1. DATE T IME GROUP 2. LOCATION \ 5. LENGTH 0!= OBSERVATION 2-"::\ minutes 6. TYPE OF OBSERVATION Gro'mti-"~li. sual 8. PtiOTOS 11. BRIEF SUMMARY AND ANALYSIS The observersighted an object that looked like aluminum sphere which reflected light rays to a orange color with a box-like top. COMMENTS: Observer later reported that she had definitely identified the object as being a hot air balloon. 9. PHYSICAL EVIDENCE FTD S E? 6 3 0-3~9 (TOE) Pr .. loue dlUotu of thle IOta ... , be u .. d. SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE ,, WHE,_. O:~ "~USEE THE PHENOMENOHT 2. WHAT TIM~ 0!0 YOU FIRST SIGHT TH~ PHENOMENOMr 3 . WHAT TIM~ 010 YOU \..AST SIOHT THE PHENOMENON? 4 . TIM /ZCN 0 OAYI.IGHT SAVh~GS QSTANOARO 5( EASTEP._. 0 C ENTfotAL 0 MOUNTAIN S . WHC.A E WE; YOU WHEN YOU SAW THE ilHEN~MENON? IF JN CITY, CIVE THE NEARE $ T S TREET ADDRESS AND INDICATE ON A HAND OR ....,N MAP WHE R E Y O U WER E STANDir~G '14! rH ru::F'ER E NCE TO rHE A D D R ESS. IF IN THE C OUNTRY, IPENTIFY THE HIGHVtA Y Y C 'J WERE ON OR HEA R ANr:> TRY TO FIX A D I STANC E AND DIR ECTION FRO M SOME RECOGNIZABLE LAt-IOMARK. ' ' ' \J fr[llb/v'5; CJ Ill CJ 6 . IMAvl'-1:-" Y":'J ,.a.qE A T THE P OIP.I T SHOw~ IN THE SK E TC\.1, Pi..ACE AN .A .. ON THE C!JnVEO LI"NC' T O SH O W H O W tiiGH T Hr::: P"iE~ :y.,.:::-'"4 tOS A 9 0VE' THE I~ORI ZON, O'l SKYLI'iE, WHt:N FIRST SEI:.t~ . PLA(;E A o O N THE SA ... E CURVED L. I H E TO SHOlr' HOW ~G:-f ABOVE THE H O R IZON THE PHENOME~lON WAS WHEN L A ST SEEN. .A. NOW IMAGINa YOU Afta ATTHa Cl!NTE .. 01' THE COMPASS HOSE. PLACE AN A ON THE COMPASS TO INOICA'fl!! THE DIRI!:CTION TO T .. !! PH.NOM!NON WHEN "RST SEEN. PLACE A a ON THE CO ... PASS TO IMDICATI!: THI!: DIRECTION TO THC PHINOM!NOM WHI!N LAST SEtrN 7. IN "rHE SK!TCH BELOW, PLACE AH A AT THE POSITION OF THE PHENOMENON YiHEN FIRST SEEN, AND A a AT THE POSITIC!'I OF THE PHENOMENON WHEN LAST SEEN. CONMECT THE A AND e WITH A LINE TO APPROXIMATi:': THE MOVEMc._.T OF THE PHENOMENON BETWEEN ~tt. AHO s. THAT IS, SCHEMATICALLY SHOW WHC::THER THE MOVEMENT APPEARL!:) TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AM EXAMPLE OF HOW TO COM~LETE THE LAq::, E~ SK~TCH. PAGE 2 OF' 9 PAG.i::S WHI!AII WI!A. YOU WHilN YOU SAW THIE PHENOMENON? (Checlr rap,ropriate .loelre.} OUTDOO .. S IN 8USINI!SS SI!CTIOM 0, CITY IN BUILDI .. G jN RESIDENTIAl. SllCTIOH 0, CITY 0 AI DRIVE .. ~ AI ftASSilNOil .. IN Ofti!H COUNTRYIIDK NltAR AIR,II!l.D IN AIRPL.A!~tl ::-AS PILOT -AS ftASSKNOilR FL YINO OVI!R CITY FLYING OVER OPEN COUNT .. Y IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING: ':l~!.CTIOH WEAl! YOU MOVIHOT HOW ,AST WI!RE YOU MOVING? DID YOU ITO~ ANYTIME WHILE 09SilRVINO THil PHENOM!.MON? NORTHI \:ST SOUTH lAST SOUTHWI!ST EXPLAIN 'WHI!T:-.ER SUCH MOVI!MI!NT I!,,ECTS YOUR SKI!TCHI!S IN ITEMS SAND I. DESCRIBI! TY'P! o,-VEHICLE YOU WERE IN AHO TYPE 0, ROAD, TERRAIN OR BODY OF WATER YOU TRAVERSED DURING THE SIGHTING. STATE WHETHER WINDOWS OR CONVI!RTI8l.l! TOP WI!RI! UP OR DOWN. HOW MUCH OTHER TRAFFIC WAS THERE? oto vou NOTte~ ANY AIRPLANES? RYES r'li LI'No. IF vEs, DESCRIBE WHEN THEY WERE IN SIGHT RELATIVE To THE TIME OF SIGHTING TH! PHENOMENON AND HERE J ,.EY WERE IN THE SKY RELATIVE TO THE POSITION OF THE PHENOMENON HOW LONG WAS THE PHENOMENON IN SIGHT7 l.ENGir1 OF T I ME CERTAIN OF TIME NOT VERY SURE FAIRLY CERTAIN JUST A GU~SS HOW WA~ TIN~ DETERMINED? & WAS nC: PHI!NOW~NON IN SIGHT CONTINUOUSl.YT YES " NO. IF No, INDICATE WHETHER THIS IS DUE TO YOUR MOVE\!ISNT OR T:1~ BEHAVIOR OF THE PHE!IfO htENO , AND DE f'cRIBE SUCH MOVEM~NT OR BEHAVIOR. INDICATE DISAP- PEARAHCES ON PREVIOUS SKETCHES. c;tt. cZLce.r PAGE 3 OF 9 PAGES ,0 ., TMI!Aa Wl!"l MOAI! THAN ONI! PHI!NOMI!NON, HOW MANY WE .. I THI! .. I!t DRAW A PICTUAI! TO SHOW HOW THEY Wl!PU! ARRANGI!D. DID THIS Aft .. ANGDI!NT CH ANGI DURING TMI SIGHTING? CONDITIONS (CAeelc appropriate 6loc:lc.) CUMULUS CLOUDS (Low fluffy) FOG OR MIST TWILIGHT H!AVY RAIN CIRRUS CLOUDS (Hilla fleecy M H~nn,_ LIGHT RAIN OR DRIZZLE NIMBUS CLOUDS (Ralrt) HAIL PAq1'L.Y :L.OUOY CUMULONIMBUS CLOUDS SNOW OR SLEET (T hwadertorm ) COM,.L.!7~L.Y OVERCAST HAZE OR SMOG NONE OF TttE ABOVE C. IF THE SIGHTING WAS AT TWILIGHT OR NIGHT, WHAT DID YOU NOTICE ABOUT THE STARS AND MOON? BRIGHT MOONLIGHT NO MOONLIGHT MOON WITH HALO MOON HIDDEN BY CLOUDS ;;:: ::::::: PARTIAL (New or quarter} t1. IF SICHTIN~ ~AS IN DAYLIGHT, WAS THE SUN VISIBLE? IF YES, WHERE WAS THE SUN AS YOU FACED T H E ?l't~ NC"4EHONt IN FRON~CFYOU TO YOUR RIGHT OVERHEAO(NeMMO~ IN B~CK OF YOU TO YOUR LEFT E. SPECIFY Tio;E MAJOR SOURCE OF ILLUMINATION PRESENT DURING THE SIGHTING, SUCH AS THE SUN, HEADLIGHTS OR STREET ~M'14~, ETC. FOR TERRESTRIAL. ILLUMINATION, SPECIFY DISTANCE TO LIGHT SOURCE. 12. GIVE A BRIE~ ::>ESCRIPTION OF THE PH~NOMENON, INDIC 11MG WHETHER IT APPEARED DARK OR LIGHT, WHETHER IT REFL.ECT~C LIGHT OR WAS SELFL.UMINOUS AND WHAT COLORS YOU NOTICED. DESCRIBE YOUR IMPRESSION OF WHETHER IT WAS SC!..I O OR TRANSPARENT, WHETHER EDGES WERE SHARP OR FUZZY. DESCRIBE THE SHAPE 0~ INDIC~TE IF IT AP?EARE~ AS A POINT OF LIGHT. INCtCA'iE COMPARISONS WITH OTHER OBSERVED OBJECTS, LIKE STA~S. A LIGHT OR O'iHEA OBJECT IN YOUR FIELD OF v :::w. PAGE 4 OF 9 PAGES THE Pt4ENOMIENON MOVE ~N A ITf,AIOHT LINE? STANO STILL AT ANYTI\1E? SUDDENLY SPEED Uflt AND RUN AvtAYT BAEAI< UP IN AATS AND EXPLOO? CHANGE COLOR' GIVE OFF S~O!< ~I CHANCE 8i'tlol~T~!:SS? CHANGE SMA~!:" !'LASH OA F!.ICY!~t DISAPPEA" AN 0 R!APPEAR? SPIN LIKE A T O P l MAKE A NO IS!' 17 FLUTTER 0~ -,oaaLET 14. WHAT O~Z" YOUR ATTENTION TO THE PHENOMI!NON? A. HOW OlD IT FINALLY DISAPPEAR? ::~E~O"f MOVE BEHIN O OR I N FRONT Or SOMETHING, LIKE A CLOUD, TREE, OR 9UILOI NG AT ANY TIMS:T ! F yEs, DESCRI B~. PAGE 5 OF 9 PAC~S tl. OAAW ~ PICTUAI! THAT WILL IHOW THa IH~PI! 0, THa PHtNOiileiENON. INCL.UOI AND LAIIEL. ANY DETAIL.I THAT MIGHT H~VE APPI!A .. tD AS WINGI 0 .. P .. OT .. USIONS, AND INDICATE EXHAUST OA VAPOR TRAILS. IHDIC~TE BY AN ~AAOW THE DIRECTION THE PHKNOMI!NON WAS MOVING. 16. WHAT ffAS TH:: A~GUL.AR SIZE? HOL..O A. ~ATCH AT ARM'S LENGTH IN FRONT OF A KNOWN OBJECT, SUCH AS A STREET LAMP OR"';'.;~ :~CON. NOTE HOW MUCH 01' THE OBJECT IS COVERED BY THE HEAD OF THE MATCH. NOW IF YOU HAD BEEN .A9L= "';':);) FORM THIS EXP tNEI'ltT AT THE TIME OF THE SIGHTING, ESTIMATE WHAT FRACTION OF THE PH EI-JOMEr-.0,_ *CU-.;) rlAVE BEEN COVERED 8Y THE MATCH HEAD. PAGE 6 OF 9 PAGES ~ 11. DID YOU OIISI!RVt: THE PHI!NOMIENON THROUCiH ANY 01' THI! trOLLOWINOf IHCLUOI! ' TY~E, '""' TER, LENS PRI!SCRI~TION OR OTHER APPLICAIIL~ DATA. INFORMATION ON MODI!L, ltVEOLAS$S SUNGL "SSES BINOCULARS WIHDSMIELC TELESCO PI! SlOE WIHOO' 01' VEHICLE THI!ODOLITI I WINO'";Wil,t.NE / OTHER . ~ A. DO YOU CA~IHAAIL V WEAR GLASSES? I YES ~ 8. DO YOU USI! RIADINO OL.ASSES? 0 YES ~:.._,;o ~ 18. WHAT '#"S YOUR IMPRESSION OP THE SFIEED f?' I14f! , .A Jl 1t. WHAT WAS YOUR IMPRESSION OP THil DISTANCE OF T~l! I PHENO '-tOHl GIVE ESTIMATI! OP IPI!I!D -;;:s.-) J, I'~ PHIENOMI!NOtU GIVI! I!STIMATI! OJ' DISTANCE.<\ 0 I ,:,f". it 20. IN ORO!P. "'HAT WE MAY OBTAIN AS CLEAR A PICTURE AI POSSIBLE OF WHAT YOU SAW, DESCRI81E IN YOUR OWN WORDS Ooeh!C,_. OBJECT OR OBJECTS WHICH, WHEN PLACED IN THE SKY, SIMILAR TO WHERI! YOU NOTED THE PHEHOMI!NON, CJSo\" SOME RESEMBLANCE TO WHAT YOU SAW. DESCRIBE SIMILARITIES AND DIFFERENCES DITWEEN THE COMMON OSJECT AND WHAT YOU SAW 21. 0 10 Y Ou N ~liCE ANY ODOR, NOISE, OR HE A. T t.MANAT'tt VJiROM THE PHENOMENON On ANY EFFECT ON YOU AS ELF, AHiMAL S C~ -.tACHINERY IN THE VICINIT"''! 0 YES l,a~ IF yES, OESCRIB!:. A. 010 THE PHS:NCIII4:'.'~0N DISTURB THE Ci~OUNO OR LEAVE ANY PHYSICAL EVI.OENCE. IF ys, O ESC~IaE. PAGE 7 OF 9 PAGES U. HAVE YOU EVKR SEEN THIS 0 .. A SIMILA .. PHilNOMI!NON BEFORt!? ES NO. " v~ts, GIVE OATil AND ANYO!'t~ WITH YOU AT THE TIMit YOU SAW THE PHENOMENON? 0 NO. " yEs, DID THEY SEt! IT TOO? GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF INDiCATE A:>OI FORMATION INCLUDING O CCUPATION AND ANY EXPERIENCE WHICH MAY BE PERT 2S. WHEN AND TO W\oo~._. 010 YOU REPORT THAT YOU HAD SIGiiTEO THIS PHENOMENON? I . 1o. DATE YOU COM?LETED THIS QUESTIONNAIRE. PAGE 8 OF 9 PAGES DEftARTMKNT OF' THE AIR FOJtCI! MKADQUAitftlt8 ,OitiUGN TECHNOLOGY DIVI810N ( A,8C) Wlt10HT.PA'M'Kit80N AU ,OftCK 8ASK. OHIO as3 Atben, Ohio Reference your recent unidentified flying object sighting ~hicb you reported to the Air Force. The information ":hich ve have received is not sufficient for a scientific investigation. Request you complete the ~ttached AF Form 117 and return it in the self- addressed envelope. ank you for reporting your observation to the Air Force. Colonel, USAF rector of Production AF Form 117 BOB Nr 2l-R258 SIGHT!Nq OF UNIDENTIFIED PHENOMEN.~ QUESTIONNAIRE THIS QUES':rlOi'i~AlRE HAS BEEN PREPARF.O SO THAT YOlJ CAN GIVE ~ntE. U. ~.AIR Jo'ORCE AS MUCII INFORMATIO~ A~ PO~lBLt: CO~CE'PNlSG Tug UN1DKNT1Fll::.D PHENO\,F..NON THAT YOU HAVE OBSERVED. PLEASE TRY TO .\N d'.:VER OF THE QUES1'lONS. THE lNFORMATtON '"/00 GtV~ r,1LL DE USED FOioe RESEARCII PURPOSES. YOUR ~: :. .,~LL NOT JJE tSED IN CON'NI~CTION WITH ANY OF YOUR STATE!\fENTS OR CONCLUStONS MntOUT YOUP p r-\ "~-=tos: RETURN TO AlR FORCI<: BASE tNV.I!"STJrr~TOU fO FORl/Al<DING TO 1-'TD (TDETR), WRl~IT- (IF ADI>CTlONAL SllEETS ARE NEEPED FOR NARRATIVE OR SKBTCIIE$ AT1' . .e CJi SEC::~I::L 'f 10 TIJTS FOH.\1 OR ANNOTATE WI'Td YOU~ NAME ,_.~ou lDE'iVTIFJC.".'l'ION.) '": _, SEe THE PH Et40MENO"f r 2 . WHI\T Tic,t~ ~!!) VOU FIRST SIGHT Ti-lE P~ENOMS:NOM7 3 . WHAT T!M~ 010 YOU LAS'f SIGHT T~E PHeNOMENON? MtNuTr:s 5. R D A.N. QP.M. 0 OAYLIGH"f SAVINGS QST.,NOAHO OcENTRAL []MOUNTAIN 0 P ACIFIC S . \HICHE 'f".!/'=!_ VOU WHEN YOU SAW THE PHE"'O,"'!ENt")"l' IF IN CI1"Y, CIVE THe ~IEAREST STREET ADDRESS AND I~IOICATE OH A HANO c.: ~''IN MAP WHERE YOU WERE !:TAN\>ING W TH Rf~FERENCE TO THf': AODRE!iS. IF IN THE COUNTRY, IDENTIFY THE 1-iiGHVIAY Y U WEHE Otf OR tiCAR ANO TR't ro Fl.( A 0\STM~Ct:: AND tJIHECTI0!4 FnO ~O~E REC06NIZA8LE LANDMARK. l'r!AC't~E y~..; .\'l!:: o\T THE POINT s~o;~"lo.ll~ THE s;,~TCH, PLACE AH "A" ON THE CJ~ViD L INE 1'0 SHOW HO'N HIGH THE ?H=::-10 ::1 WAS 1\BOV THE H:JRI:'O~, OR SKYLI:H:, WB.;.:t-1 FIRST S.E't:tL PLACE. A "B" ON THE SAf.1E CUR'JEO LINE TO ShO':f MO.,., ~!G-i ASOVE THE HORIZO!i "':"SE P>iENO:.:I!;:N.::>N ',VAS WHC:::N LAST SEEN. U.S. AIR FORCE TECHNICAL INFORMATION Thi~ questionnaire has been prepared so that you can give the U.S. Air Force as much informat1en as possible concerning the unidentified aerial phenomenon that you have observed. P lecse r~-v to answer as mciny questions as you possibly can. The information that you give will be used b r research purposes. Your name will not be used in connection with any statements, cenc !us Jns, or publications without your permission. We request this personal if"formotion so that ii i t is deemed necessary, wa may contact you for further details 1. When did you see the obiect? Day Month Year 3. TiiT'e Zone : (Circle One): tastern c. Mountain d. Pacific 4. Wher~ were you when you sow the object? (Circle One): (Circle One): a. Daylight Saving b. Standard City or Town State or County 5. how long wos object in sight? (Total Duration) M inutes Seconds a. Ce~:1 in c. Not very sure b. Fair ly certain d. Just a rguess I .......... L 5.2 Was ob;e-:~ i r: ~ s:-.t continuously? 6. What was the c or c itic n of the sky? c. o r tgn b. C loudy -'!(-_ IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the object? (Circle One): a. In front of you b. In back of you c. To your right d. To your left e. Overhead f. Don't remember FTD O!:T 62 164 Thle form uper .. du f .Tn 164, jul 61, whic h ia obsoleht. UUOIMI[ Y~U ARil AT.TH~ ~l!NTI" 0;;: CO;,.'AsiAOS!:. PLACF. A" 11. Olo4 THE co.-.taAU TO INUICATE Ttfl! DIRECTION TO THil PM!:MOM~NON WHEN FIRST SEEM. ,.LACE A a ON TH::; CC'11,4PA!Iil TO INDICATE TH~ Olllti!C rtOH TO . THE PHI!NCM~NON WH~N L~ST S1EN IN THE SJo<E7CH BELOW, rLACE AN A AT THE POSITIO N OF THC: PHC:NOMENON WHEN FIRST SEEN, AND A '"FJ" AT THE POSITtr-~ C'= THE PHENOMENON WHEN LAST SE:::N. CONNECT THE A ANO a WITH A. LIN~ TO A?~ROXIMATE THE MOVE.McN-OF THE PHENOMENON BETNEEN ~aA" AND o. THAT IIi, SCHEMATICALLY SHOW WHETHER THC: MOVE:-':::tH An?EAilo;: 70 BE STRAIGHT, CUHVEO 01!\ ZIG-ZAG. REFE~ TO SMALLER SKETCH AS A~ EXAMPLE OF HOW TO Cm.tPLEi~ THE L...t~GE~ SKETCH. WHitA. Wl!fltB YOU WHI!N YOU SAW THI! PHEN