lt\.tlt' . 10. CONCLU~iOS :o.D. Report, t::.e ob~e:::-var a:cd t'10 \\i tr.a~sos \:ere i ~ .. LE:t-.C. .. ri ,)f OBSERVATION 11. BRIEF SUMMARY AND ANALYSIS Report i 3 TY?E OF OBSERVATION anC. blue, 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 have observed. Please try to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your name will not be used in connection with any state"'ents, conclusions, or publications without your permission. We request this personal ;,formation so that if it is d .. med necessary, we may contact you for further details. 1. When did you see the obiect? Mo th Year 3. Time Zone: (Circle One): ra) tastern b. Central c. Mountain d. Pacific 4. ~here were you when you saw the obiect? Nearest Poatal Addres 5. how long was obiect in sight? (Total Ouroton) Q Cttrtain b. Fairly certain 2. Tir.,e of day: _Q..9s.Q (Circle One): (Circle One):~Daylight Saving Y.Standord or Town State or County Hours ~Jnutes c. Not very sure d. Just a guess 5.1 How was time in sight determined? ;:==.;J,.l.o~ 5.2 Was obiect in sight continuously? 6. What was the condition of the sky? fa:) Bright 7. 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 ~. In back of you c. To your right d. To your left e. Overheetf t re"f1n~:!r FTD OCT 62 164 Thle form eupereed .. FTn 164. Jul 61. which le obeolete. d. 'F you sow the obiect at NIGHT, what did you notice concerning the 5TARS and MOON? 8.1 STARS (Circle One}: Don't rameml.r 8.2 MOON (Circle One}: Bright moon I ight Dull moonlight c. No moon I ight -pitch doric d. Don't renoember 9. What were the weather conditions at the ti" you sow the obiect? CLOUDS (Circle an.): a. Clear slcy Scattered clouds Thick or heavy clouds 10. The obiect appeared: (Circle One}: WEATHER (Circle One): b. Fog, mist, or I ight rain c. Moderate or heavy rain e. Don't remember s a light b. T ran spa rent e. Don't remember 11. If it appeared as a light, was it brighter than the brightest stars? (Circle One): e;) Brighter c. About the sanoe b. Diniihlr d. Don't lcnow 11.1 Compare brightne~s to some common obiect: 12. The edges of the obiect were~ (Circle One): Fuzzy or blurred L ilce a briyht star c. Shaw:ly out I ined d. Don't remember 13. Did the obiect: a. Appear to stand stilt at any time? b. Suddenly speed up and rush away at any time? c. Break up into parts or explode? d. Give off smolce? e. Change bridttness? f. Change shape? g. Flash or flicker? h. Disappear and reappear? (Circle One fOf' each question) Don't know Don't lcnow Don't know Don't know Don't lcnow Don't know Don't know Don't know 14. Did the obiect disappe while you were watehing it? If so, how? 15. Did the obiect iirDv W.incl soeitthing at any tim1, larly a cloud? . IF you cmswerecf YES, then tell what Don't Know. 16. Did the obiect (Circle One): ht front of IOR:Itlint ot ony _tin:1, particularly a cloud? Don't Know. IF you answeNd YES, then tell what 17. Tell in a few words the following things about the obiect: 18. We wish to lmow the angular size. Hold a match sticlc at arm's length in line with a lcnown ol.iect and note how much of the ol;.ct is covered by the head of the If you had perforned this exp1rhnt at the ti" of the sighting, how much of the obiect would have been cawrect by the match head? o 'P\; te ttl~ 19. Draw a picture that will show the shape of the obiect or obiects. Lobel and include in your sketch any details of the obiect you taw such a1 wings, protrusion, etc., and eepecially exhaust trails or vapor trails. Place an a.row beside the drawing to show the direction the o&iect was mewing. Do you th inlc you can estimate the speed of the ot,iect? (Circle One} Yes IF you answered YES, then what sp1ed would you estinaate? ------- 21. Do you thinlc you can timate how far away froili you the obiect woa? (Circle One} IF you ans YES, then how f (C ire le One): a. Inside a builcling b. In a car {f) Outdoors d. In an airplane (type) wauld you say it was?--ln ,...)-Q ~"\ '\ t c;, 23. Were you (Circle One) a. In the business section of a city? @tn the residential section of a city? e. In open countryside? d. Near on airfield? e. Flying over a city? f. Flying over open country? 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) East e. South d. Southeast f. South Wist 24.2 How fast were you n10ving? -----~-miles per hour. Did you atop at tng at the oliect? (Circle One} 25. Did you observe the c*iect through any of the following? a. Eyeglasses e. Binoculars Yes b. Sun glasses f. Telescope Yes c. Winctshielcl Theoclol ite Yes d. Winctow glass 26. In orde, that you con give as clear a picture as possible of what you .saw, dscribe in your own 'Norch a c:ommon obiect at obiects which, when placed up in the sky, would give the same appearance as the obiect which you sow In the following s~etch, imagi,e that you are at the point sho~n. Place or' "A" on the curved I ine to show how high the obiect 'Mil above the horizon (skyline) when you lirst sow it. Place a "B" on the sa"e curv-.d line to show how high the oliect was above the horizon (skyline) when you last saw it. Ploc:e an "A." on the compass when you lirst saw it. Place a "B" on the compass where you lost saw tho obiect. 28. L.lraw a picture that wi II show the motion that the object or objects made. Place an "~/' at the bet inning of the I path, a "B" at the end of the path, and show any changes in direction during th course. 29. IF there was MORE THAN ONE obiect, then how many were there? --~l:l~'-~t - ""!:.! --- Draw a picture of how they were arranged, anJ put an arrow to show the direction that they were traveling P\E Pt.V TO S U OJEC T O~.-ARTMENT OF THE HEADQUA,.TI:IItS l"OPtJ:IGN Tl!CHNO L.OGY OIVI!JION I ,.,.C l Wl'tiGHT.,.ATT&!'t.ON AU. l"O~CI .ASK. OHIO "!5"33 U?~ O~servation , 3 ~hy 1967 Re:';!:-ence your unider.tit'ied observati on. '!he information \lhich ~e ~ave received is not sufficient f or a scientific evaluation . Re~"J.est you complete the attached FTD Form 164 and return it in t~e envelope provi ded . Thank you for reporting your oba~r,ation t o the Air Force. r 1~-Y35 C. MANATr Colonel, USAF ':"::.!.::-ec t or of Technoloy end Subsystems F?D For m 164 v/envelope 30. Hove you evet seen this, or o simi lor obiect before. If so give dote or dates ond location 31. Was anyone elM with you at the time you saw the object? (Circle One) 31.1 IF you YES, clid they SM the obiect too? (Circl One) 32. Please give the following information obout yourself: Miclclle "'