: J :':cRVA TION l9. F'-:YStCAL c \ .;)C:t\CE 11. B.-<i::P SW.U.-\Ai~Y AND .I.NALYSIS to i.1ov0 from S tv :1, then st.op:::.Jd r:.. s.:;;;or.d., then di::;:.!'l'fX!<'.:cc d for a !3e ccmd, then :'ro::1 '1:.h c::::1, O'.:>je~t h~ a orar.ee elm:. Cnc place of :rcp.Jrt, o":J:er7~r si:.a.>.:.e:ci object di2. not disappear, another it stated it dici di3a.p~ar. 1- y in~ccuracies in report f-TO St;P ~3 (;. :;::? (7D:=) Pr;~vloun od.t.ona o( lh l torr.' may b 6 uaod. u.s. AI R FORCE T ECHNICAL I H FORMA TIOH lnis questionnaire has been prepared so that you can give the U.S. Air Force as much infor~o:on as possible concerning the unidentified aerial phenomenon that you hove observed. PI~:::.:-ry to answer as many questions as you possibly con. The information that you give will be usr:c for research purposes. Your nome will not be used in connection with any statements, ccr'lcl-.>ions, or publications without your p e rmission. We request this personal information so t h :l! ' it is deemed necessary, we may contact you for further details. l. When did ~ou see the object? Mi nut') s _Aee~JJ._. Month Ye or (Circle One): 3. Tim<} Zone. (Circle One): a . tastern Cb. Cer.troD c. Moun~!'lin d . Pacific \. (Circle One): a . Dayligh t Saviny \ (;> StanJord 4 . '~here we:~ you when you sow the object? Necr~s Postal Address City or Town State o r Count y 5. hcw long w~S oSject in sight? (To al Duration) Hours Minutes Seconds c. Certain c . Not very sure ~) Fcirly certain d. Just a guess He'"" .,.,c';,-e i ;, sight determin~d?A.JfttZ&!( fltt?rou/VIP/1.~ -DM11~/A/2 Y~rH ~e~AT /ho/r~ 6. What was t,~ ::ord:tion of the sky? o. 3rrgh t 7. IF you sow tl,e oSject during DAYLIGHT, where was the SUN located as you looked a t the object? (Circle One): o . In front o f you /1/ /;4 d. To your left b. In bock of you e . Overhead c. To your right f. Don' t remember FTD OCT 62 164 Thl f orm aupcrsetle& F T n 16<1, .Jul 6 1, which h nh~ol .. te. tl. IF you sow tht! object ot NIGHT, wl10t did y o u notice concerning the ~T/\I~S und MOON? 8.1 STARS (Circle One): MOON (Circle One ): Bright moon I ight Dull moonlight No moonli ght -pitc h dork d. Don't remember L. ?'1 t remem r 9. What w-ere i;,~ weather conditions ot the time you sow the object ? CLOUL>S C-clc One): WEATHER (Circle One): b. Hozy b. Fog, mist, o r I ight ro in c. S c o tterd clouds c . .~odcrote or heavy rain d . Thic k cr heavy clouds d. Snow e . Don't remember 10. T'-le obrec r ~ppeored: (Circle One): d. As o l igh t c. Don't remember ll. li i t op:-eored as o light, was it brighter than the brightest stars ? (Circle One): @ 3 r ighter c. About the some d. Don't know 11.1 Ccrr='-::7'! :,rightness t o some common object; 12. The eds~s ::! t'1e object were: (C ic ~ : 1: : o. Fuzzy or bkr:e~ b. Like o bri~nt SiCr ~ Sharply ou!lrr.eO:: . . ....~on t rerr:emcoe,. 13. Did the obje:t o . Appeo; r~ s-.n~ still at cny time? (Circle One fo r each question) b. S.Jd:!enlv !; d up and rush away a t any time? on' t kno w Don' t know Don't know Don' t know Don' t lmow Do n't know Don' t know c . Break -~ "\to por t s o r e x p lode? d . Give or' S'":'O ? c . Ch:mge orgHn-ss? f. Change sh~:;e? g. Flush or flicker? h. Disoppcor and reappear? 14. Did the object disappear while you wer" watching i t ? If so, how? Mdt/4 r.-*fP,Y! St>v7# rv /YP/irl'l 7'/rt!=tY dTO~.P~.l:> A-5&~o.V.2> -T,rr.,S.# 15. D;d tne-::: ~ct mov" behind something at any time, particularly a cloud? Don't Know. IF you an::wered YES, then te ll what i t mv ~-: behind: 16 . Did the C::: e d move in front of something a t any time, particularly a cloud? (Circ'c: One): Don't Know. IF you answered YES, then tell whot 17 . Tell in o few words the following things about the object: 18. Wa ,.,is~ t;:. know the angular size. Ho!o o match stick at arm' s length in line with a known object and note how much of -:-e ~bject is covered by th-3 heed of the match. If you had performe d this experiment at the time o f th.:: signtins , 1ow much of the object .....,ould hove been covered by the metch heed? 19. Ore., r ,:.i::--~ ::..ar will show ~!-e ::!-:;:;e of the object o r object s . Lobel and include in your sketch any d e tails of th e ol:.,-:- ~c: you sow such os wnlis, protrusions, etc. , and especially exhaust trails or v a por trails . Plo~e 0:1 ::-="' :~ide the drawing o s h o w the direction the ob'ect was moving. ?~ 4..1~ ..lf);u,..{., 20. Do yo u think you can e stimate the speed of the object? d r fcm ;d.~/ ~ rl:: .1'/ Z IF you on :;,.,:red YES, then what speed would you estimate? ~Je .... cy . 1-. "/ Do y~v ;;,:~:'< f:>U con e:stimote ho w for away from you the obj=tct,w s? . ,1-.# ,::leOn~) Ves ~ IF yoJ ~ns- '0d YES, then how for :;way would you say it wa? - ;,6. 22. Where w-.:~! "!)U located when you sow the object ? (Circle 0:-:e . 23. Were you (Circle One) o. insid~ c :"Jilding d . In an a :r?lanl! (typb} a . In the bu~iness sect ion o f o city? @ In the residentia l section of a cit y ? c . In open countryside? \"'~ -d. Near o n airfield? e . Flying over a city? f. Flying over open country? A03:LE o r other vehi c le at the tim~, then complete the fo llo wing questions: ::c.l What c ~ction were you movi:-as? (Circle One) b. Ncrheast d . Southeast f. Southwest 24.2 How b~: wer':! ,IOU moving? -------~' i les per hour. 24.3 D i,j y-:.v stop at any time whi!~ "~u were looking ot the object? (Cite 'e One) ' No 2 5 . Did you ob-;-:v~ t:.,e object through cry ~f th e fo llowing? Binoculars f. Telescope Theodolite Yes 'r-'indo-"" h . Northwes t 26. In order thor~ o w ::::::n give os clear a pict ure as possible of what you sow, d~:;cribe in your own words a common object or objec-s which, when placed up in t h,e s would give th e some appearance as the object which you sow. '7. In the following sketch, imogi_ne that you ore at the point shown. Place on "A" on the curved I inc t o show how high the object was above the horizon (skyline) when you first sow it. Place a " B " on the some curved l ine t o show how hi~h the object was above the horizon (skyline) when you lo s t :.ow it. Place an "A" on the compass when you first sow it. Place o "B" on the compass where you lost sow tl1e object. '::3 . :.lrow a pi.::'ure that will show the motion that the object or objects rnode. Place on "A" at the beginning of the path, a " b " a t the end of the path , and show any changes in direction during the course. 29. IF tf-:ere w:::;; MORE THAN ONE o bjeci then how many were there? _ Drew a ;:>ic :L"e of how they were ouonged, an.:l put on arrow to show the direction that they were traveling. 30. Hov e y ou ever seen this, oro simila r obj.,ct before . If so giv e dote or dotes and location. 3 1. Was c ny::>n ~lse w it h y o u o t the t ime you sow the objoct ? (Circle One) 3 1. 1 IF y.;-.; onsw~r~!td YE S, d id they see the object too? (Circle One) their names and addresses: cl./tdiud/ {) ~ 32. P lea s e give the fo llowing in formation about yourself: First Nome Middlo Nome Cit y Zone TELE?HO"i:: NUMBE tndic a te cy add itional information about yourself, including any special expe rience , which might be pertinent. 33. When ond to W"l om J id you report tha t you hod sean the obj ct? Do y Month Y eor 34. Dote you c orrpleted t h i s questionnaire: 35. lnforrroricn .v"'ich you f eel pertinent and which is not adequately covered in the specific points o f the queslicrn:J -.. Jr a narrat ive explanat ion of y our sighting.