OA iE '. TIMe GROUP 1. NLII!8ER OF OBJECTS LENGTH OF OBSERVATION 30 m:inutes r.. 1"1'PE OF OBSERVATION Ground Visual (l, Ptf OTOS 19. PHYSICAL EVIDENC E PROJEC1" 10073 RECORD 2. LOCATION 10. CONCLUSION lllSUF'FICIEi\T DA' Y\ FOR EVALUATION 11. BRIEF SUMMARY AND A NALYSIS Observer stated Brightness of t:' ObJect ~ppearcd were :ruzzy end tct the object appeared to be a light. le object was compared to th~t of a star. be brighter than the sta:-. Edges of the >lurred. The object had a rroring sound. f=TD S E P 6 3 0-329 (TOE) Prel ou e e ditio n o f lh h l o rm ""'' ,. u .. d. IUI'L. Y TO OIE,.ARTMENT OF THE AIR FO~CE UFO Observation XUJ.1.:I.o., Reference y(>ur unidentified observat1.on. The information which have received is 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. S C. MANATI' Colonel, USAF rector of Technology und Subsystems F?D Form 164 v/envelope U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you con give the U.S. Air Force as much information as possible concerning the unidentified aerial phenomenon that you hove observed. Please try to answer as many questions as you possibly con. The information that you give will be used for research purposes. Your name will no t be used in connection with any statements, conclusions, or publications without your permission. We request this personal information so that if i t is deemed necessary, we may contact you for further details. When did you see the object? 3. Time Zone: (Circle Onc):r a-:_. t:astern b. Central c . Mountain d . Pacific 4. Wh.,re were you wh"n you sow the object ? Neore:tt Postal Address (Circle One): P.M. (Circle One):Q Daylight Saving b. S tandard Le/'y'-~tt~ City or T o w n toto o r County 5. hOW long wos ohjttct in sighr? (Totol Durcr.o n ) a. C.Htoin c . Not very sure b. Fat(ly certain d. Just a guess 5.2 Was object in sight continuously? 6 . W:1ut . .,.,; thlol conditi'Jn o f th'! 3'<y? c::claudy 7. IF you sow the object during DAYLIGHT , where was the SUN located as you looked ot the object ? (Crrcl<! Om,): IJ. In front o f you b . In bock of you c. To your right e . Ov.::h~od f. Don't remember FTD OCT 62 164 8. IF you saw the object at NIGHT, what did you notice concerning the STARS ond MOON? 8. 1 STARS(CircleOne): d. Don't remember 8.2 MOON (Circle One): a . Bright moonlight b. Dull moonlight a No moonlight -pitch dark d. Don' t reme mber 9. What were the weathe r conditions a t the time you saw the object ? CLOUDS (Circle One): a. Clear sky c . Scatte red c louds @Thick or heavy clouds WEATHER (Circle One): '---('Fog, mist, or light rai n c. Moderate or heavy rain e . Don' t remember 10. The object appeare d : (Circle One): b. T ronsporent (_I) A s a I ight c. Don't re member J 11. If it appeared as o light, was it brighter than the brightest stars? (Circle One): ASrigh fe r c. About the some d . Don' t know Compa re bright_ness to some common ~jec(tr.f / } /J t The edges a t the o ilj .,ct were: (C irc!e One);/ a ,/ Fuzzy or blurred '-b . Like o br iyht s tar c. Sharply outlined d. Don' t remember Did the object : (Circle One for each quest ion) Appear ro stand still a T cny tirne? Don't know b. Suddenly speed up and rush away a t any time? Don ' t know c . Break up into ports or explode? Yes d. Give off smoke? e . Change br ightness? Yes cgon 'tkn~w _) f. Change shape? on't 'l<now Flc-;h or flicker? Do.,' t know Don' t know 14. Did the object disappetor while you were watching it? H 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 16. Did the object move in fr ont of something at any t ime, particularly a cloud? (Circle One): /Yes) Don't Know. IF you a nswered YES, then tell wha t :CG i \ Sro R~ T e ll in a few words the following things about the object : CoN Dt Tl o N :1(: We wis h to know the angular size. t-lo ld o match stick at arm's length in line with o known object and note how much o f t he object is covered by the head of the match. If you hod performed this experiment o t the t ime of the sighting, how much of the object wou ld hove been covered by the match head? 19. Draw a p 1cture that writ show th e shape of the object or objects. Lobel and include in your sketch any details of the o bject ~hot you sow such as wings, protrusions, etc., end especially exhaust trails o r vapor trails. Place en arrow beside the drawing to show the direction the object was moving. 20. Do you think you con estimate the speed of the object? (Circle One} Yes G~ IF you answered YES, then what speed would you estimate? ------- 21. Do you think you con estimate how for away from you the obje c t was? IF you answered YES, then how for away would you soy it was? o_-_,(_'-'-'/_L.:_- h_-_:;;>_L () [ k (Circle One} 22. Where were you located when you sow the object? (Circle One): 23. Were you (Circle One) a. In the business section of a city? (~)In the residentia l section of a city? a. Inside a building b. In a cor c . In open countryside? d. Near on airfield? e. flying over a city? G";butdoors d. In on airplane (type) f. Flying over open country? 24. IF you we re MOVING IN AN AUTOMOBILE or other vehicle a t the time, then complete the follo wing questions: 24.1 What directio n were you moving? {Circle One) e. South g. West b. Northeo~t d. Southeast f. Southwest h. Northwes t 24.2 How fo::s~ were you moving? --------J m",i les per hour. 24.3 D td you s t op CJt any t ime while you w"'" looking a t the object ? (Cir.:fe Om:) D id you o b serve !hi! object through any of d-e fo llowing? o. Eyt'gbsse~ Binoculars Sun glos ses Yes Windshield Theodolite d. Window g loss 26. In ord.:r tt, o t you con give as c l:.w r o pic1 Jre as possible o f what you sow, d o;crib.:: in your o'Yn words a common objec t or object s which, when placed up in the sky, would g ive the some appearance as the object which you sow 27. In the fo ll owing sketch, imagine that you are a t th e point shown. Place on "A" on the curved lin~ t o show how h igh the object was above the horizon (skyline} when you first saw it. Place a "B" on the some curved line to show how high the object was above th e horizon (skyline} when you last sow it. Place on "A" on the compass when y ou firs t sow it. Place a "B" on the compass where y ou last sow the object . ~-? 28. l.lrow a picture that w i ll show the motion that the object o r objects mode. Place on "A" at the beginning of the path, o "13" ot the end of the path, and show any changes in direction during the course 29. If t nere wa s ''-'ORE THAt~ ONE object, rhen h ow many were tl,ere? Drew Q picture 0! now they were arranged, an.:l put on arrow t o Sn,')W th e direct ion that they were traveling. 30. Hove you ever seen this, or o similar object before. If s o give d ote o r dotes and location 31. Was anyone els e with you a t the time y ou sow the obje c t ? (Circle One) 31.1 IF you answered YES, did they see t he object too? (Circle One) 31.2 Please list their names and addresses: 32. Ple ase give the f lowing information about yourself: F irst Nome State Zone TELEPHONE NUMBER-------- 1ndicat~ any etddit ionol inforMation about yourself, including any special experience, which might be pertinent. 33. When and to whom did you report t hat you had seen the object? 34. Date you completed this questionnaire: 35. Information which you feel pertinent and which is nat adequately covered in the specific points of the questionnaire or a narrative explanation of your s ighting.