1-' IWJi:CT 10073 Rf:CORD G'n t,1r .TIME ::.~ouP 2. L OCATION .1. NUHE\[R OF .""oSJECTS 10. CONCLUSION fossiblo (AIHC ;\FT) .' LENGTH OF ;::~sERVATION I' Tl'PE OF 0B5E~VATION 1 Grcunj Vis .Hl.l r;:-COURSE l _.jouth e3.st -South \.,r~::;t I $j, PHOTOS I?. f'HT'SICAL E'll:::>cNCE 11. BRI EF SUMMARY AND ANALYSIS Obj-:ct hnd blinkin;: red and ".l)luo. ,Jhon r~d lir,ht \-t~nt out , blu= li:~ht rcplac~d reel 1 i.ght in 5illr.C place. L'b::;~rv:-:r i3 a youth of 12 years old and stat~d h e obs~rv3d UF0 , -. p,....vlo\11 a dlUon o l thla lorm may b u~d. U.S. AI R FORCE T ECHNICAL INFORMATION -;-;.,,! ;v"s~ionnoire has been p repared so that you can give t he U .S. Air Force as much inforr::- .:.-~-~c.ssible concerning t he unid ntifiod aerial phenomenon t ha t you have observed. Pie:!= :: cnsw~r as many que:;tions as you possibly cnn. Th~ infor:notion that you givl'! will b-'! L's:::: :- ;:,soarch purpo:;es. Your name will not be used in connection with any s totoments, c c-,dJ!> ;-._, or publication:; without your ptormission. We request this p<'!rsonal infortnation s o ho! ,c doemed necessary, w! :r.oy contact you f o r further details . 1. '~hen ;lid you s'!~ the object ? 2. Tir.,t: of day: /)t fwr ll _ Mont h Yeo~ (Circ!e One): :::. Ti-ne Zon~: (C,rc/e One): o. (t::ostern'" b. CS'i11rol c. Mounlui" (Circle 01e): a . I?_Qylight Saving d . P o c if:c e. Other _ 4. Where .,...er~ y;;;._ nhen y ou sow the ob:::-:? City or Town State or Count y 5. how 1:-.,_ NOS ;,.:>j~ct in sight? (Toto J~::iion) Hours Minutes Seconds o. =.:i:!ycertain 6 . What wen tt.,e :~ r l or of the sky? a. (Brigl~ b. cloudy 7. IF you sow rhe cSi~cr dur ing DAYLIGHT, where wos the SUN loca ted as y ou looke d a t the object? (Circle One}: o. In iront o f you b. In back of you c. T o your right d. T o your left c . Overhead f. Don' t remember Thla form ouper .. erle~ FTn l f\4, fu l 6 1, which lo ub~nl~te . t!. IF you saw thP object o t NIGIIT, whot 010 you n o tice concerning t iH! ~T/\I<S oncl MOON? B. 1 !:>TARS (C trcle One): r:! : '1' r remember 8 .2 MOON ((,cfc Ollc): o . B r ight moonlight Dull moonlig h t ~ ~ionliiJ-pitch dark d. Don' t remernhor 9. Whet ..;o:~ -e weathe r conrlitions o r the ti111e y ou sow the object ? CLOUDS C;rcle One): ~VEATHER (Circle One): b . Fog, m1st, or light rain c. Sco+!f.' :::: c louds c . .v\od.:rote or heavy ruin d . Thic~ cr heavy clouds e . Don' t r.:member The o~1e;:t appeared: (Circle One): b. T rorts?:' !nt 11. If 1! c::-eec-~.::1 os a light, was it br'g-t~ than the brightest stars? (Circle One): o. Bighter c . About the same d . Don' t know 11. 1 C ::>r::>::~ brightness t o some ::c'"'..,~n object : :l, F uzzy or b l ;:reO: 13 . Did the o~ .:-:. (Circle One for each question) Appea r t-: ~::u'lc s t ill at any time? Don' t know Don' t know Don' t know Yns Don't know Do n ' t know Don' t know Don' t know Don' t know b. Sudde .. d: s ed up and rush away a t any t ime? c . Bre.o~ p ir:> ports or explode? g. Flash or fl cbr? h . Disappear and reappear? 14. Did the object disOP!>eor while you wAnot watching it? If so, how? d t:../) 15. Did h!: oS:~ct move b-,hind ~oml"'thin9 c1t any tim~, porticuiCJrly a cloud? No Don' t Know. IF y ou on!lwer.,d YES, then tell what it rnr.:'-ed behind: 16. Did ~he -:::;ect move in front of something atony time, particularly o cloud? (C ire :: One): Don't Know. IF y ou nnswM"d YES, th~n tell who: 17. r~ll in 0 few words t ht: followin g things about the object: 18. W~ w is h ~o know the angular !liz~. Ho ld a matc h !itick a t arm' s length in line with a known ohject onrl note how mu:~ of rh e object is covered by the head of the match. If you hod performed this experime nt :~t the tir11e of the s i :;ht i:-1g, '-ow much of the objc:ct would hCJve been covered by the match hel'ld? 19. D:::....,. c p;:;.,e .:..,o:Jt will show the sh: e o f the objec t or object s . Lobe l and include in yovr sk~tch any d e tails of tn'! o!: c "Ot you saw such os wings, protru sions, etc., and especially exhaust trails or vapor trails. Plo~e cr ::.:--.... :..:s id e t he d:oUf;n; ~o !>hvw the direction the object was moving. (Circl~ One) 2 1. Do yov !rti,..,, you cr.n e~timoto how fo r cwoy fron; youth~ obj.:.ct was? ( C tc/o On~) IF you c;-.!Z -'!rl:ld YES, ~h.,n h ow fv r o wo y would y ou ~oy it wo:;? 22. Wh.~rc "'~--'OV locat~d wh'!n yc.-u sow th"' o!>::!ct? a. lns;ci~-: ouilding b. l r1 a c c r f. Oth~r 23. Were yoJ (Circ le One) o . I;; th-:: bu-:il"' ~;;s s.-:ctic n of a cilj? b. !r th~ ro-.icl'llltia ! '<;C1ion d a dtt ? ~ F lying",. o ~iij? f. F lyin g ov.., CP' '1 c:>u11try? ou ,.,~o: MOVING IN AN AUT0~03lLE or other v"nicle at the ti1:1v , the;, c-.>npl.:t" th:. fo ll ow:ng qu.::stions: 24.1 What J irection W"!re you mo .. inJ ? (Circle On.,) e. South g . \Yost f. Southwest h. Northw-st (C:Io One) Yes Binoculars f. T~l::~cop. Yos Theodolite Y o s No 2.S. In orc0r the .,.,:.~ c:.n give as clear o picture a:; possibl.:~ of what you "-OW, do,;cri"- in your own words a common objcr.t cr ob1.::c- L.ich, wlv~n pl;,ced up in the sky, would give rle som~ opp-3oranc~ as the object which yo1.1 sow In til~ follo.,.,ing ~ketch, imogire that you o,t: o l ~h~ point !.ho wn. Dluce nt '';, '' vt h;:~: C'J v.,d I in, o sh~ w lt!..w hig h the obj~c~ wa s obova the horizon (~kyline) wh..,:1 y o u firs t <;')wit. 1-'lw:c o "n" ,.., ,~, !Ct.-n u" d :,n~ t o show ho'>" hi ~e obj~ct was ahov~ th~ hori7on ("''ylinu) whe n y o u lost ~o~o~ P. rllcot:".~ on " A ' ' Ctl'l t'1-: cnm">ot s wh~n yo".J '28. t h .,..., o pictue th:-:~ will sho w the motion tho t th'! object or obj.:ct s rnode . Plac<' c::1 " A " cJt the r, .. ginnint~ :Jf t h:: ::- the-end of the path, o'1..:! sl-)ow any changes in d ir!'ction dur tng th. CI')Ur!>e 29. IF there ..,-::s ;y.::;~= T HAN ONE C'b:.-~. then h ow mony were the re? Draw o p ;::-'J"' :>r row t ht!y were crr=:-g:d, on.:l put on arro w t o show t ho direction tho t tlw y wore trovel ing. 3 1. Wo~ c-~ :l,.._ ~ ;~with you at t h.: t1mo you sow ihe objact? (Ci1ci.J One) 31.1 1:= v<:-~ ,,SWI)r3d YES, di d tby so~ th0 o!ljoct too? (Circ/:3 One) ::n.2 P!-:..s~ li~t t hoir nom!::s and addr~.:;set.: Pbo:>e g w e lha f" l lowing in rormotion about yourso!f: TEL2PHC..= NUMR Fir!St No,.,., AGE -1-/ l:: SEX tndi:::::~ oy oddi tional in formc:i.:>'1 c~" t your~dlf, includino ony sp~ciol <t;{pMi~,,c.,, which rnio!:r b p.Htin - 33. Whan e nd 1~ ..-:-o.1'l Ji:l you report thct you hod stt:n tho o~ject? Doy M.,nth DEPARTMENT OF THI:. AIR FORCE HEAOQUARTER 5 FOf~EICN TECHN OLOG Y DIVI S I O N I A F 5 C l WFUGHT-PATT:!R!IJON A I R f'Oi'tCE ~A!;:!. OrflO .;!)4 :'\ 3 Ref.:e::-~:1ce y~ur unidentified observation. The information whic h -we :-.::.--e received is not s:.tfficie n t f o r a scie ntifi e ev aluation. ~e~..:.~::.t you complet e th e a ttached FTD Form 164 an d return i t i n thz :nv elop e provi de d . Thank you for reporting you r observ~tlon t o -.: .. ~ Air Force ~.-:.-:=:.5 C . HANAT1', Colonel, USAF :-~:tor of Technol ogy ~nd Subsys t e ms F::i.'D Form 164 'vt/ e n velopc