~")A i;: Tlw.:: GROUP 2. LOCATION t-,t, .t:.[ R Or OBJ ECTS 10. CONCLUSION L eNGTH OF OBSERVA T ION T'I'?E CF OBSERVATION SRIEF SUMMA RY AND ANALYSI S 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 have 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, ccnc:luslons, or publications without your permission. We request this personal il"formation so that if it is deemed necessary, we may conto(t you for further detoi Is. 1. When did you see the obiect? 2. T i r.,e of day: /&'--- Htlur Minutes 3. Time Zone: (C ;rei e One): a. to stern b. Central c. Mountain 4. Where were you when you sow the obiect? how long was obiect in sight? (Total Duration) b. Fairly certain How was time in sight determined? (Circle One): (Circle One): fa:'\ Daylight Saviny Y. Standard City or Town Hours M inutes Not very sure d. Just a guess 5.2 Was obiect in sight continuously? 6. What was the condition of the sky? 7. IF you sow the object during DAYLIGHT, where was the SUN located as you looked at the object? (C;rcle Onei: a. In front of you b. In beck of you d. To y our left e. Overhead c. To your right f. Don't remember o. IF you sow the obiect at NIGHT, what dici you notice conc~rning the ~TARS und MOON? 8.1 S T AR5 (Circle One): b. A few d. Don't remember 8.2 MOON (Circle One): (a~ Bright moon I i ght b-. Dull moonlight c. No moonlight -pitch dark d. Don't remember 9. What were the weather conditions at the time you sow the object? C L QUOS (Circle One): NEATHER (Circle One): b. Fog, mist, or light rain c. Scattered clouds c. i-Aoderote or heavy rain Thick or heavy clouds Don't remember The object appeared: (Circle One): G;-:solid d. As a light b. Transparent e. Don't remember 11. If it appeared os o light, was it brighter then the brightest stars? (Circle One): o. Brighter c. About the same d. Don't know 11.1 Compare brightness to som~ common object: 12. The edges of the object were: (Circle One): 13. Did the object: a. Fuzzy or blu:-red b. Like a bri~ht star t;) Shar!'IY out I ined d. Don't remember a. Appear to stand still 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 bri~tness? f. Change shape? g. Flash or flicker? h. Disappear and reappear? (Circle One for each question) Don't know Don't know Don't know Don't know Don't know Don't know Don't know Don't know 14. Did the object disat:)peor while you wePe watching it? If so, how? 15. Did the object mcwe h-.hind aomttthing at any time, particularly o cloud? (Circle One): ;f_es No Don't Know. IF you answered YES, then tell wha t 16. Did the object move in front of something at any time, particularly a c louc:l? (Circle 011e): Yes_ '~) Don't Know. IF you answered YES, then tell who? j 17. T "II in a few words the following things about the object: 18. We wish to 1cnow the angular size. Hold a mateh stiek at arm's length in l ine with a known obiect and note how much of the obiect is covered by the head of the match. If you had performed this experiment at the time of the sighting, how much of the object would have been eovered by the match head? 19. Draw a picture that will show the shape of the obiect or objects. Label and include in your sketch any details of the obiect that you saw such as wings, protrusions, etc., and especially exhaust trails or vopor trails. Place on arrow beside the drawing to show the direction the obiect was moving. j...J o ge A 20. Do y ou th int< you can estimate the speed of the obj .-ct? (Circle Ons) IF you answered YES, then what speed would you estimate?.---:..\~ ..... -_ ""-v- ) i/~.:.. 21. Do yov think you can e'timate how far away from you thtt obiect was? (Circle One) 22. Whert! were you located when you saw the object? (Circle One): 23. Were you (Circle One} a. In the business section of o ci"J? Inside a building b. ln the residential section of a city? In open cou.,tryside? Outdoors d. Near on .:tirfie1d? d. In an airplane (type) Flying ovtJr a cit'/? f. Flying ove:-o~rt country? 24. IF you wer.a MOVING IN AN AUTOMOBILE or other vehicle at the time, th~n complete the following questio ns: 24.1 What direction were you moving? (Circle One) a. Nort+-. c. t:ast e. South g. West b. Northeast d. Southeast f. Southwest h. Northw~st 24.2 How fast were you moving? miJe.i per hour. 24.3 Did you stop at any time while you were looking ot the obiect? (Circle One) Did you observe the object through any of the following? Ey~glosses Yes Binoculars Yes No b. Sun glasses Yes 'Nindsh ield Theodolite Yes d. Window glass Yes 1, No) 26. In ord~r that you can give as clear o picture as possible of what you sow, describe in your own words o common object or objects which, when placed up in the sky, wou ld give the some appeorance os the object which you sow 27. In the following sketch, imagine that you ore ot the point shown. Plac~ on A" on the c:urvd line to show how high the object was above the horizon (skyline) when you f;r5t sow it. Pface a a" on the some curved lin~ to show how high the obiect wa5 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 lost sow the object 28. tJraw o picture that will show the motion that the object or objects made. Place an "A" at the beginning of the path, a "B" at the end of the path, and show any changes in direction during th~ course. 29. IF t here was MORE THAN O~E object, then how many were there? ----------- Draw a picture of how they were arranged, anJ put an arrow to show the direction that they were traveHng 31. Was anyone else with yoJ llt the tim" you saw th1t ohj :~t? (Ci rda One) 31.1 IF you answered YES, did th~y :=;oJ th~ o!lil!ct too? ( C ircl.l Ono) 31.2 Please list thir names and addre-sscu: 32. Pleas~ give the follo\-/i11g information abcut youtl-ali; TELEPHONE NUMB Indicate any additional information about yourself, im: IL~d ing any sp~ i a: '~p~n~nc~, wh i:h might be partin~r:t. When and to whom diJ you report tha T you had sasi1 th~ o bj::ct? Day Mcr.th Year 34. Date you completed this questionnaire: 35. Information which you feel pertinent ond which is not adequately covered in tne specific points of the questionnaire or a narrative explanation of your sighting UHQASSIRID-; I. ~ L--' DEPARTMUIT OF THE AJR FORCE STAFF MESSAtl BRANCH ACTION: RDC-4 INFO:XOP-1, XOPX-2, SAFOS-3, DIA-l (12) ADV DIA SMB A275PTTU JAW RUWJ8MA0479 194211?-UUUU--RUEOHOA. FM USAFTFWC NELL IS A FB NEV T 0 R U',V M F V A I A D C :VJSJA/? 7A IRO IV LUKE AFB ARIZ qtJCIFGA/FTO \'/PAFB OHIO RUEOHQA/CSAF RUEOHqA/OSAF WASH DC ZEN/UNIV OF COLORADO BOULDER COLO 80302 U~CLAS OCI 00047 JUL 1q67. SUBJ: UFO REPORT THE FOLLOWING REPORT IS lAW AFR 80-17. PARA 11A: (1) OVAL C2) HIGH-FLYING JET ACFT .(3) WHITE (4) O~JE (5) N/A (6) NONE (2) NORTH TO SOUTH 45 DEG (3) 45 OEG (4) NORTH TO SOUTH (5) VANISHED SUDDENTLY (6) THREE ~INUTES. PARA 11C: (1) GROUNO-VISUAL, AFHQ JAN 0-309C U NCLASSIJJID UNCLASSIRID DEPARTMOO OF THE .liR FOICI STAFF MISSAII BRANCH IMCOMIItl MESUII < 2) N I G HT PAR A 11E : HOME CR E F PAR A 1 1F ) PAR A 11F : D AV I 0 PAGE 2 RUWJBMA0479 UNCLAS LEE \'1 A IT E , 25, 1610 NORTH 11TH, LAS VEGAS , MAIL R 0 OM , 12TH GR AD E , APPEARS VERY CONFUSED AND DOUBTS THIS REPRESENTS AN "EXTRA TERRE ST R A I L V IS IT AT I 0 N." < 2) N I A PAR A 11G : C 1) 0 ARK BUT CLEAR , 2l T PETER V. THATCHER CT FWC-0 I) REPORTING OFFICER, NELL IS AFB NV U NCLASSIFJED Pi~OJECT iC073 RECORD J 1. DAn;: TIME ~ROUP 2. LOCATION ., , l ~ J. S\'llJRCE I. Civilin!l ! .S. LENGTH OF OBSERVATION ( 30 SeCO:lC.S 6. TYPE OF OBSERVATION : Ground Visual ~ 7. COURSE 1 St!.'"~ight r 8. PriOTOS ~9. PHYSICAL EVIDENCE 10. CONCLUSION INStiFFICIE!\-:r DATA FOa EVALU~l'ICN For.o 164 ~ent ov~r 30 dayc ago if fo~ is returned the c e vill be r~-eva.lu(:.ted... 11. BRIEF SUMMARY AND ANAL YSlS Ooject appeared to be fJ:--a-:; disk 3ha!?ed cJ'ld white speckled silver color. It 't.rant ov;:;:r a uountain end c-? .. ""10 bo.ck. os-~in. Object had a stro.ight f~ight :path. Object disa:ppeared by going over the horizo~. . DEfiARTMKNT Ofr TME AIR FO,.CE H~ACQ\.IA,.T.!"S FO~IIGN TEC HNO\....JG'f OIVI~ION ( ~F~Cl W"IOHT ItATTC ... ON AUt ,O .. C:I BA.a. OHIO .,.:u RI~L't TO TDET/tJFO UFO Observation , 5 July 1967 Ias Vegas, Nevada 89107 Reference y r unidentified observation. The information vhich we have received is not sufficient tor a scientific evaluation. Request you complete the attached FTD 164 and return it in the envelope provided. Thank you for reporting your observation to the Air Force. '*"v C. MANATr, Colonel, USAF rector of Technology and Subsystems F~D Form 164 v/envelope 12EPUTMDr Of THI All STAfF MISSAII IRAIICII IMCDMIII MISSAII ACTION: RDG-4, INFO: XOP-1, XOPX-2 S, 0-3, DIA-l (12) ADV CY DIA FM USAFTf"'f NELL IS IF 8t NV T 0 RU'IIWVA/ADC Rt.llc!J\127 A IRO IV LUk.E ~&-ARIZ RLEOF' IF' 1fT 0 YIPAF 8 CHI 0 RtDHO\ICSW RL0HQAIOS* WASH ot ZN/ LN IV (f CQ.~AOO BOllti:R CQ.O 81312 A,TTN OR C 01 Oat 01 A IL > rORr FTD WPAF B OH10 CTOETR>, CSAF CN'ROC >, OSAF' CSAf-01 >. SU8Jt-lf 0 REP~T THE f" Q.L a. IN G RE PmT IS lAW AFR 80-17. PARA 1 1As C 1) fl.. A