l 30. Hove you e v\!r !.C;~/~his, or a simi lor obj,ct before . If so give dote or dotu s and location. .with you ol thf' tim~ y::lu sow the object ? (Circle Ono) Yes 31.1 .... ered YES, d td the., see the ohject too? (C~rclo One ) t he ir nam\!S and addresses: following informrtion ol..:>,_,. yourself: Lo. Nome Zone Stele rnd1CCi! ::-v : :-::-_..,.,1 in fo rmcti-:>n c::: . ;'::lurself, including any spt:cio l cxp;:rit:nce, which mioh t b~ p..:rtinc n t. Wllfn ond ~ v ou n:port that you had see n th!: 34. Date you completed this questionnaire: 35. l nformotb; w~ich you feol pt'ftinen t and whic h is n ot adequately covered in the specific points of thu question-;:- : cr o narrative explanation of your sight in!J. TD3:'/:JFO DEPARTMENT OF THE AIR FOHC~ HEADCUARTEI't!l FOREIGN TECHNC",LCiGV OIVI!li.::>N I A r :!IC) WRICiHT-PATTER:50N Alll FO,.C DACo!. OHI O 454~3 U?C C;,servati on, 13 !:;-r G7 R-"':?:-ence y(lur unidentified observation. The information which ...,,~ -.~ve received is r:::>t sufficient for a ocicntifi c eva luation. ?o-_est you complete "t!i, attachecl FTD Fonrt 164 and return it i n th~ envelope prov11~c. Thank you for reporting your observation t' :ne Air Force. .--_:j::.. ltl\NATr, Colonel) USAF 1 /1tch :---tor of Technolc_:y an~ Subsystems F'l'D Form 164 w/envelope HEt-:0 F:.t.'1 Tm! R8COdD; lL .'; .. 67 nt 09h5 r cccjv<:J. collect phone call fro:n l>k. S ie Railroad. Electric iA.n for Pennny 1 v u n in and f C. '-Jf;t U.S. AIR FORCE T ECHNICAL IN FORMATION i nts ~uestionnoire has been prf'porud so that you con give t ho U.S. Air Force os much inic-~t 1 os pos:>ible concerning the unidentified coriol phenom<lnon tho! you hov" obso.:rv.::d. to onswer as nony q:.~estions os you ;-ossibly con. The inforrr.otion that you give will ~c ~,.:;-.; for res:~orch purposes. Your nome will not be usod in connection with ant s totem"'nts, c:>n.:: ~ :>ns, or publication:; without your p~rmi:.-;ion. We r quest this pcrsonol info rmation s o !~ :;; f is doo.:med necessary, we may contact y ou for further d c toi Is. 1. When di.:: .. -" sec the object? (Circlt' One): A.M. or Mont h "oar (Circle One): (Circle 011e): o. Doylirht S .. JVin g b. ~tondcrd Cit y or Town Stat., ar C counly c . No t very sure d. Just o guess o. "'Bright "' b. Cloudy . , ~: i.::t during DAYLIGHT, wh ... rc wns the SUt~ locoleJ OS you looked at tho oujecl? ( C irdo One ~. 1n fron t of you b. 1~ bock of y ou d. Toyourll'ft c . Orfnod f. Don' t rem ... rnber c . To your r ight FTD U(T{o:i 164 8. IF you sow:,<! o!>1ect ot NIGHT, whot did you notice concerning the STARS ond MOON? 8. 1 ST ,\RS fCir: 'e One): d. ~:::' : remember 8.2 MOON (Circle One): a. Bright moonlight b. Dull moonlight c . rnoonl igh-=-t---p~i-tcT1 dorY d. Don't rcm~mber 9 . Whc.t 'r-11: t:1 ,, ..,.eother conditions at t,e t ime y ou sow tho o!Jject? CLOUDS r( c One): WEATHF.R (Circle One): b. Fog, mist, or I ight rain c. /i.l"d rotc or heavy rain J. l'l'c'.. cr 1., 1vy clouds c. Don't r~ .. rnb...:r :;:>;:-eond: (Circle One): I l. 1~ t: -:.:;;~-:re~ .l a light, was it !:>rig:.~; -;on the brightest stars ? (Circle One): c. Other ----- D id the objec (Circll' On for each qu(Sstion} Appear t o -~-:i sttll o t any t il'i'e? Don't know :-~ ,.J uo and rush a H O f ot any t imc? ~f;'\ Don't kno w i~ --.:t s or cxplor.le? Don' t knuw Don't knCIW ChonJ~ bf':-: ss? Yos Don't know Fla::h or fl,~/cr? ~oN I)) Don'~ kno'v Oi:;oppor and reappear? Don't know 14. Did t h e objec t disoppo a r while you were , .,a t c h in g it? If s o, how? Don ' t Know. IF y o u a n ::worc d YES, t h m to ll wh<it i t r..:." "'.J behind: 16 . Did tl->c: :::: a:t move in front of s:::-ethin:1 ot any t imo, p a rtic ulorly a c loud? (Ctrd. One): Yes Don ' t Know. IF y ou answ':!red YES, t h e n tell wlwt eN words the following thin3 s aboJ~ the obj::ct: l~o , ~ wis'-: '''<.,ow the angula r si2.e . Hold o ma tc h s tick o t arm' s length i n line with o known object a nd not:: h o H t mu : h of:.~ o!:>iect is covered by th~ head of th o matc h . If y ou hod pe rfor me d this experim~nt ot tho: tim~ of th..: s i:;l.,r'13 :. : w muc h of the. objec t .,...ould hove bee n covered by the match heod? Drc =;: . -- wtll show: ~ s-:-t> o f the objec t or objects. Lobel a nd include in your ::;ketch o uy detai l., of,...,~::.:: , :.v s O N SJ~-::s .,.j .. s s, protrusions, e tc . , and especially e xhaust trails o r vapor traib. 20. D o you think you con estimate the speed of the obje c t ? (Circle o~c) No I IF you answ~.:rc-:! E5, then what sp~cd would you estimate? _ /;.)-/,/,PI/ Os. lit ~- O o you th;ll'< ;ol can e~timatc how for away frorn you the ob1ect was? ~ v E S, then how for owoy would you soy it wo s? !ff',lll' / .>cotcd when y<>u soH th:: object ? 23. Were you (Circ le One) ( C ~ref Ond: o . In the business section o f a city? b . In the residential section of a city? b. lr. u c~ c 'O"tdoo~ c . (In open cou ntrysideT d. Ncar on airfie ld? e. Flying ovr o city? f. Flying over op;,n coun!ry? ,::. v:>-.J wc e .v.:-'l'lG IN AN AUTO"-'O~ILE o r other v~:hicle o t the time, then complete the followin:: questions: I '>d. l \'.'he dw:-ion w ere you rnoving? (Circle One) d. Sourh~'Jst f. Soulhwest .mi los per hour. 1 24.3 Did f:>U ! o, .,~ any time while yov "ere lookintt a t the object? following? Binoculars Ye s Tole--cope Yes Theodol it e Yo'> 2 6 In ord~r t~'l l )' ::i: " o~ cl~or a pichvc os p o!.sibl.: o f what you sow, des c ribe in y our own words a co mmon object or <Jba~'.-tS .. ,i;,, .. !len rloccJ u p in t h e sky, would giv o the same appearanc e os the object which y o u sow. In tho fol b ....,jng sketch, imagine that you oru a t tho point shown. P lace on "I\" on the curved I ino t o show how high the c ct was obov1.} the horizon (skyline:) when you first sow it. Ploct o "B" on the $Oma cJr,.~d line to -., r"e obtec t was above the hori::on (skyline) whon you /..,sf sow it. Place on "A" on tlw c.ompo.:. ;: S~W it . Place o "B" on the compass where you lost c;aw th~ o!.>juct.