1. OA TE TIME GROUP 3. SOliRCE 4. NUMBER OF OBJECTS .S. LENGTH OF OBSERVATION 6. TYPE OF OBSERVATION e. PrlOTOS 9. PHYSICAL EVIOEI'ICE Pi~OJEr:T 10073 ReCORD 2. LCICA TION 10. CONCLUSION INSU]PIC tATA FOR EVALUATIO~ 11. BRIEF SUMMARY A ND ANALYSIS FTD SEP 63 0-329 (TDE) Jrevloua 4i1Jon of th!a f o n " a ., b u .. d . 14. Did the object disappear whiljf you were watching it? If so, how? 15. Did the object move behind something at any time, particularly a cloud? (Circle One): Yes Don't Know. IF you answered YES, then tell what it moved behind: 16. D id the object move in front of something at any time, particula rly a cloud? (Circle One): Don't Know. IF you answered YES, then tell what 17. Tell in o few words the following things about the object: 18. We wish to know the angular size. Hold a match stick at arm's length in line with o known object a nd note how much o f the object is covered by the heod of the match. H you hod performed this experiment at the t ime of the sighting, how much of the object wa~Jid have been covered by the match head? 19. Drew a pictur., tnot will show the shape of the object or objects. Lobel and include in your sketch any detai Is of tne objecf that you sow such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on arrow ~side the drawing to show the direction the object was moving. 20. Do you think you con estimate the sp&ed of the object? (Circle One) IF you answered YES, then what speed w ould y o u estimate? -------- 21. Do you think y o u can estimate how for away fr o m you tho o bject was? (Circle One) IF you a n swered YES, then how for away would you say it was?--------- 22. Where were you located when you saw the object? 23. Were y ou ( Circle One ) (C ircle One): a. In the busines s section of a city? a. Inside o building b. In o cor Fc:) Outdoors b. In the residentia l s e ction of a city? ~ In open countryside? ld.J Near on airfield? d. In a n airplane (typo~) e . At sea e. Flying over a city? f. Flying over open country? 24. IF y ou wer!t MOVING IN AN AUTOMOBILE o r other vehicle at the t ime, then complete the following questions : 24.1 What d ire ction were you mov ing? (Circle One) e. South g. West b. Northeast d. Southeast f. Southwest h. Northwest 24.2 H o w rost w~re you moving? _., iles per h our. 24.3 Did you s top a t ony time while you were lookin g at the object? (Circ!e on, ) 25. D id you ob s"'rv" t h " obj.,ct th rougn a ny of th e following? a. E:~;bs:stn cf) Bincx:ulars Yes No b. Sun g loues Telescope Yes No c. Windshield Yes Theodolite Yes Window glass Yes No h. Other 26 . In order that y ou can give as clear o picture a s p ossible o f what you sow, d escribe in y our own words a common obj::1 :;r o~;:~c:~ w~ich, wh-~n ;>be. d up in t h e .: ky, Ho uld giv ~ the s c mc op~oronce as th~ o bj .,c t which you sa.,., 27. In the following sketch, imagine tha t you ore a t the point shown. Place or "A" on th" curved li n e t o show how high the objec t was above the horizon (skyl in<!!) when you firs t sow it. Place a '"B" on the s ome curved lin~ to show h ow high the object was above th~ horizon (skyline) when y ou last saw it . Place on "A" on the compass when you first sow it. Place a "B" on the compass where you fast saw t ire object . 28. L)raw a picture that will show the motion that the objec t or object s mode. Place on "A" ot the beginning of the path , a"~ " at the end of the path, and show any changes in direction during th~ course. rno'.-'r n 5 ler'+ 4c., r-rsh.1- 29. IF there was MORE THAN ONE object, then how many were there? -------------- Draw a ?icture d l-ow they were arranged, onJ put on arrow to show the direct ion that they were traveling. 30. Hov~ you r SOltll thi:l, cr o simi Ia~ o~j:'lct blfor3. It uo gi v:) doi.9 ~r da~d~ ond loco1:~n. 31. Was anyone else with you at th" time you saw the ob;.,ct? (Circle On~) 31.1 lf you answered YES, did thay see tha object too? (Circle On<.t) 31.2 P lease li s t th~ir names and addresses: 32. Please givo th e following information about yourself: T ELEPHONE ,_I LIMBE. l~dicot~ a ny odditionol ln fo-nction obo~ y?u:self, incl~din; en: ~;:>eci:1! I!X!lerit~nce, which might be pertinent. Wh~n and to whom did you r.!!port that you had st.:~n th" obj~ct? i---:/-. 34. Date you completed this questionnaire : 35. Info rmation which you feel pertinent and which is not odaquately covered in the specific points of the questionnaire or a narrative explonati? n of your sighting. ~C..l rn..e_ L'-Juul c{ II[P'LY TO S U B JtCT OE!ItARTMENT OF THE AIR FORCE HEAOQUA,.TE,.a I'O,.I:IGN TECHNOLOGY OIVI510N I AI'.C l W"IGHT . .-ATT&,.aON AI,. ,.O,.C aASII, OHI O .us33 UFO Observation} 12 J:.me 1967 Reference y(1ur unidentified observation. '!he information vhich we have received i s not sufficient for a scientific evaluation. Request you complete the attached FTD Form 164 and return 1t 1n the envelope provided . Thank you for reporting your observation to the Air Force . JAMES C. MANATI', Colonel, USAF Dir ec t or of Technology and Subsystems F?D Form 164 v/envelope " E PI.Y T O S U B J EC T DE .. ARTMENT OF THE AIR FORCE HEAOQUA,.TI: .. S I'O,UEIGN TECHNOLOGY OIV I!SION I AI'8C) W,.IGHT ... ATTS,.SON AIJII I'"O JIICI: 8AIJIE. OHI O -4!! ... 33 UFO Observati on Refer e nce your unidentified observation. 'lbe inf ormation which we have received i s not s ufficient f or a scienti f i c evaluation. Reques t you complete t he at tached FTD Form 164 and return it in t he envelope pr ov i de d . Thank you for r epor t i ng your observation to the Air Force. JAMES C. MANA'IT, Co l onel, USAF Direc t or of Techno l og y ~nd Subsys tems F~D Form 164 v/envelope . 2. LOCAT ION ; 1. NW.B CR Or OBJECTS 10. CONCLUSION _ at tine o f siil'lt.:!.nc. LENC.Tri OF OSSERVATION 11. BRIEF SUMMARY AND ANALYSIS (t .. T'fP!.: O F OBS!:RVATION PriYSICI.L E V !DENCE Observe r stated ob~ec t rcsemoleci Vcn ..... ;; ia 1;'-tly .: r...::.::.r.t... \. ; -i jcc t bad. a bl t.e-w:litc to rcddis,'1 and ever: '-~-~c~!iin . . ~c ....... . j Objec t we.s fuzzy e~d. nppc:lrell to have a p~lsc..-~ei..; 1 -._:::.:.n .. (TOE) i>rvloua dill on o! lhl form may bo uo~d. U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has ~on prepared so that you con give t he U.S. Air Force a s muc h ormation as possible concernin g t h e unidentified aerial phenomenon that yov hove observed. Please try to answer as many questions as you possibly con. The information tha t you give will be used for research purposes. Your nome w i II not be used in connection with any stateme n t s , ccnclusions, or publications w ithout your permis!>ion. We reque s t this personal information s o at if it is deemed necessary, we may contact you for further details. l. 'Nhen d id you see the object? 2. Tir11e o f day: Hour Minutes (Circle One): 3. Time Z o ne : (!: oy 1g t OVIny \ b. StondOrd----~ (Circle One): (Circle One): c. Mountain d . Pncific 4. Where were you when you sow t he object ? City o r T own State or County 5. how long was o b je c t in sight ? ( T o ted Dur o tron) Hours Mrnutos ~..-o.-.Certain \ c. Not very sure 5.2 Wa s object in sight continuously? 6. What was the condition of the sky? a. B r ight '-.Q.,_Bri ght ) 7 . IF you s ow the object during DAYLIGHT, where was the SUN located a s y ou looked a t the object ? (Circle One i: o. In front of you d. T o your left b. In b~Jck o f you c. To y;)ur ri;.L, e. Orrh~cd Thla fMm aupereede~ FTn 164, lu i 61, which Ia obsolete. IUI'L v ;ro TDET/UFO UFO Observation Dayton, Ohio Reference y(1Ur unidentified observation. The information 'Which have received is not suffic ient for a scientifi c evaluati on. Request you complete the attached FTD Form 164 and return i t i n the envelope provided. Thank you for reporting your observation to the Air Force AMES C. MANATr, Colonel, USAF l Atch Director of Technology and Subsystems F~D Form 164 v/envelope tl. IF you sow the object ot NIGHT, wha t did y o u notice concern1119 tho ~TAkS und MOON? 8.1 STARS(CircleOne): 'cr.-D~n't remember 8.2 M.OOI'J.L~.!rclo.: One): .::a. _Bright m2C?...nJ i"Q.!~ b. Dull moonlight No moonlight -pitch dark d. Don't rememb~r 9. What were the weather conditions at the time you sow the object ? CLOUDS (Circle O;"'e): ot/EA THER (Circle One): Ca. Cleo~ sky, ) b. Hazy b. Fog, mist, o r li ght rain c. Scattered clouds c . Moderate or heavy rain d . Thick or heavy clouds e . Don't remember 10. The object appeared: (Circle One): e. Don t remember b. Transparent c . Var>or 11. If it appeared as a l ight, w-:~s it brighter than the brightest stars? (Circle One): a . Brighter 12. The edges of rho object were: (Circle One):, o. r:_u:n:y o r blurred .> -b:-Like o bri~tst~r c . Sharf\ ly out I i ned d. Don't remember 13. Did the object: a . App.!.lr ~o stond :;till ct "lny ti.r1e? d . D o n't know (Circle One fo r each question} b. Suddenly speed up and rush away a t any time? Don't know Don't know Don't know Don't know Don't know Do.,'t know c. Break up in t o port s or explode? d . Give off smoke? e. Chon3e brightness? f. Char.ge shape? g. F lash o r flicker? 14. Did the obiect d i sao~ar while you wert~ watch ina it? If so, how? 15. Did the nbittct move b-.hind som"lthinq o t any time, portic u iCirly a cloud? (Circle One): Yes Don't Know. IF you answered YES, :hen t~ll whot it mnv"d ~hind: 10. Did the obi.,ct movo, in front of o;omething ot o,v ti"'P., particu la rl y o clc-ud? Don't l(now. IF you onsw-.red YES. then tell what (Circle 0fle): i n front of: 17. Tftll ;, a f,.w wor the followinq thinos about thft object : 18. We wish to kno..v th~ on!J11Ior si:te. Hold a match stick ot arm's len(lth in line with o known obj~ct and note how much of the obj~ct is c~ver.-d by thr: h~tnd of the match. If you hod performed this ex~riment ot th e t im' of the ,I sighting, h ow mur.h of th~t obiect woulri hove been covered by the match head? ~{:_' <~ ~ , 19. Draw a pic ture that will show the shape of the object or objects. Lobel and include in your sketch ony details I of the object that you sow such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place on arrow beside the drawing to show the direction the obj~ct was moving. 20. Do you think you con estimate the speed of th" object? (C ire IG One) IF you answered YES, then what speed would you estimate? ------- 21. Do you thin I< you con uti mate how for away from you the object was? (Circle One) Yes ~o/ IF you answered YES, then how far away would you say it was?---------- 22. Where were you located when you saw the object? (Circle One): Inside a building b. In o cor d. In on airplane (type) 23. Were you ( Circle One) a. In the business section of a citr.? In th;; j section-~f-; ;?) In open country~ide? Near on a irfield? e. Flying owtr o city? f. Flying over open country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24.1 What direction were you moving? (Circle One) a. North c. East e. South g. West b. Northeast d. Southeast f. Southwest h. Northwest 24.2 How fa~t wttre you moving? _, iles per hour. 24.3 Did you stop at any time whi le you were looking at the object? (Circle One) 25. Did you observe t he object thro ugh a ny of the following? Eyeglasses Binoculars Sun glosses Windshield Theodolite Yes No d. Window glass 26 . In ord.,r th a t you con g i1e as clear a pic ture as possible of what you sow, describe in yo ur own words o common rh~ obj~ct ...,tJ ich f O U sow 27, In the following sketch, ima g ine that y ou c1e a t tl,e p oint shown. P lace o r "A" o n th~ c urved I in~ t o show how the objec t was above the horiz on {sky l ine) when you first s ow it. P la c e a ''B " on t he same curved lin~ t o show h ow h igh the object was a bove t he horizo n {skyline} when you last saw it. Place on " A " o n th e c ompa s s when y ou f irst sow it. Plac e a " B " o n th e compass where y ou fa s t sow tl1c object . 28. lhaw o picture that will s how the mot ion that the object o r objects mode. Place o n "A" at the beginning of the 2 9 . IF there wa s MORE Tt-IAN ONE o bject, then h ow many were there?------------ Draw a picture llf h o w they were arranged, anJ put on a rrow to show the d ire c tion tha t the y we re travelin g.