P.~OJECT iC07J RECORD fl. OA TE TI..4.E GROUP 2. LOCATION 4. NUMBER OF OBJECTS Wycmissing, 10. CONCLUSION Sataellite Echo I vas passing N: of the sighting area and should. have been visible ~ the time of the sighting. ~. LENGTH OF OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS 22 seconds 6. TYPE OF OBSERVATION Ground Visual 9. PHYSICAL EVIDENCE ObJect was like a bright light or flickering. ObJect appeared as a fTD . ~[? 6) 0-329 {TOE) Prevtou edltl,:,ne o l thh f orm may tN u .. d , star. White~ flashing and diamond tllckering in the 30. Have you over seen this, or a simi l,u ohiect hfottt. If J O gh., dote or da~4):; o mJ :cx:uti .rt. 31. Wa1 anyone else with you at the time you saw the obiect? (Circle On") 31.1 IF you answered YES, d id th~y see tha object too? (Circle One) 31.2 Please list their names and addresses: 32. Pleas~ give the following information about yourself: First Name TELEPHONE NUMBER Midd I Name Indicate ony additional information obout yourself, including any special experience, which might be pertinent. 33. When and to whom did you report that ycu had se~n the obj~ct? let. Date you completed this questionnaire: Information which you feel pertinent and which i s not adequately covered in the specific points of the questionnaire 011 a narrative explanatitJn of your sighting. (Maj Quintanilla/70916/mhs/ 12 Aug67) Ul''O Observation, Enve l ope "The l'fotlcHI'I ~ Ru1i"f'.ll /' opf'rto xP ~v- Ufo. en 'L Q.--Gvv _A..l'-f~.cr I U 8 JlCT D! .. A"TMKNT 0,. THE -''A P'O,.C:I HIAOQU AMTI"e , O .. IION TICH,..O\.OQY OI'II~ION I " " ~C) W"IGHTI'ATTIAeON AUt ,O .. C& aAea. OHIO t4!S431 TDF:r/tJFO UFO Observation Reference y(ur unident1t1e4 observation. '!be information 111hich we have received is not autt1c1ent tor a scientific evaluation. Request you complete the attacherl FrD Form 164 and return 1 t in the envelope provided. Thank you for reporting your observation to the Air Force. S C. MANAT!' Colonel, USAF irector of Technology and Subaystema FTD Form 164 v/envelope U.S. AIR FORCE TECHNICAL INFORMATION .)f\ 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 obsrved. Please try to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your name wi II not be used in connection with any statements, conclusions; or publications without your permission. We request this personal informotion so that if it is deemed necessary, we may contact you for further detai Is. 1. When did you see the obiect? 2. Tir,,e of day: 3. Time Zone: I. tastern (Circle One): b. Central c. Mountain d. Pacific 4 . Where were you when you saw the object? (Circle One): (Circle One): Hour M inutes Daylight Saving ostal Address City or Town Stote or County 5. how long was obiect in sight? (Total Duration) Hours Minutes Seconds <9) Certain c. Not very sure b. Fairly certain , d. Just,~ guess . . ,. ,. 5.2 Was obiect in sight continuously? 6. What was the condition of the sky? 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the obiect? (Circle Onej: a. In front of you b. In back of you c. To your right d. To y our left e. Overhead f. Don't remember FTD OCT 62 164 Thle fo;:,rm up.reedU FTn 164, j u l 61. whlct\ i obolete. ~. IF you saw the object at NIGHT, what dirl you notice concerning the ~TAt<~ and MOON? 8.1 STAR~ (Circle One): Don't remember 8.2 MOON (C,rcle One): a. Bright moon I ight b. Dull moonlight c. No moonlight -pitch dork (1; Don't remember 9. What were the weather conditions at the time you saw the object? CLOUDS (Circle One): NEATHER (Circle On~): @::Clear sky b. Fog, mist, or I i gh t rain c. Scattered clouds c. Moderate or heavy rain Thick or heavy clouds Don't remember 10. Th~ object appeared: (Circle One): b. Transparent @ As a light e. Don't remember . 11. Jf it appeared as a light, was it brighter than the brightest stars? (Circle One): a. Brighter e About the same d. Don't know 11.1 Compare brightness to some common obiec:t: . 12. The edges of the object were: (Circle One): a. Fuzzy or blurred @ Like o briyht star c. Sharply outlined d. Don't remember 13. Did the object: (Circle One for each questbn) o. Appear to stand sti II at any time? Don't know Suddenly speed up and rush owoy atony time? Don't know c. Break up into ports or explode? d. Give off smoke? Don't know e. Change brisJ1tness? Don't know f. Change shape? Don't !<now g. Flash or flicker? Don't know h. Disappear and reappear? Don't know 14. Did the obiect di saooear wht le you were watching it? U so, how? /\/G 15. Did the obiect move ...._,., ind som-.~ in~ ot any timfl, oorticu l~rly a cloud? (Circle One): Yes Don't Know. IF you answered YES, then tell what 16. Did the obiect mov~ in front of 5on:ething ot orw time, oorticuforlv o clot.1d? (Circle One): Yes .(._) Don't Know. IF you answered YES, then tell who' 17. T etl in a few words the following things about the object: 18. We wish to know th an~ular size. Hold a match stick at arm's length in line with o kn()Wn object and no~e how much of the obiect is covered by the head of the match. If you hod ~rformed this exP'trime,t ~t the t ime of the sig~tinq, how much of the obiftct would hove been covered by the match head? CA)JJ-_.. ,'. _., - ... . _ 19. Draw a picture that will show the shape of the object or objects. Lobel and include in your sketch any details of the obiect that you saw such as wings, protrusions, etc., and especially exhaust trails or va~!r:.~s,....---~ Place an arrow beside the drawing to shaw the direction the object wos moving. _ "=7' _ _.-. 20. Do you think you can stimate the speed of d1e obiect? (Circle One) ~ No IF you answered YES, then what speed would you estimate? J _ . -_. _ _ 21. Do you think you can eatimate how far away from you the ob;ect was? (Circle One) IF you answered YES, then how far away would you say it was? --------- 22. Where were you located when you saw the object? (C ire le One J: a. Inside a building b. In a car Outdoors d. In an airplane (type) 23. Were you (Circle One) In the business section of a city? In the residential section of a city? In open countryside? Near on airfield? Flying over a city? Flying over open country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete t),e following questions: 24.1 What direction were you moving? (Circle One) c. East e. South b. Northeast d. Southeast f. Southwest h. Northwest 24.2 How fast were you moving?. .mi las per hour. 24.3 Did ytN stop at cmy time while you were looking at the obiect? (Circle One) 25. Did you observe the obiect through any of the following? a. Eyeglasses Binoculars Sun glasses f. Telescope Yes Windshield Theodolite Yes