. ' Civll ian I L'SJFFICIENT "JA'":'., ~en :BVAI.UATION f 1. NU1~P.E R ~F OBJECTS ~bserver sighted a silvery colored object ~r.at haC. white revol; , One ~ights on the edges and a red light on top. 55 Minutes f,. TYPE OF OBSERVATION , Ground-Visual ' 7 , COURSE ~ Not Reported \ 8 . PtiOTOS 19. PHYSICAL EVIDENCi: Observer was sent a Fonn 117, out never retu~ed it as ~t s r-TO S E P 6 3 0-329 (TOE) Prelou edltio" of thh forB auar be uud. ti. IF you ~\lw the obiect ot NIGHT, what dtrt you notice conc erning the ~TA~S <.md M80N? 8.1 STAR~ (Circle One): 8.2 MOON (C~rcle One): Nona o. Bright moon 1 i ght b. Dul I rnoonl ight c. No moonl~ht -pitch doric Don't reme"'ber d. Don't remember 9. 'fthat were the weather conditions at the time you sow the object? CLOUDS (Circle Q.,e): NEA THER (Circle Omd: 9. C ~ear _sk,y b. Fog, mist, o r light rain c. Scattered c I oud s c. i~odP.rate or heavy rain d. Thick or heavy clouds d. Snow e. Don't r"!member 10. T he object appeared: (Circle One): a. S o lid (d.--'As a r} -J.tJd ut.-t e. Don't remember .:JJu:.. b. Transparent 11. If it appe~n~d as o light, was it brighter than the brightest stars? ((;rcle One): 'i; B r i gh_!g-"P c. About the same b. Dimmer d. Don't know 11.1 Compere brightness to some common object: 12. The edges of the object were: (Circle One): a . Fuzzy or blu~red b. Like a bri~ht star c. Shar~ly out I ined d. Don't remember 13. Did the object: a. Appear to stand sti11 at any time? b. Suddenly speed up and rush away at any time? c. Break up into parts or explode? d. Give off smoke? e. Change brightness? f. Change shape? g. Flash or flicker? h. Disoppecr and reoppeor? e. Other I r c.~.c .:i a;-,ccr.ietitJ; vzc't (: < ~()flcl. c'l:>,.. J,yrzf:l, c; cf!STt :P b:l rJ\~.e. (Circle One for each question) Don't know Don't know Don ' t know Don't know Donlt know Don't know Don't know Don't know 14. Did thjlt obieet disaDKMOf while you ~er watehi"'Q it? If Jo, ht"w? fr u.,Jpt2.ltt ~lf' t~l~ fnnes ''1t?n 'T 15. Did the abieet move ~hind somft~in~ at any time, portieu lctrly a e lnud? (Circ:le One): Don't Know. IF you answered YES, then tefl what 16. Did the obiftct move in fr()nt of ~orMthin~ at a"y timtt, pnrticularly o claud? (C irc:le One): Yes Don't Know. IF you onsw~red YES, then tell what 17. T ftll i" a f,w words the following things about the object: a. Sound ll.C .O::~'i.L2J. b. Color.~ t 2 ntH.:h-~ :. iu L 18. We w ish to know the an~ular size. Hold a match stick at arm's length in line with o known ob!.ct and nots how muc:h of the object is covered by thtt hftnd of the match. If you had perforrMd this excwtrintfJnt ot the ti1n1 of the sighti.ng,_how much of the ob!ect would have been covered by the mateh head?,.._ C(bc_.._.._r .~ <t - 19. Draw a picture that will show the shape of the obiec:t or objects. Lobel and include in your sketch any details of th~ obiect that you saw such as wings, protrusions, etc., and especially exhaust trails or vapor trails. Place an arrow beside the drawing to show the direction the obiect was moving. ~. Do you thinlc you eon estimate the spoed of the object? (Circle One) IF yov answered YES, then what speed would you estimate?------- 21. Do yo.J thinlc you eon estimate how For away from you the object was? (C irele One) IF you answered YES, then how far away would you say it was? --------- 22. Where were you located when you saw tne obiect? (C ire: !e One): 23. Were you (Circle One) a. Inside a building a. In the business section of a city? b. In a car c. In open countryside? c. Outdoors d. Near an airfield? d. In an airplane (type) e. Flying over a city? f. Flying over open country? f. Other a t hc/n?, lrck,,lJ. c'-4-r 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. WfJst b. Northeast d. Southeast f. Southwest h. Northwest 24.2 How fast were you moving? ,miles per hour. 24.3 Did you stop at any time while you were looking at the obiect? (Circle One) 25. Did you obsrv the obiect through any of the following? Eyeglasses Binoculars Yes b. Sun glasses Windshield Theodolite Yes No d. Window glass 26. In order that you can give as clear a picture as possible of what you saw, describe in your own words a common obiect or objects which, when placad up in rhe sky, would give the some appearance as the o'oiect which you sow. 27. In the following sketch, imagine that you ae at the point shown. Plac~ or ''A" on th curved linft to show how high the obiect was above the horizon (skyline) when you first sow it. Place o ''B" on the some curved line ~o show how high the obiect was above the horizon (skyline) when you lost sow it. Place an ''A" on th compass when you first saw it. Place a "B '' on the compass where you last saw til(~ object 28. L)raw a picture that wi II show the motion that the object or objects made. Place on ''A" ct the beginning of the ~ path, a "B" at the end of the path, and show any changes in d irec:tion during tht> c ourse 29. IF there was MORE THAN ONE object, then how many were there? ----------- Draw a picture of how they were arranged, anJ put on arrow to show the direction that they were traveling. 30. Hove you ever Jeen this, or o simi lor object before. If to ~ive date or dahu a.1d location. 31. Wat. anyone else with you at the time you saw the obiect? (Circle One) 31.1 IF you answered YES,. did they see the object too? (Circle One) 31.2 Please list their names ancf addresses: 32. Please give the following information about yourself: .AB-ccc\i\\ta (VLU.J. _ TELEPHONE NU Midd I Hom Indicate any additional information about yourself, including any special experience, which might be pertinent. 33. When end to whom did you report that you had seen the object? Month Yoar let eel th i questoonn - ... --'fi c paints of t ., camp .. - ----d in the IJI"CI 34. - ----. t adequately covere d hich IS no : -h au f .. l pertone . f your sighting. . - /)z.-. I nfor mat ion wh lc Y t i ve "xp Ia nat' on o h . ,. v Clt.. J_l.(_.; t. C Lu ,; t ' 35. questionnaire ar a narra ' (:_ tt/:?~ .. 'Co-- ) I ZrJ.. ~'-- CEfiA'IItTM .. NT 0" THE AlA ,.O~Cl HaADOUAIItTIIIt. ,OIItltON TICHHOLOGY DIVISION f AI'IC) WltiGHT.~AM'&ReGN Alllt '0JitCI aAal. OHIO .. 114111 UFO Observation 6 Ju.Jy 6? Reference y(~r un1dent1t1e4 observation. The information Vhi~h we have recei~ed is not suft1c1ent for a scientific evaluation Request you complete the attached F'tD Fozsm 164 e.nd return 1 t in the envelope provided. Thank you tor reporting your observation to the Air Force. ,.JL.L:..s C. MANA'I'r Colonel, USAF ~.rector of Technology and Subeystema F~D Form 164 v/envelope TDPT/UJ~ Maj H Quintani11a, Jr/70916/lsb/ 12 Jan 68 UFO Obaervation, Jul.y, 1967 Brooklyn, New Yor. l. Tbia repllea to your letter concerning your observation or nn uniden- tif'1ed tlying obJect. _ 2. Wb:SJe reY1eving our apondence files ve found your ~etter ip , which 70~:reported aeeing unidcmt1t1ed object on GIJ_uiie~lq-f;'-Be- cauK ot ao error, your sighting waa not inveatigated at "that t.ime~ We handle over 10,000 letters ..aQd investigate appraximatel.y 1 000 U70 sight- inga & ; cmce 1n a vbile an error ia ude. We regret that thia baa kept-ua traa inveatig,ating your obaervatiCil~ However, it you would c:cm- plete. the in~l.clled A7 :Fo1m 117 ve will inveatigste your sighting in an atten;t ... to dotezmine the stimulus for your observation. 3 . Tb . you. ror reporting your obaervat1an ~o the Air Force, once aga.3ot pleaaeexcuse ua for not. respond1ng tc your correspondence earlier ll.7 v/mvelasle roo~lyn, New ork 11229 D9pt. of the Air ?orce Wa.shir13ton, D.C. 20335 Gentl~men: tf'ollowing a drawing of a n object I s r i P sky a~out the middle of July I t co u 1 d be s e en from a. bout 8 : 50 ? N u n t i l 9 : L~ S P M I could see it V&3ry -v.;ell throug h poHerful binoc,J.lars. I t seemed to be about four or five ~iles awsy . ~hen I aaw this object I was standine o~ the cor- ,_le in 3 r ooklyn. I \ ! o ul d a. p p ..r e c i a t a your c o n t a c t i. n g m ~ , a t y o ; .. r earliast convenie~ce, ~;ith 2. LOCATIO~ CO CLUSION Nt;MaO: R OP 03JECTS 03SERVATION ( I-IY\,CJ J:"J_ 010 ~ rrr}.. Q , Cit Wi.JlG J.J-~._Utv-t ou-. .p "LJ''o'V U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can 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 nome will not be used in connection with any statements, cenclusions, or publications without your permission. We request this personal ;,formation so that if it is deemed necessary, we may contact you for further details. 1. When did you see the object? 3. Time Zone: (Circle One): d. Poe ific 4. Where were you when you saw the object? Nearest Postol Address (Circle One): ( C ircle On e}: a . ~-~gh}? i.r