Pi:OJECT 10073 RECORD 2. LOCATION 1. l '1 L TIME GROUP -10. CONCLUSION Other a (UNRELIABLE RC~CBT) . . 4. NUMBER Of OBJECTS The obaerYer is oDly 12 yra old. SiDee it ia Tery doubttall tba a dark object would be aeeD agaiDat a dark background, aud there s. LENGTH OF OBS!RYATION 11. BRIEfl SUMMARY AND ANALYSIS the obsex'ver, the aighting ia be1Dg ~ carried U iable ~pert. [; 6. TYPE OF OBSERVATION ~7. COURSE The obaerYer a1gbt~ a gray diao ah~ped :obJec\ .1D t~ SV that 9. PHYSICAL EVIDENCE had a back aDd torth te . . fORCE TECHNICAL IHfORM.l.TIOH This questionnaire has been prepar.d so that you can give the U.S. Air Force as much information as possible concerning the unidentified aerial phenomenon that you hove observftd. Please try to answer as many queations os you possibly can. The information that you give will be used for research purposes. Yout nama will Dot be used in connection with any statements, conclusions, or publications without .yo~r permission. We request this personal information so that if it is deemed neceaaory, we may contact yfN for further details. 1. When did you '" the object? 2. Time of day: 3. Time Zone: (Circle One): a. Eastem b. Central c. Mountain fd. Pacific (Cirt:le One): or (Cirt:le One): a. Daylight Saving b. Standard 4. Where were you when you saw the obiect? 5. How iong was obtect in sight? (Total DwtstiM} o. Certain ;;,. fairly .:erto:n City Towtt (b. Cloudy State ot Co""'' 7. 1:= yC~v U'41 ~!, obiect during DAYLIGHT, whe,. was the SUN locoted as you loo~ed at the obj~ct? (Circle One): a. In front of you b. In back of you c. To your right d. To your left Overhead e. Don't remember FTO o~r q l S~ Reproduced by Library of Congress, Legislative Reference Service 8. lF y o u saw th~ obt~cr ot Nll,~iT, wnat did you notice co'"'~t-rneng t~e 5TARS and M001'4? 8.1 STAR5(Cird~ Or~): 8.2 MOO~ (Circl~ Omrd: a. Bright tn('lanl ight b. Dull monnl i~ht c. No mo~nli~ht -pitch dark d. Don't re"''"be' d. Don't r~memb~ ': 9. What vnH~ thtl wenthr ""~itiM5 ot t;,e 'ime you 'ow~. ~bj~ct? CLOUDS (Cirde 01td: a. Clear skv c. Sca ttered clo\;d!' ~;'Thick or hetovy cl 1uds b. Foil, ~i:;t, or li;"'t r~rn c~ Mod~,.,t ... r>r hec"Y ro~n C"l. A!' o l ight T r o " ;por~nt Don't r.,,ember 11. If it appeared as o iiqh, was it briqhter thon ttHt brightP-:t !tor"? (Circle One): e. Bright~r b. Oim"er c. About the sa.,~ d. Don't know ( C i:cle Q~l; o. Fu tzy or b :urreo :J ' y out i i ned i 13. Did the object.: a. Appear to stnnd :; till nt nny time? b. Suddenly soef!d uo anrt rush owoy at any time? d. Give C"ff ~,.,oit..,? ~. Ch::mge briif't., ... -ts~ f. Ch 11 n 9" sh ope? g. Flash or fl icke:-, h. 0 i sapceor ar.d r ... Ot'oeer? (Circle Ornt for each-Quttostio,.) Don't know o~, know. 'r r S No l.Jon t n1l Dnrt't know Don't know Don't \cnow Oo,t know Don't kn'!)w 14. Did the ob,ect disappear while you w~r~ watching it? If so, how? 15. Did the object move behind something at ony time, particularly a cloud? ( C i rc IP. On~): Don't Know. IF you answered YES, then tell what it moved behind: 16. Did the object move in front of so"1ethi.,g at any time, particularly a claud? (Circle One}: ~ Yes No Don't Know. ;' 17. Tell in a few words the following things about the object: I 18. We wis., to l<now the angular size. Hold a motch stick at orm's length in line with a known obiect and note how i much o f the ob1ec r is c overed by the head of the match. If you hod performed this experiment at the time of the l sight!,;, how muc:h o f the obje-ct would h ::ve been covered by the match head? Draw c ~icture thot w i ll show the shape of the ob;ect 01 objects. L~bel end include in y04Jr sketch any details of the objec~ that yo"' sow such as wings, protrusions, etc., and esi)eially xhaust trails or vopot trails Place an arrow bestde t~e drawing to show the direction the obiect waa mOYing 20. Do y~u th Ink you can estimate thtt speed of tl,e ohi ~c t ? (Circle One) IF you answered YES, then what speed would you estimate? ------- 21, Do you think you can estimate how far away from you the obiect wa.s? (Circle One) IF you answered YES, then how for away would you soy 22. Where were you located when you aow the obj-ect? (C irc/e One): . a. Ins ide o building b. In o car @ Outdoors . d. In tJn o irplone (t)pe) 23. w.,,e you ( Cirdtt One) t4. In th i! businets sarctioo of o city? ,~.I In th e ,,:.:dentiul sectio" of a city? c . 1.1 oo.:tn .:ountrysidtJ? d. t~t)\IP Qn gjrfi~ld? " Flyi~tJ ov!!r a city? f, Flyl.19 ov~r ..,poen country? a. North c. Ecnt e . St?vth g . West b. Northeast d. Sou theC1Jt f. Souih..,,s t h. Northwe~t 24.3 D id yoJ stop ot 0T1Y t ime while YO\! w'r~ locking t-:t tMe objec~? ( Circ/., One) 25. Did yo" observe the obi~ct thro.Jgh any ot ~. following? Binoculars ~..:n ~icsses e e sc:::ce c. Windshieid Theodcii Yes No Wind~., g'ass 26. In order that you can give as clear a picture os possible of whot you aaw, describe in your own words a common object Of' objacts which, whn plcc~d up in th "'<y, would give th ltJnwt :1p~aranco ~s th e object which you saw. 27, In the following s1ceteh, imqine that you are at the point ahown. Place an .. A" on the curved I ine to aho how high the obiec:t waa obcwe the hotiaon (alcyline) when yov litst saw it. Place a "8" on the aame curved line to ahow how high the obiect waa a~ove the hotiiOft (skyline) when you last saw it. Place an "A" on the compoaa when yow lirst aa~ it. Place a "B .. Oft the compo11 where you last aaw the obiec:t i 28. Draw o pic:turt!t thot wi II show th4!t moti~n that the obiec:t or obiec:ts made. Place an "A" at the beginning of th ' path, a "B,. at the en<fof the path, and ileu-. .;ny changes in direction during the course 29. IF ther as "'ORE THAN Qr.E ob,ect, rhen how many were rft.te? ------------- Crow a ptcrure at how they were orranged, ond put an arrow to no m e direction that they were traveling. 30. Hove you eve r seen th is, or a a imilor obiect be fore. lf so g ive date or dotes a nd loc a t iot'l. 31. Was anyone else with you at the time you saw the obiect? (Ctrcle One) 31.1 IF you answered YES, did they see t~e object too? (Circle One) 31.2 Please list their names and addresses: 32. Please give the following information about yourself: F int NaMe Middle Name C i t y Zone State TELEPHONE NUMBE Indicate a ny additi~ol infornKJtion about yourself, including any lpecial exp4trience, which might be pertinent When and to whom d id you report that you had seen the object? 3<4, Date you completecl thia qvesti.,,.eire: Information which yow f .. l peutinent ancl which is not adeqwotly ccwered in tne spcific pointa of th queationnoire a notroti,. explonoti~ of your ithti"t