ? Mont h r cot 2. Tir,,e o f day: (Circle One): 2 . Ti-~ Zone (Circle One): a. t.os ' er:1 d. Pocii : (Crrcle One): c . Day I ight Sav i ny Cety or Town S t ate or Counly =-~ v ccrt::in c . Not very sure d. Just o guess 6. Whot W"l!i (_a) R right Monutos Soconds .lllr.J\" 7 . If= you S O N r1e ~;, ~ct during DAYLIGHT, wh'!re wos the SUN located os y o u look,.d o t the object ? (Circle Or~;. c. In front of you b. In bock of you c. T o your ri ght To y our left e. OvNh .. CYI f. Don' t rcm;)mber ,,. (i. I r yoll sow tne ebjl."C'I o t NIGlll, whot cf,r( ynu 110I IC.t! C'()ll("('rrliiHJ thl" ~ l td<S unci MOOt'!? o. E3r i gh t moon I gh t b. Dull moonl ight No moon I i qh t p i t c h d ork d. Don ' t rt-mem"er 9. 'V.Ioc! wf:e ,.,~ ..,eothor conrltt j,,ns ot tf.e t ime you sow the ob1ect? CLOUuS t :'e One): c. Sent :~e .: louds v'IE/,THE ~ (C~r~/C' One) b. Fog, m1<.t, o r l rght roin c . , .,.,cvJ~rot o I wavy rorn (', Don' t ron rnbor c . ;\bou t th e surne ci. Don't know 11.1 Cc-,.:rt or"s1~ness to so"'! c.:--o~ object : o . Apnc '" scnd sti ll a t un> ri~e? b. SJd~rd. ; ~ up a nd r u!:h OWO)' o t or.y , e. Ch::Hj~ bri ~ !l'less? h. Disuppeor c:rd rroc1ppear? e. Other _ (Cm:lc On for r.och qu Don' t know Don't know Don't know Don't know Don't know Don': know 14. Did the obiect disappear while you Wftro watching ir? If s o, how? 15. Dicl t~e =-~ ~::t movlt b-thind IIOm"lthing at any t ime, pl'lrticulorly a cloud? Yes No Don' t Know. IF you on!\wnr~d YES, t hen te ll whot ;-..~ :-d behind: 16. Did tl..!: =-~ 'ct move in front of s:>r-~!'-ling at any time, partic u larly a cloud? (C ,-~ Oue ): Yes N o Don't Know. you :'lnsw.,red YES, th.,n tell who: i n fr-:-~ of: 17. r., in= :,.w words tht: fo llowing things about the object: 13. 1-e wts n : know t h o anculm :;i:.a. Hold o mutch s tick ot a rm' s length in line with a known object onc.l note how mu.:n o' :"-: object is covered bt th ,. h&od of the match. If you hod performed this experi ml!nt e~t t\e tim~: of th e si;~ti,... .,~w much o f the object w~)Jid hova been covered l:y t h match hend? f:,l, c ~ - 19. Drc"":.: : ... .:.at will sh-:;,.., ~-~ s:..::j)e o f the object or obtcct s . Lobel and include in yovr sbtch any detotls ~ ,~u sew s u :l' cs .., ,. ; .. , protrusions, ~tc. , and especially exhaust trails or vapor trarls. -!,de the drc ... ' : : ~-.,w the direction the ob,ect was moving. ..-20. D o you think you con estimotn the spe;,d of tho o bjuct? (C irclo One) IF y~ r.r.-. .... ... d YES, t h .tn v:h o t s~od woulr! you O'ltim.J'u? ... 21. Do yo-J ::u!'l -1-:>u can e~tin:nlt~ h o w fer o .vo y fran; Y~'u th~ objoc! wa~? (C :b One) IF you or.s .,.,..,dYES, tht~n how f or owoy would you soy il wCts'? :>v locot.,d when you SC"'' th, obit~c:? (Circle Cr.~ o . lnsi~: c ~Jilding b. In o c:r e . At s ttc 23. Wt:re yoJ (C~rclu 011"!) o , n r-.: ~u:.lf,eSs SI"C'I n v o Cl'i. d, N r,r 'J , c i r '; "lcl i e . Flymq v r ll ci f. t=lyinq ~ver o '"' 1;. v-.: . .., .... 'OVINC IN AN AUTO .... C31!..:: o o th r v .'- icle at !n liM , th ... t COil:ll~t~ ;lo;:: folio ,;,,g quest ions: 2:. 1 l'l"ho -c;:tion weriJ y ou m:)l;ng? (Circle One) o. South g. w~st b. , . rL.~ost d. Southto~t f. Sot th .,.,, !; t h. North;.rst of the Fo ll o"''in q? y-; Binoculars Yes No f. T co lo<~cop .. Yos Tl,er.t!olite Ye s No 2 6 . In or.hr th::' u ~, giv .. os cleo~ a oictur os po~sibb of what you so.v, ~.., .cdi;.., in your ow;, word .. o cotnmon objr t :-r ~!:. ~:-s w!lich, when p lac:&d u;:> in thl'! dy, would give) the ~on'!J o ;>r nronce as 1ho objec t which you !:OW l" ql, th_ o':l o:-~'"r w~s above the ho:izon (s~yline) wh"n you f~r:.: '>'1N rt . Jl.,!._ o ''j-3" o'l ,.,.., ~ofT': ct.rv i rn .. t o sho w ho .. L .':-a "l .. o',joct w,,., chov~ tho: hnn:ron (skylinP) wh f n you /o:,' <.nw it. Ploc.: en "II." 011 h~ c:o'1!)\ .. s. whC"n you ! .-~ roc N rt, P I oct: o "G" on the corupo:;s wh"r" y ot lo~t !.Ciw tltc obrect. , fC.lW ol rrcrvf!~ ih::~t wil l show the r.:n.on 1 lOt t~e ob!ec:t or obJt!ct s rn~d!:. P lace o, " A " ot th" Mgrn.,ir.~ >f the ['> the end o f th~ p'lt', ~-. ~.ow nny chon::;~ in d irec l ron durrn~ tht. rr.uro;e. : ' "len how many w..:rc therz? --,-:-, onJ put on arrow to show the drrection !hot th~y W-e trovelin9.