10. CO~CLU:IO~ '~ INS'J.gl'ICir:f\"T DJ.T..\ FOR EV .Al.U.t..TION it~tter was not recoivad untill late May 68. at vhic!:. t~r:a it t.~..:; ~ 5. Lt:NG7H Or OCSERVATCON .:.. T'IP.: Or 03SERVATION J. ?:-tuTOS v. p;,ysJCAL EVID;:h"CE 11. BRIEF SUL:.:JARY A~ ANAL. YSIS . ~ 34. Date you completed thes qut!stionnaire: 35. lnfotmation which you feel pertinent and whi ch is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting. . Official U.S. Air Foret 14. Did the object d iappor while you were watching h? If 10, how? 15. Did the object mov~ behind something at ony time, porticularly a cloud? (Cirde One): Ye1 _f;; ) Don' t know. IF you an1wered YES, then tell whet 16. Did the object move in front of 10mething at any time, particularly o cloud? (Circle One)~ Ges 2 No Don't know. IF you answered YES, then tell what 17. Tell in o fe..,.. words the follo .... ing things about the object: 18. We wish to know the angular size. Hold a match 1tick at arm's length in line with a known o~ject and f!Ot~ how m.u~h of th~ object;, covered by the heod of the match. If you had performed this experiment at the time of th sigh1ing, how much of the obiflct would hove been covered by the match head? roo J1J e Draw a pcture that will show the shape of the object or obj\cts. label and i~clude in your sketch any details o f the objet' that you sow such OS wings, protrusions, e tc:dnd especially exhaust trpils or VOP.Or trails. Pla ce o n arror beside t he d rowinr to show 1he direction the object wos moving . ' , UFO form continued 20. Do you think you con estimate the speed of the object? (Cirr;/e One) Yes (No/ IF you a nswe red YES, t hen wha t 1peed would you estimate ? ...,JM.-......;\...;;.;..i, Do yo u think you con estimate how far cwoy fr o m you th e object wos? (C i rcle One) No If you answered YES, then how far away would you say it wos?_...!A:::::::_: ..:/j~[l'/_: '-' 22. Where-er you located when you saw t he object? 23. Were you (Circle One} (Cird Qne}: In the business section of o city? ~.-...... a . Inside o building b . In the residentia l section of o city? c. In open countryside? Near on airfield? d . ln4n airplane (type ) e. Flying o ve r o city? Flying ove r op.en cou e . Atse a 2.&. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then comple~e the following questions: 24.1 Whot d irection were you moving? (Cir cfe One) c. East e. So ut h g . Weo:.t b. Northeast d . Southeast f . So uthwest h. Northwest 2.&.2 How fast were you moving? miles p e r hour. 2~.3 Did you stop at a ny time while yo u were looking c t the object? (Circle One) Did you observe the o b ject through c ny of the following? o . Eyegla5ses Yes No Binoculars s No Sun glosses Yes No f. Telescope Windshield Yes No Theodolite Yes Yes No h. Other Window g lo ss 46. In order tho t you con give os cleor a picture c s possible o f whot you sow, describe in your own word5 o common object or ob- ~cts which, when placed up in the sky, would give the so me cppeoronce cs the object which you sow. Official U.S. Air Force '27. In the following sketch, imagine thot yo u ore at the point shown. Place on "A' on the curv e d line to show how hig h the object wm above th e horizon (skyline) when you first ~ow lt. Ploce o " B ' on the ome curved line to show how high th e object was above the hori.zon (skyline) when you lost sow it. Place on " A" on the compass when you firs' sow it. Ploco o " S'' on the com pan when you lost sow the obj!tct. 28. Draw o picture that will show the motion that the object or objects made. Place on " A at the beginning of the path, a "8" at .... q end of the path, and show ony changes in direction durin~ the course . 29. IF there was MORE THAN ONE object, then how many were there? _ Draw a picture of how they were arranged, ond put on arrow to show the d irection that they were traveling . fOrm continued HCJv c you 9ver ~"~" th i; , oro similar obtect before. If ~o g ive dote or d o '!H and location. Wc.n onyone else with you at the time you sow the object? (Circle On!!) No J 1 . 1 IF you amwered YES, did they see the object too? (Circfa One) No Ple ase givtt the following informot1on obout yourself: TELEPHONE NU~R._-+J' ..... l/;..._ hdicote any additional information about yourself, including o 'ly special experience, which might be p~rtinent. , 'Nh!:!n and to whom did you report that you hod seen the object? Official U.S. Air Force UFO fc l 34. Dote you cotnpleted this questionnaire: 35. ln jormotion ""hich you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative "planation of your sighting U. S. AIR FORCE TECHNICAl INFORMATION This questionnaire has bMn prepared so that you can give the U.S. A ir Force as much information as possible concerning tht unidentified aerial phenomenon that you hove observed. Please try to answer as many questions os you possibly can. The information that you give will be used for research purposes. Your nome will not be used in connection with ony statements, conclusions, or publications without your permission. We request this personal Information sa that if it is dMm&d necessary, we may contod you for further details. 1. Wnen d id you see the object? Month Year Hours Minut (Circle One): A.M. 3. Time Zonea (Cirde One): o . Eastern b. Central c. ptajn d. (fl'ocific ) 4. Where were you when you sow the object? (C irde One): o ( Do~.igh t Saving.) b. Standard City or Town; State o.c. Coun"f/ .., r Nearest Postal Address 5. How long was object in sight? (Total Duration) Hours Minutes Seconds a . Certain c . Not sure b. Fairly certain d.(Just o guess') 5 .2 Was o b ject in signt continuously? Yti!s ' No _ 6. What wo~ the condition of the sky? 7 . IF you sow t he object during DAYLIGHT, where was th e SU.~ locate d as you lo ol<ed a t the object? . (Circle O n e ): o . In front of you d. To your left b . In bock of you e. Overhead c. To yourrig;H f. Don't remember fTD o:::r 62 164 T!u:; form Jllj)f>rSPde:o r TD 1!)~. jul6 1, "htc h :c; Ctl-:.Q!ete . 8. IF you ~ow the object at NIGHT, what did you notice concerning the STARS ond MOON? 8 .1 STARS (Circle One): b . A fow d . Do n' t remember 8.2 MOON (Circle One): a . Bright moonlight b . Dull moOAlfahr.----- - c . . No moonlight-pitch dark d . Don t remem er 9. Whet were the weather conditions at the time you saw the object? CLOUDS (Circle One): WEATHER (Circle One): b. Ho::y b. Fog, mist, or light rain c. Scattered clouds c. Moderate or heavy rain d . Thick or heavy cloud d. Snow e . Don't remember 1 0. Tha object appeared: (Circle One): @:_ As ali e~on't remember b. Transparent 11. lr 1t appeared as a light, was it brighter than the brightest stan? (Circle Omt): c. About the same d. Don't know Brigh,.._-.. Compare brightness to some common object~ . o s*r-c~-P 12. The edges of the object were: (Circle One): ta:"""Fuuy or blurre b . li a a right star c. Sharply outlined d. Don' t remember ! ~-D!d the object: a. Aopeor o stand still ot any time? b. ~5uddeiirys-peeaup]JtJ~.tatan)' timV c. Break up into ports or explode? d. G ive off smo<e? e . Change brightMss? f . Crong~ shape? 3 ~=tosh o r flic!cer? h. D soppear and reappear? (Circle O ne for eoch question) '-..No . Do n' t know No Don' t know r Don't SCno Don' t know Ye s '-'N'c>-> Don't know Don' t know No Don' t know . Official .u.s. Air Force U t 15. Did the object move behind someth ing ot ony time, particularly o ~laud? J (Circle One): Don't know. IF you answered YES, t hen tell what Did the abject move in front of something at any t ime, particularly o cloud? (Circle One): O.;Y No . Don't know. IF you answered YES, 1hen tell what 17. Tell in o fe w wo rds the following th in gs about the object: We wish to know the angular size. Hold o match stick ot arm's length in line with o known object a nd note how much of th e object is covered by the head of 1he match. If you hod performed this experiment at the time of the sighting, how much of the abjed would hove been covered by the match head? I t! : r know tf: ifvv'5 ,'inr,oJna+tcn, bv+. i+-5ee'i1 19. Draw o picture that will ~how the shape of t he object or objects. label ond include in yo ur sketch o ny details of the obj':cf tho t you ~ow such a s wings, protrusions, e tc., ond e sp ecially exhaust trails or vopo r trails. Pla ce o n orrow beside the drowing to sho w the direction the object was moving . . Air Force UFO form continued ~en tell what ,nd note how much ohtre he sighting, how ml!ch of J: f ec ~;c~ any details of the object lrrow beside the d rawing Do you think you can estimate the speed o f the object? (Circle O ne) Yes {t;i:> IF you answered YES, then what speed would you estimate? _ Do you think you can estimate how !or away from you the object war.? (Circle O ne) (!-;.;:7 No IF you answered YES, then how for away would you say it was? .-+-------- 22. Where were you located when you saw the object? (Circle One): a . Inside o building b . In o cor d . In on a irpla ne (type) 23. Were you (Circle One) o . In the business section of a city? tx::::tn1'fte residentinlsertjo~ of o tity?-- J c. In open _countryside? d . Near on airfield ? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle o t t h e time, then complete. the following questi ons: 24.1 What direction were you moving? (Circle O ne ) a . North c . East e . South b . Northeast d . Southea st f . Southwest 24.2 How fast we re you moving? miles per hour. 24.3 Did you stop at any t ime while you were looking at the object? ( Circle One) Did you obse rve the object through ony of the following? o . .:>un glasses c . Wind~hield d. Window gloss e . Binocula rs g . Theodolite h. Northwest 26. In o rder that you con g ive os clear o p idure o s possible of what you sow, d escribe in your own words o co mmor. object or ob- jects which, when placed up in the sky, would givethe some oppeoronce a s the object which you \OW. Official U.S. Air F 27. In the following sketch, imagine that you ore at the point ~hown. Ploco o n "A" on the curved line to show how high the object was above the horizon (skyline) when you first sow it. Place a " B" on t he some curved line to show h ow high the object was above the horizon (skyline) when you foJt sow it. Place on " A" on the compass when you Firsf sow it. Place o ''8" on the com pou when you losf sow the object. 28. Draw o picture that-will show the motion thot rhe object or objects mode. Place on "A" ot the beginning of the path, o " S" ot the end of the path, and show any changes in direction during the course . 29. IF there was MORE THAN ONE objecT, ther. how many were there? _ Oraw a picture of how they were arranged, and put an arrow to show the direction that they were traveling ., o form continued 30. Hove you e ver ~ecn this, or a similar obje ct before. If so give dote or dotes and location. r -- 31. Wos anyone el se with you ot the time you sow the object? ( Circle One) 31.1 IF you answered YES, d id they see the object too? (Circle One) 31.2 Please list their names and addresses: 32. Please give th e followin information about Middle No,e . j\J u -~ (v\'-JC~ SQSCt .4:-~ e)(Ft"el&"NCE ~\OVd }:: CVL5 H .l 1-L~J; I R!ED TO SE-E" (T L,-J /Tifot:J r /VlY GL-~5fS) 5 o T 33 Wh~n ond to whom did you report that you had seen the object? Official U.S. Air Fore':- 34. Dote you completed thi' questionnaire: Month Yeor 3.5. Information which you feel pertinent end which is not adequately covered in the apecific points of the questionnaire or a narrative explanation of your sighting. ,tv I IH fol y FA meR. ~]) 1---/ E ANt> :i.. j\JST LcM .. [.' c,.p ,11-TTI-IF '5TARs FOR. A ~Ew Mc\JV!EtJrs.)AJ~'t _]_ Notte l?D IHA 1 SBJE-RM..... S'TA-R s SE-E-i'V\ED T o . 'ffAV~ ''Yf L-L L'LU i 5H 0 R R-f.'DD/S 1-1 c 0 LOR s ) A J\f l> Wt' NOIICCD v\J'HAl W\::-Tf-fovGHT \0 ec .. -n-t~ }-(oiz.JzoN _ DUT "'c;, I w.P,J rr rH 1s PR('i'JI..Glf Qv 1/'C \JICf:_I!CAL' ~ S..A'W SoM~\\{\1'-\f: .t\JJ <''liNG j