P ROJt:C-r .0'! .; RECORL> ~-JNCLl.iSIO" A' approx ~030 CST. ; was settina a-c e.zimuth L ENGTH OF OBSERVATION TYPE OF OBSERVATION 7 . COURSE 8. PtiOTOS 9. PHYSICA~ EVI~ENCE 11. BRIEF SUMMARY AND ANALYSIS Obsel'ver sightea a bright white light on the NW. The obsexver stated that "the object. was aa tne tull moon. F TO ~E P 6 3 0329 (TOE) p,.wtoua dltlc.ft of Uua ,.,. aap be ud. about as br :d, ~ U.S. AIR FORCE TEQiNICAL INFORMATION Tltis questionnaire has been prepared so that you can give the U.S. Air Force as much information as possible concerning the unidentified aeri~l phenomenon that you hav~ observed. Please try to answer as many questions a s you possibly can. The information that you give will be used for research purposes. Your name l.rill nc't be used in connection with any statements, conclusions, or publica- tions witho~t your permission. We request this personal information so that if it is deeced n ssary, we may contact you for further details. the object? 3. Time Zoe~: (Circl~ One): a. Eastern (b. Central 4. \.:here were you when you saw the object? earc:st ostal Address Time of day: (Circle One): (Circle One): Hours Minute s Daylight Saving State or County 5. How long was object in sig~t? (Total Duration) a. Certain b. Fairly certai~ c. Not very sure d, Just a guess 5.2 W~s c~ject in sight continuously? 6. What uas = =ondition of the sky? a . !Jright b . Cloudy IF you s~w tt~ object looked at the object? during DAYLIGHT, (Circle one) a. In front of you b. In back of you c. To your right \.a. BrightJ where was the SUN located as y ou d. To your left e. Overhead f. Don't reoembl?r saw the object ot NIGHT, what did you notice concerning the STARS and One): 8.2 HOON (Circle One): a. BriBht moonlight b. Dull ooonlight c. No moonlight--pitch dark Don It rcraecibetr d . Do:t t r.-:~::c the weather conditions at the time you saw the object? C~JUDS .... (Circl:e One) : WEATHER (Circle One): b.. Hazy b. Fog, mist, or light rain c . Scattered clouds c. Moderate or heavy rain d . Thick or heavy clouds e. Don't remember 10. The o: ct appeared: (Circle One): b . Transparent C!!. As a ligl}_.t ) e. Don't remember If it appeared as a light, was it brighter than the briehtest stars? c. About the same d. Don't know 11.1 Cc~pare brightness to some common object: 12. J.l.~ eC s of the object , re: (Cir~le One): a. Fuzzv or blurred (b. Lika'" a ~.right st-;:v c. -~n~r-.:~v outlined d. Don~ ember A~-- o stand s~i,, at any time? rus h away at E : , ,: ..:? into parts or explode? Ch.:.::::;~ ~rightness? Ch::.:: shape? c1G3~ ~ r flicker? Disa?~ear and reappear? (Circle One for each question) Don't know Don't kno\J Don' t kno\o~ Don't kno Don't know Don't know Don't know 14. Did the object disappear while you were watching it? If so, How? 15. Did the object move behind something at any time, pnrticulnrly a cloud? (Circl;: 0ne): then t .::.:.1 what it moved behind: Don't know IF you answered YES, 16. Did tna object move in front of something at any time, particularly a cloud? (Circl~ One): Yes Don't know IF you answered YES, the n t ell what in front of: Tell i n a few words the f ollowing things about the object: vi e wi.s.1 to knew the angular size . Hold a match stick at liP~ v.:.th a kno\m object and note how much of the objec t he~d of the match. If you had performed this experiment sightin3, how much o f the c~ject woul~ have been covered ann's l ength in is covered b y the at the time of the by the matcl1 head? Dr a~; a ?icture that ~.;ill show the shape of the object or objects. Label and incl..tJe in your sketch e..::../ cetai-ls of the object that you sa'" such as \vines, ?rotrcs~cns, etc., and es?ecielly exhaust trails or vapor trails . Place a~rcw ceaide the drawing to show the direction the object \~as moving . you think you can (Circle One) answered YES, estimate the speed of the object? speed would you estimate? 21. Do y\)u think you can estimate how far away from you the object was? (Circle One) If you answered YES, then how far awny would you say it was?_, Z~-~:~ - r_ _ l~1e were you located when you saw the object? (Circle One): a. Inside a building \c. C:1tdoors ' d. I~ an airplane (type) Were you (Circle One) In the business ~ection of a city? In the resident~nl sec- tion of a city? In open countryside? Near an airfield? Flying over a city? Flying o~er open country'(? IF yo u were 1-IOVING IN AN AUTOMOBILE or compl2te the follm11ing questions: other vehicle at the time, tltcn 24.1 What direction were you moving? (Circle One) a. North c. East b . Northeast d. Southeast f. Southwest h. Northwest 24.2 How fast were you moving? miles per hour. you stop at any time while looking nt the (Circle One) o!:lserve the object through any of the following? Eyeglasses e Binoculars glasses Yes .No~ c. :.;::.~dshield Theodolite In crci~= : hat you can giva as clear a picture descr:~:: ~:: your own wo:-cs a conmton object or t~e snme appearance as possible of what objects \Jhich, when as the object which 27. In the followins sketch, im3~ine that you are ~t the point shown. Place an "A" on tha curved line to show hoto~ high the object totas aLove the horizon (skyline) when you first saw it. Place a "B" on the s.:une curved line to show how high the o~ject was above the horizon (skyline) when you lost S:JN it. Place an "A" on the com?ass when you first:_ sato~ it. Place a "B" on the compass when you last saw the object. 28. Dre.w a r>icture that will show the motion that the object or objects m3llt!. Plnca an "A" at the beginnin3 of the path, a "B" at the end of the path, and snow any chan~es in direction during the course. 29 . IF tt2re was more than one object, then how many were there? !)raYJ a !)ic ture of how t!ley ttJere. arrange<l, and put an arro~o~ to show the cirection that they were traveling 30. Have you ever seen this, or a similar object before? If so, give date or d:1tes and location. ; ;;; 31. Was anyone else (Circle One) with you at the time you saw the object? 31.1 IF you (Circ:e One) answered YES, 31.2 PleAse list their names see the object too? addresses: 32. Please give the following information about yourself: First Name Street City TELPHONE NUMBER lr.dicat~ any additional infoxmation about yourself, including any sp~cial exper~a~ces, which might be pertinent. 3J. Whe n and to whom did you report that you had seen the object? 34. Dnte you com~leted this questionnaire: 35. Inforr~ation which you feel pertinent an~ which is not adequately cov~reu in the specific points of the questionnaire or a narrative explanation of your si~hting. SEND TO: U.F.O. aeport Air Force Research and Develo?oent Uri~h~-rattcrson Air Force Base Dayton, Ohio