5. LENGTH OF OBSERVATION 20 Minutes to 1 Hour (.. lYPE OF OBSERVATION Grcund-Visl.al J Stationary I 8. ? HOTOS 11. BRIEF SUMMARY AND ANALYSIS Observers sighted an object that flashed flic~er~c agi colors from white, green, red. and blue. One ob~crver that the object resembled a balloo~ ri~ing and f allino air flow. The ~bject wa~ seen rough~y in the sw. COMMENI'S~ The repvr"ta is by two l.nd~r.~ndent witncs.:;~os. Sai d that ~fl8 COject diSG; ared at 0235. e abo..:~ c a.e 9. PHYSICAL EVIDENCE . MULTIPLE' U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you con give the U.S. Air Forc e as much information as possible concerning the unidentified aerial phenomenon that you hove observed . Please try to answer as many questions as you possibly con. The infor mation that you give w il l be used for research purposes. Your nome will not be used in conne c tion with any statements , c onclusions, or publications without your permission. We request this pl'trsonol informot ion so that if it is deemed necessary, we may contact you for further detoi Is. 1. When did you see the object? 2. Tir11e of doy: M i nutft s Day Month Year 3. Time Zone: a: tostern 'b.- central (Circle One): c . Mountain d. Pacific (Circle One): (Circle One): a. Daylight _Saving ...._b. Standard 4. Where were you when you saw t he object? Ne9rest Pot.tol Address City o r T own Stole or County 5. h ow l ong was ohject in sight? (Total Duration) Hours Minutes o. Certain c. Not very sure b. Fairly certain d. Just a guess 5.1 How was time in sight determin~d? -------------------- 5.2 Was object in sight continuously? Yes ---- 6. What was the condition of the sky? o . Bright b. C loudy 7. IF you saw the object during DAYLIGHT, where was the SUN located as y ou looked at the object? (Circlt-! One}: c. In front of you b. In bock of yov c. To your right d. T a your left ... Qv.:!rhl!ad f. Don't rememb.,r FTD OCT 62 164 Thle form upereedee FTO 164, Jul 61, which h ob~olete. t3. IF y ou sow the object ol NIGHT, what did you n otice concernir:'g the ~T Af.<S and MOON? 8. 1 STARS(CircleOne): 8. 2 MOON (C,c/e One): o . Bright moon I i ght b. Dull moonlight No moonlight -pi tch dark Don't remember Don't remember 9. What were the weather condition s ot the time you saw the object? CLOUDS (Circle One): /o.-Clear sky b. -rtazy -- c . Scattered clouds d. Thick or heavy clouds WEATHER (Circle One): b. Fog, mist, or light ra in ~oderote or heavy rain e. Don' t remember 10. The object appeared: (Circle One): b. T ronsporent ....-d. As a light e. Don'r-remember 11. If it appeared as o l ight, was it brighter than the brightest stars? (Circle One): a . Br ighter , c . About the same b. Dim1n"r d . Don't know 11.1 Compare br ightness to some common object: 12. The edges of the object were: (Circle One): a. Fuzzy or b I urred b. Like o bri~ht star c . Shar!'ly outlined d. Don't remember 13. Did th~ obj .. ct: a. Appear to stand still at any time? b. Suddenly speed up ond rush away at any time? c . Break up into ports or explode? d. Give off smoke'? Change brightness? f. Change shape? g. rlash o r rl i.: ker? Disappear ond reappear? (C~rcl~ One fo r ecch .:JUI!:Stion ) Don't know Don't know Don't k:-tow Don't know Don't know Don' t '.<now 0 -;,n't know Don't know 14, Did the obiect disacpeor while you were watching it? if so, how? 15. Did the obit"tct move ~ind somet+,ingat any time, porticulnrly a cloud? (Circle One): Yes Don't Know, IF you answered YES, then tell whot it moved behind: 16. Did the obj.,ct mov" in front of so~thing at o ., y t ime, part ir:ularl:, o c lolld? (Circle One): Don't Kno w. I F you a n swered YES, then tell wha t 17. Tl'!ll in a ff'!w wnf~, the followinq things about ths object : b. olor --~ 18. We wish to know th!t onf!vlo r siztt. Hold a match stic k at arm's lenQth in line with a knovm obitt:ct ond note how much of thtt obj.,ct is covered by th~t h~od of the match. If you h od oerformed this "xootrim.,nt a t the ti~ of the sighting, how much o f th~ obiect would have been covered by the match head? 19. Draw a picture that will show th e shape of the object or objects. Lobel and include in yoor sketch any details of the object thcrt you saw such as wings, protrusions, etc., and especially oxhaust trails or vapor trails. Place on arrow beside the drawing to show the direction the object was moving. 20. Do you think you con estimato the spoed of the obj~ct? (Circle One) IF you answered YES, then what speed would you estimate? ---------"'.:--'" Do you think you con estimate ho~ far away from you the object was? IF you answered YES, the n how far away would you soy it was? ! _ _ _ , _ Where wertt you located when you saw the object? (C ire le One): Inside a building 23. Were you (Circle One) a. In the business section of a city? ( b. In the residential section of a city? (Sln a cor c . In open countryside? c . Outdoors d . Near on a irfield? d. In an airplane (type) Flying over a city? f. Flying over open country? 24. IF you wer~ MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24. i What direction were you moving? (Circle Ono) o. North c. East e. South g. West b. Northeast d. Southeast f. Southwest h . Northwest 24.2 How fa~t were yoo movins? -------.J i les per hour. 24.3 Did you stop a t any t ime while you werl!l looking at the obje ct? (Circltt One) 25 . Did you obs.rve the object through any of the following? Eyeglasses Binoculars Yos (No b. Sun glosse s f. Telescope ( :.:..--Windshield Theodol ittt d. Window glass Yes ( ~0, h. Other 26. In order that you can give as clear a picture as possibla o f what you sow, J <'.scribe in your own word s a common object o r object which, when placed up in the sky, would give the some appearance as the object which you sow 27. In the following sketch, imagine that you ore a t the point shown. Place or "A" o n t he cvrv~d line t o show how high the object was above the horizon (skyline) when y ou f i r s t saw it. Place o ''B" on th& some curved line to show how high the object wos above the horizon (skylin6) when you lost sow it. Place on "A" on th e c ompass when you first saw it. Place o "B" on the compass where y ou lost s o w the obje c t . 28. l.lrow a picture that will show th e motion t hat the object or objects mode. Place on "A" at the beginning of the path, a " B " a t the end of the path, and show any changes in direction during th~ course. 29. IF there was MORE THAN ONE object, then how many were there?----------- Draw a picture of how they were arranged, onJ put on arr ow to show t he direction that they were traveling. 30. Hove you ever siten this, oro simila r obje c t before. If ll O giv., dot(!J o r datu and locatiotl, 31. Was a nyone else with you at the time you sow the object? (Circle One) 31.1 IF you onswer.G YES, did they see the obj~ct t oo? (Circle One) 31.2 Please liat their names and addresses: 32. Please give th~r following information about yourself: Middl No~ Zon;, State TELEPHONE NUMBER Indicate any additional informa t ion about yourself, including o ny special experience, which might be p4trtinent. 33. When and t o whom did you report that you hod se.,n the object? Month Year 34. Date you completed this questionnaire: 35. Information which yov feel pertinent and which is not adequately covered in the specific points of the questionnaire or a narrative explanatio n of your sighting. U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you con give th e U.S. Air Force as much information as possible concerning the unidentified aerial phenomenon that you hove observed. Please try to answer as many questions as you possibly can. The information tha t you give w i ll be used for research purposes. Your nomo w i II not be used in conne c tion with any statements, conclusions, or publications without your permission. We request thi s personal information so that if it is deemed necessary, we may contact you for further details. 1. When d id you see the object? Month Yeor 3. Time Zone : (Circle One): a. to stern b. Central c. Mountain 4. Where were you when you .iOW the object? (Circle One): (Circle One): a. Daylight Saving b . Standard Neore st P uta I Addrtts s C ity or Town Stohl o r County 5. how long was object in sight? ( T o rol Duration) Hours Minute s Seconds a. Certain c. Not very sure b. Fairly certain d. Just a guess 5.1 How was t ime in sight d etetrmined? -------------------- 5.2 Was object in sight continuously? 6 . What was th~ condition of the sky? a. Bright a. Bright b . Cloudy 7. IF you s ow the object during DAYLIGHT, where was the SUN located as you looked at the object? ( Cir=le One ): o. In front o f y o u b. In boc\t of y oo c. To your r ight J . T o y o u r left '!. Overh~nd f. Don't reme mber Thla form auperaedes PTn 164, juJ 61, wl\leh Is o b s olete t!. IF you sow the object at NIGHT, what did you notice concerning the STAf~S ond M00~1? 8 .1 STARS (Circle One): 8.2 MOON ((,rcle One): a. Bright moon I ig h t -b . Dull moonlight c~ -No moonlight - - p itch dark d. Don't remember d. Don't' remembctr 9. What were the weather conditions at the t ime yoo sow the object ? CLOUDS (Circle One): 6 Clear sky b.-Razy~ - c. Scattered clouds d. Thick or heavy clouds 10. The object appeared: (Circlt! One): b. T ransporent WEATHER (Circle One): b . Fog, mist, or light rain c. Moderate or heavy rain e. Don't rern~mber 11. If it appeared as o light, wos it brighter than the brightest stars? (Circle One): ~ ci. Brighter c . About the same d . Don't know 11.1 Compare brightness t o some common object : 12. The edges o f th., object were: (Circle One): o. Fu:zzy or blurred b. Like o briyht star c . Sharp ly outline d d. Don't remember Did the object: (Circle One f o r each qu~stinn) A ppear to "Stand still at any time? Dc n ' r !<now b. Suddenly speed up a nd rush owoy at any time? Dcn't k~ow Break up into ports or explode? Dcn't know d. Give off smoke? Dcn'r know e. Change brightness? Dco't !mow f. Change shape? Don't ~now g. Flash or flicker ? Dcn' t <now Disappear 011d reappear ? 14. Did the obie c t di sappeor while you wer~ watching it? If so, how? 15. Did thl! obj.,ct move be., ind some~hinQ a t a ny time, porticule~rly a cloud? ( C ircle One): Yes Don't Know. IF you answered YES, then tell what it mov~d behind: 16. D id th e obi"'ct mtW_, in front of somethinq at a ny tim.,, oarticulo rl y o c loud? (Circle One): Do n't Know . IF you onswer.,d YES, then tell wha t 17. Tell in a f"'w words the following things about t h e object: 18 . We wish t o know the onaulor s ize. Hold o match s t ick o t a rm' s lenQth in line with o known obied and note how much of the obiect is covered bv th e hend o f the motch. If y o u had perfOfmerl this ex~riment Cit th e time o f the sighting, h.,w much o f the object wn u ld h ove bl,en covered by the match head? 19. Draw a picture that will show the shoi)e of th e obje c t or objects. Lobel and include in your sketch any details of the obje c t that you sow such as w ings, protrusions, etc. , and especially exhaust trails or vapor trails. Place on a rrow beside the drawing to show the direct ion the object was moving, SIGHTING OF UNlDE~TIFIEO ?~E~C QUESTIO liRE 3UDCET BUX~AU ~OYAL NUltiB1 2 I . X2$1 T HIS QUESTIONNAIRE HAS OEEN Pl~EPARED SO THAT YOU CAN Gl VE THE U.S. AIR FORCE AS MUCH INFORMATION AS POSSIBL E CONCERNING THE UNIDENTIFIED PhENOi\IENON THAT YOU HAVE OBSERVED. PLEASE TRY TO ANSWER ALl) OF THE QUESTIONS. T H E INFORMATION YOU GIVE WILL BE USED FOR RESEARCH PURPOSES. OUR NAM E WI LT,. NOT BE USED I N CONNECT ION WITH ANY OF YOUR STATEI'IlENT S OR CONCLUSIONS ~lTHOUT YOUR PERMISSidN. RETURN TO i\IR FORCE B ASE INVESTIGATOR FOR FORWARDING TO FTD (TDETR). WRl GH T - PATTERSON A FB.OHI045433, lAW AFR80-i7. ( I F ADDITIONA L SHEETS ARE NEEDED FOR NARRATIVE OR SKET