2. LOCA liON Vt. iec.i CONCLUSION l. GIH Or c;.:.~RVATION 1 \'?E Oi= OnSc~'/ATION ?:-iYSICAl. 11 SRI E F SU~-.i.MARY AND ANALYSIS pr.,viol:u dH . .:m c ! thil t o r .-::a &nay be uaed. In the following sketch, imagine that you ore at the point shown. Place on "A" on the curved I ine to show how high the obj~c:t was above the horizon (skyline) when you first sow it. Place o "B" on the some curved line to show how high the obiect was above the horizon (skyline) when you lost sow it. Place an "A" on the compass when you first saw it. Place o "B" on the compass where you /as t sow the object. 28. L'r'Jw o p::~:..re that will show the i.l~tion that the object or objects rnade. Place on "A" ot the beginning of the potn, o .. ot the end of the pctr, o nd show any changes in direction during_}he course. 29. IF there w~s .'..,A!JK~ THAN ONE ob;ect, then how many were there? _ _I-0;J_j;:_j _ DraH c pic~w~ ~f how they were r.:-r=nged, on.:J put an arrow to show the direction that they were traveling 30. Have you ever seen this, or a similar object before. If so give date or dates and location, , ' 31. Was anyone else with you at the time you saw the obiect? (Circle One) 31.1 IF yov answered YES, did they see the object too? (Circle One) 31.2 P le\l s~ I ist their names and addresses: 32. Please give the following information a bout yourself: First Nome Middle Nome City Zone State TELEPHCN= NUMB tndicote o~y additional informotior. :bout yourself, including any special experience, which might be pertinent. 33. When and to whom did you report that you had seen the object? Month Day Year 34. Date you completttd this questionnaire: 35. Information wnich you feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanation of your sighting. DEPARTMENT OF THE AIR FORCE HEADOUART!:"S FOREIGN TECHNOLOGY OIVI510N f AjrSC) WltiGHT-PATTERSON Alit FONCE BA!IE. OHIO 4!1 .. 33 UFO Observation ~ 2.l+ ./ . .;b 6'7 Re:-=:-ence your unidentified observation. The information which we ~a1e received is no~ sufficient for a scientific evaluation. Req-.1.~st you complete t'he attache(l FTD Form 164 and return 1 t in the envelope provided , Thank you for reporting your observation to ~he Air Force. Jft.J-~3 C. MANA'IT, Colo:1~1, USAF i)i:'e::tor of Technoloy =.r~d Subsystems F'l'D Form 161~ 'W / enve J < .. EPI.Y TO DEPARTMENT OF THE AJR FORCE HEADQUARTEfUI ,OREIGN TECHNOLOGY DIVI"JIO N ( AF~C) WRIGHT-PATTERSON Alft FO~CE IIA!tE. OHIO .4:S.o433 U?:) Observation . 21t-E':-.!1.> G'l Re: rence y our unidentified observation. The information which w-e have received is not sufficient for a scientific evaluation. Re~'..lest you complete t~e attached FTD Form 164 and return it in 't:-.e envelope provi.:l~d. Tnank you for reporting your ob servation te; the Air Force . MANATr, Colcr:el, USAF r :::irector of Technol06Y end Subsystems FTD Form 164 w/enve lope 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. Pleos~ t ry to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your nanie will not be used in connection w i th any statements, conch.:s ions, or publications without your permission. We request this personal information so that if it i s deemed necessary, we may contact you for further details 1. When d id you see the obiect? (Circle One): 3. Tii'T'e Z one: .. , j Month (Circle One): a. .cstern) b. Cen r-rcT c. Mour.t:>i n d. Pacif ic 4. Where w~r~ y ou when you saw t he ob je~t? (Circle One): (a';j Daylight Saving b. Standa rd Near~ sr ? es t o State or County 5. how bng w~s object in sight? ( T cb I Duration) Hours Minute s Seconds a. Ce rt o in c. Not very sure d. Just a guess Fairly certain 5.2 Was c~je:: .r-$:;ht cvnt inuously ? 6. What was the co:"ldirion of the sky? , b. Cloudy 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 b. In back of you ~;.-To your right d. To your left e. Overhead f. Don't remember FTD OCT 62 164 Thl f orm auperae des FTI> 164, jul 61, which l obsolete. ~. IF you sow the object ot NIGHT, what did y ou notice concerning the ~TARS und MOON? 8.1 ~TARS (Circle One): 8.2 MOON (Circle One): a. Bright moonlight b. Dull moonlight c. No moonlight -pitch dark d. Dc n,t remember d. Don't remember 9. Whet werf!> --e weather conditions at the time you saw the object? CLOU:)~ ( :: ircle One): Clea r S><" c. Scat~-=:r-::-:1 clouds d. Thi~k cr !-Ieavy clouds HEATHER (Circle One): Fog, mist, or light rain ,~oderote or heavy roin Don,t remember 10. The ol:ie::t appeared: (Circle One): d. As a light b. Trcns~-=r~nt e. Do1 ,t remember c . Y::pcr !f ;~ a~pe::-~d as a light, was it br ighter than the brightest stars? (Circle One): c. 3~ighter c. About the some d. Don't know 11.1 Cor-~.:.;~ brightness t o some c~nmon object; 12. T he ed~e~ o: t~e object were: b. Like a br i J t src:- Sharply our: r1ed (Circle One for each question) Appe::~'" ::. s:-:r'!d still ot a ny time? Don't know Suddenly speed up and rush away at any t ime? Yes Don't know Break up into parts or explode? Yes Don't know ( No' d. Give off sr:1oke? Yes Don't know Change bri3htness? Don't know Change shape? Don't know Flash or flicker? Don't know h. Disoppecr and reappear? Don't know 14. Did the object disappear while you were watching it? If so, how? 15. Did the obi ect move behind something at any time, particularly a cloud? ( Circ le One): /Yes) No ., Don;t Know. IF you answered YES, then tell what 16. Did the ocj~ct move in front of sor.1e t h ing at any time, particularly a cloud? (Circie One): Don't Know. IF you answered YES, then tell what 17. T e II in o few wqrds 'he following 6 ings about the object: 18. We w is h tc know the angu lor s ize. Hold a match stick at arm's length in I ine with a known object and note h ow much of t~e object is covered by th e head of the match. If you hod performe d this experiment at t he time of the s ighting, :. ow much of the object would hove been covered by the match head? Draw o p i.: L -!! So~ wi II show the s:.ape of the object or objects. Lobe I and include in your sketch any detai Is of the oSje-: " you saw suc h os ,.,ings, protrusions, etc., and especially exhaust trails or vapor trails. Plac e on orro..,... Ses i:!e the d rawi ng to show the direction the object was moving.