.... .:~VATION S..;MMARY AND .-....... AL YSIS - Le fuzzy or o Sound: no solliiu. r' ,9 J.fi'li'Cl"'"' 'l'IUC ."li!G ten to .flft n seen tl0th:tn socrJt \.e .t .r.n'' :i~ tctPll- li!:e r'C'~lC hPl' nr11r j:1f"'r ' tier Lyr bD:)l>k Hi;.h (tenth c;ruu ~ Lynbroo~( -~r1tr o:lo.l,y Club. exrlcducti:'l for tlt5s object :in I offer no let ter v;ill bu UH:-:;t',ore.-1 'd th vn tJ. If i'urt,l-10-r 1:.:::-.intion is r eyues tcd jus t a~k . ";<tin l ask th;.t ~ln y ~ .lforr~o t ion c onnect eel :1 it PL :~be sent t o ~e. S U O J EC.T OEIItARTMENT OF THe AIR FORC HEAOQUAinl:"a f'ORI:IGN Tt:CHNO\..OGV OIVI510 N I AI'SC I WftiGHT-PATTIE"SON AI" I"O"CI: IIA9X, OHIO o4:So4~3 TDETI"JF'O L:::1J1ool, L. I., lTev York 11563 Re:"_ :-ence y~.Jur unidentified observation . The i nf ormation vhich v: ... ave rece i ved is not sufficient for a s c i entific evaluation . Re:; ... es t you complete the attached FTD Form 164 and return it in ~h~ enve l ope provid~d. Tnank you for reporting your obgervation to ~he Air Force. MAI'JATT, Co l or:e 1 of Technology and Subsys t ems F~D Form 164 v/envelope U.S. AIR FORCE TECHNI CAL INFORMATION T s questionnaire has been prepared so that you con give the U.S. A ir Force os much i.,fcr:-~ ; ~ o:; possible concerning t he unidentified aerial phenomenon that you have observed. to answer a s many questions os you possihly can. Tlte infor:notion that you give will be uH:: or roseorch purposes. Your nome will not be used in connection with any statements , cc.,:l1. ~ns, or publications without your permission. We request this p rsonal information s o that ;t 1' i s deemed necessary, we moy contact you f o r further details 1. ',\hen did yo~ S<!'e tho object ? 3. Ti:-e Zon~. Month Yeor (Circle One): ~t9stern b. Ccnlicil c. Mount:~in d . Pacific (Circle One): 4 . Whre w~re y:-Ju when you sow the object? City or Town N:~c: ~r ?ost ol Address Stole or Count y 5. how long ""05 object in s ight? (1:::: :.u o tion) c. Cen::i:~ =:: - ly certain c. No t very sure {j':' Justo guess Minutes Soconds 6. What was t .. ~ ;e"~'~ion of the sky? (;} Oright 7. IF you sow tne obj ~ct d uring DAYLIGHT, whe re was the SUN locoh:d as you lookc:d at the object? (Circ:lc One): o. In front of you b. In bock o f you c. T o your right d. T o your left o . Overhead f. Don' t rcmern!l'!r Thla form auperA""'~" FTn 164, t u l C>l, whlr.h I a otnolele. tL IF y m 1 sow the oSjf"Ct o t Nlt":.HT, what di~ y o u notic< ron<crn in; thr-~TM<S und MOON? BriiJhT moonltght Dull rnoonl tgltl c. N o moon l igh t . pitch dark t remember .I . d. Don't rcrn.,mL r 9 . Ylhm w~r~ :- weothcr conditions 0 1 the time yoo sow the object ? 1'/E A Till R ( ( irclc One): b. F-og, r11st, (If lt"ht rotn c . ,/,nd .. rn!l' o h" IVY rrun d. Thick N r noty c louds d. Sne>w iO. T:,~ ob ect c~pearcd: (Circ!e One}: d. As c light c . De~ ' rr.memb~r 11. If i~ o;:..oeo"::! c s a light, woo; it bri:iho:: rhon the.: brig 1tc:; t s t ars? (Circle One): o. drtnto r c . About thC' some b. D _,mer d . Don't kno w 11.1 Cv~::a ~rightness t o some .::>--;,n obj~ct: c:. Fuzzy o r b!o re-: (Ct rc/1! O: f:> er;eh our.: s f ion) Don't know Do.,' t know Don't h tow D o11' t know Don' t kno w Dnn't kno w Don't know a . Appear :. s ::.,1 s t ill ot any ltme? b. Sudd'!n It ! ... ed up and rvr,h away at ony c. Break 1..'' .~ ~ - -Jrt :; o r explode? c. Change br Z' lness? g. Flash or fltc.<'lr ? h. D i sappe or ,,nd reo ppea r ? l.d. Did t h e obill'c t di~oo~Cf' whi 18 y ou WI!Jr~t watch in~ it? If s o , how? 15. Dirl r'-;~ cb ~ct movl'l ~hind st:~mo!~inp ot any t im.,, pr:1rticulorly a c ll")11d? Yes Don' t Know. IF you on~w-,r~d YES, then tell wha t Yes Don't Know. I F you onsw<tr4'ld YES, tht:n tel! whet 17. T~li h a: ... ..., word~ th~ followinq things about th~ object; 18. We wis h t~ kno'"' th" on!lUlnr siz~. Hold a match stick a t arm' s length in lin~ with a kn~'"ln obj'!tct and not., how much of;,:! obi~ct b cov~red by thrt h~od of the match. If you had p~rfC".rm.,d this ,;cn-,rimMt at the tilll"t of the sighti:-~g, :..c"f much of th~ obj~c~ wovl1 hov" been cover&<! by th~ match head? 19 . Drew :1-; =~-.. .:..ot will show tLH! shoi>!' of the object or objects. Lobel and includ~ in your ~ketch any d"tails of ti--e~=-~-=---: vov sow s u ch : s wbg.;, protrusions, etc., and especia lly e:<houst trails o r vapor trails. Piece cr c:-::'-;esido e drawing to show the direction the obj~ct was moving. Do y o u thin < you can ostimate the spottd of tf,;-, objoct ? (Ct'c,, On~) IF yoo onl ---d YES, then what spee d would you cutimato? -~..;f; ?r :::::::.. :=: - 21. Do yoo .. ::'1~ ou can utimattt how far away from you thn objoct wa:s? IF you .:n:; ... .,r~d YES, then how for owoy would you 3oy it was?-------------- 22. Whore w~rtt I':>V locot&d wh~n y ou saw th~ obj~ct? a. lnsid~ :l :.ui lding Outd004' s In an o tr :;,lane (typa) 23. Were you (Circle One) In thf' business !;ect ion of a city? In the rosid.~ntiol soction o f o city? @;In o;>~n countryside? d. Near o n airfield? F lying ov.,r o city? Flying ovor opn country? j 24. IF you wore MOVING IN AN AUTOMOBILE o r other v!'hicl~ at the t imo, then compl,te tho following c;uostions: 2-.1 What .,,r~ction were you mavin~? (Circle One) c . South g. WC'I:r.t b. Nc r1t-ost d. Southeo3t f. Southvest h. Nrthwest 24.2 Yo"' :.::st were you moving? mil.,s per hour. 24.3 O id y::v stop a t a ny time wh;le yoJ w~ro looking of the object? (Ctr: e One) 25. Did 'f?v ~oo; 'V .. r~e object throu; 'l c-y ct the following? Binoculars Yos Th::odol it.- In orc!ttr tl,:a 'f?U c'ln give as clear a picture a5 possibb of what you s a w, d~o;cribe i n your own word:; a common obj:!ct or o;, ~c -~ ...,t, ich, whrm placed up in The !:ky, would give th sam~ Opl>"aronc.., as the object which you sow In th& follow ing ! <-:~ch, irnagir~e th~t you cro o t the point si-owu. Pbce or "A" 011 t h l cu~v ... d li n to show how high the obj&ct "'"'S above the horizon (skyline) when you f ir:;t sow it. Ploc 0 a ''8 " on t h 3 some r uvl'!d liM to show ho.,., hi9l.. '"~ o~ject was above th~ horizon (skyline) when you /ac;t !.ow it. Place an "A" on the comnolS when you f1:: .. ~.-it. Place a "(3" on the compass where you last "aw th e objct. 28. !'ro w o pictuie that will s h ow the no~i:>, that the object o r object s mode. Place on " A " at the beginning o f the poth, a"~".:~ the end of the path, o,d show any changes in direct ion during tht. course. 29. IF f1e'e .... .._s ... ~,= I HAN ONE o ci, tnen h ow many were there? D:a\01 o;, :.-:-~; ~:l..,. !!-tey were c~-="~e:;, onJ put an arrow t o show the direction that they were traveling. 30. Hove you ever se~n this, oro s imilar ohject befor.t. If ~o give dot.., or dolvs ond la<:o~;on 31. Wo$. ony~ne ~;~&with y ou ot the tima you sow the obj, ct? (Circlo One) 31.1 IF yc:-u ::.,swor"d YES, did they see th~ object too? ((ire/., One) No 3 1.2 Pboso l is t th-,ir nom"s and addresses: TELEPHCN~ NUMBE lndico t" o.,y ~:lditionol informat ion about yourself, i11cluding any s pecial O;(pttrience, which might be pertinent. 33. When and to wt,:~ d id you report tha t you hod s een the object? Dey Month Yo or 34. Dote you complt&d this questionnaire: 35. lnformoti011 ... :.., 'c.n you feel pertinent and whic h is n ot od3quote!y cov~red in tho specific points o f t h, qu~stionncsr~ ="' :1 narrative cxplonoti-:>n of your sighting