P~OJEC: 1C073 RcCO~D ::>N.:r S:JMi>IARY AND A, AL Y SIS C c~ ~??~.J.~cd a~ a briDht ~t~r. T\u-ncd red as \::~e::-. :i:r. '-P~)car~d to zig-z;;.g. Object disappeared DEPARTMENT OF THE AIR FO'~CE HEAOQUARTE115 FOl'tC:IGN Tt:CHNQI..OG V DIVISION ( Ar'!JC I WRIGHT-PATTEn!'ON All't FOiiCI<: DA"\'!, OHIO -4!5<f.:lJ c:~ - rvation , l l Ap~ 67 ?.e .... renee your u.~ide."'l-:lf:!.ed observation. Tne inforrr.ation \o/hich v: .ave received is :10' .. sufficient for a :JCitmtific evaluation. ? . .:. :.!est you comp1e~c -:r.e att~chec1 FTD Form 164 nnd retur n it in -:.._ enve 1 ope pr o-., 1 i ::d. 7hank you for repo't'ting ym;.r observation r. -chc J\ir Force. F~D ?'or.n 164 v/~nvelop, U.S. AIR FORCE T ECtiHICAL INFORMATION -~ :; q uestionnaire has been prepared so that you con give the U .S. Air Force a s much irb-:; on as poss ible concerning the unid~ntifi..Jd aerial phanomen on that you hove observed. P'~-== ry to onswer os many questions as you possib ly can. The informat ion that you give will be 1. :::l f or research purposes. Your name will oot be usod in connection with any statements , c.~"'... ~ ons, or publications without y o ur permission. VIe request this pe rsonal informat ion :.o th:: : i s doomed necessary, we may contact y o u f or f urthe r details . he object ? 2. T ime of day: Hour Minu tl' :; (Circle One): ( Cifcle One): ,a , Eas'er,'' 6. Cenf cl c. Mot..:-loin (Circle One): a. Daylight Saving l b. S tandard ' d. Poe: c c . Oth ~r 4. 'nhtre w~: ) OU when you sow t he o:l;ect? ~ ?ostol Address City o r Town Stole o r County ~:; o!:l;e c t in sight? Ci'=-' Dvrot ion) :. CNt:in _ ~ f : tr!y certain b. C loudy c , No t ve ry sure d . Just o guess Minutes s .. c:onds 7. IF you sa"' tL.e !1 ~ct during DAYLIGHT, whe re wos the SUN locutcd os you lookod a t the o b ject? (Circle 011o): c. In front o f y o u b. In bock o f you c. To your r ight d. To your I~Jft c. Ovcrhecd f. D on ' t re me mber 8 . I F y o u sow t ho!' object o t N IGHT, what d id y o u notic e concerning tho STARS o nd MOON? 9. Wha t wer~ ~ .. ,.,eothor conditions ot the time yov snw the o bjec t ? CLOUDS t( : WEATHER ( Circle One): o. C ll;'ors} b. 'Fog, mist, o r l ight ra in Sco:~er -~ ouds c . Moderat e or lwuvy ro in o. Thic~ C': :Jvy clouds c. Do n ' t rememb e r (Ctrclc One): \~As o light e. -~M t -er.e m f! r 11. If it c.,:-co~-= - i o lio!,t, wo s it brigl..er tl.:on the brightc:;t sta rs ? (Circle One}: o . :;.r ~,tel) c. Abou t the some d . Don't know ll.l Co:-~-~ ~rightness to some co-.... on obj~ct: (Circle One f o r each q u,.s tion} o . App~o: t~ ~coo;: !:till a t ony t ? Don' t know b. Sud "' .-:-ee : u;) ond ru s h owoy o t o ny t ime? Don't know c . Brcol< V" -:: :l*'' S o r e xp lorJc ? Yes No on' t know P. Chonp b!15r.!., Don ' t kno w f. C hange si-:-. ~-; Do n' t know g . Flnc;h or f1s.' ~-? Yes No D ' ' h. D i r,opp ... or .,., ~ reappear? Don ' t know disopp~or while y ou wer.! wotchi.l1 it? If so, how? 15. D1:: h ==-!'CI movi! behind so'llei~ing at any tirnc , particularly o cloud? Yes (._No_ Don't Know. : r .,. One:): If you onswurcd YES, then t II , ... l,cr i: =~.-lbchind: 'ct move in fron~ of Sv":'~:L,iny o t any time, particularly a c l,,;cl? Don't Know. IF you anHforcd YES, thrn tdl ,o~hnt =:-. = =-,w \fords the fo l lowir g !~i-_;s o bout tht: obj'-'C'I; 10w th~ ongu lcr rrur.'-1 o: - object is covered b; ~!;~-,,.:,-_..,much of the objec "1:>ld a ma tc h stick or orm' s length in line with a known objt"cl and nuto l.ou i ~ head of the matc h . If )'OU hod performed this c.Ypcrimnt at the I im: ('If t h .... ~;ld hove been c overed by tl.t.: motel h e:od? I ,. of the CJ~ject or object s . Loool and incluc~ in yo;r sk::tch o .. y d~!uil!: of !:' .::. : : v-::u so.,.. s-~ :, w'r-;;, orotru-.ions, etc . , a nd c sp::ciolly exho;;;t trails o r vapor troil:.. 20. 'Oo you thi n k you con cstirTrote the speed o f the object ? -:~;; e:t imo:e how hr away frorn y ou the obJect was? IF y ov ::r.Sf""' , YES, thc-11 how for o.-~:::y would yo u soy it wol>? 'ocotcd whe n you so~ ~biect? 23 . w~rc ycu (Circle One) o . In th.: business sect ion of o city? In th ru!>idcnti ol sect ion of o citt? c. In o;>.:n c ou.rlry!.irl(?. d. Ncar on oi rf u~ IJ? c. F lyina over o city? f. F ll'rng v1cr o;>~n country? lNG IN AN AUTOI/.03 :...:: ~other V('hiclc ot th~ tim::, th.:n co.upleh: th~ fo lbwing questions : '1 ~! :!i:e: 'on were you mov:ng? 'U' you movrng. _ ------ f. Southwost h. Northwe~t mi lcs por h our I 24. 3 Did y~ .. ~ .. :. -: c 1y tim-: while io~ .-!:re looking at the ohtcct? o:-.~:t tnroug, c- c. Binor-u lurs f. Tclcsccre g . Thocdolitc h. o :hcr 2(,. In ? ~ r t!r'lt yO> ... -:: s .e 'lS c l"cr a picture as po<;s1blc o f Nh'lt you 50., , d.-.scrib!: in your o 'lil word . o commorr objc: or objNt: .. -:-,when ; locd up in the sky, would give the ~omc opp"oronce oc: the o!lj,.ct .-.'li,~h yo1 sow . 27. In the fol'c..,.ing sketch, imagine tha t you ore at the point shown. Place on "A" on the: curve d line to sho w how high the o!J e::t was above the horiz on (skyline) when you first sow it. Plac e a "B" on the sam:) c urved lino to show 1-o .. !.:,;h tho object was above t he horizon (skyline) when you la!>t saw it. P lace an "A" on the compoH Place o "B" on the compa:;s whore y ou las t sow the object. 2S. )ro-1 o;: - ... ro that will show t he moti::~n that the object or objects modo. Place on " A " a t the beginning of t ho r= ~, o ' ::. ' ' at the end of the pc h, on:J show any changes in direction during t h e course :~ ':=-'ETHAN o:-..:: -=!:',then how m\JIIY W.:!rc there? - .: "l~w they we:e =-::.,:;~d, anJ put on arrow to show t ho direction t ha t they were t ravel ing. 30. Hove you ever ~een this, or a si,.;,ilor object bdare. If so give dote or dates and location. 31. Was on/o , .. ::.e with you a t the tim2 you sow the objoct? (Circle One) 31.1 !;= y-:.: ::- ~wered YES, did th<!y see the object too? (Circle One) 31.2 Pie.: : :;t th~ir names and od.Jresscs: 32. Pleusc gi.,re : ~ following informCltion about your self: First No mo Middle Nomo Cit y Zone l ndi::cte c-t .;~.:!!i~;,ol information o b1..1 yourself, including any special cxpl!l'icnce, which might be pertinent. 33. Whe n a nd to ...,;. .:1"" :; .d y ou report that y ou h od seen th_ object? Day Month Year 34. Date you c omplct.,d this quest ionnaire: ~. lnforrrati. ~ ... :,i:h you fee l p~rtinent and whic h is not adequately coverud in the specific points of thJ quostiooO":i;:! :: a narrative explanation of your s ighting.