'l'DE:l'/UFO o:::Y....\RT>ofENT OF THE AIR FORCE HEADQUAptT~Il!l FO~ti:IGN TI!:C HNOLOGY O IV 13ION I I> 'nC I WP!lGfi ;-.,.ArT ~,;c~ON A l '1 l'"'?t4C J. .IAJJ. OH'~ ~J C!.j UFO Observati on Reference y~,.,ur unidentified observation. The information 'Which we have received is not sufficient for a scientific evaluation. Request you complete the attached FTD Form 164 and return it in the envel ope provided. Thank you for reporting your observation to the Air Force. JANES C. MANATl', Colonel, USAF Direct or of Technology and Subsystems F?D ?orm 164 v/envelope This questionnaire has been prepared s o tha t you con give t h e U.S. Air Force a:; much ormat ion a~ possible concerning the unide ntified oer ia I phenomenon that you hove observed. Pleas e t ry t o answer as many quostions as you possib ly con. The information thal you giv e w i II be used for r~seorch purposes. Your nome will not be used in connection with any stat~ments, ccnclusions, or publications without your permission. We request this personal information so that if it is deemed necessary, we may c ontact you fo r f urther deta i Is. 1. Nhcn did you see the object ? 2. Tir,,e of day: Doy 0 Mont h (Circle O ne.l: 3. Time Zone: (Circle On e): i, t= "'stern c. Mountain d . Pacific (Circle O..,e): 4. Where were you whe n you sow the object? Stole o r C ounty City o r Town Nearest Postal Address 5. how long wos object in sight ? (Totol Duration) s .. conds a . Certain c. Not very sure b. Fair ly certoin C: st ~.guess:) 5.1 How wos t ime in sight determined?--------- ------------ 5.2 'has object in sight continuously? 6 . What wos th e condition of th e sky? a . Bright ~ Br .1 7. IF you sow th e object dllring DAYLIGHT, wh':!re was the SUN locot'!d as you looked ot the object ? (CirciP. One): a . In front of you b. In b ock of you . c . T o your right d . To your le ft e. Ove rheod f. Don' t remember Thl ! OTm "UPe :-. .. de FTrl :o-4. Jul 0 I, -...h ch IJ >bolt.-. d . IF you '>OW the ob, ..... , o t N IGYT, w!lOI dtcl ynu not icl: concrnng thl' ~. r ,'\ ' S md 1..\QCN? S.l !>TARS (C i:dc One): d. Don't rem.,mber 8. 2 MOUN ( ( ~rcfe One J a. Brtght maanl1ght b. Dull rnoanlto:;ht ~ro mol\(lli~ht -pitch dork ~on't ~:mber') 9. Y,hot were the weather conditions o t t'-te t tme y ou sow th~ object ? CLOUDS (Circle o.,e ): c. Scattered clouds d. Thick or heavy clouds WEATHER (C irc/e On~): b. Fag, mist, o r li ght rain c ... ~od,.rotc or heavy rain e . on' t remember~ 10. The ob1ect appeared: (Circle One): r nnsporent ::1. As a l ight e. Don't remember 11. If it appeared os o light, was it brighter than the brightest s tars? (Circle One): c. About the some d. Don' t know 11.1 Compare brightness t o some common object : 12. The edges o f t h e object were: (Circle One): a . Fuzzy or blu:red b . Like a bri~ht stor {: Shar['ly outlineSV Ct.---fron T reme~r 13. Di::l th~ object: (Circle One for each question} a . App~or to s tand still a t any t im-e? Don't know Suddenly s oeed up and rush awcy at any time? YP.s Don't know 13rcok up into ports o r explode? Don't l<:1ow Give off smoke? Don' t !<now Change brishtMss? Don'! knt) W e . f. Change shape? Don't know q. Flash c r flicker? Don' t know Disappear ond r~appeor? -Doo' t lcno_:7 1 ~. Did 'he obj"'ct di~opo whi Itt y ou "'""'*'\ .. etching i;? I~ so, ho .... ? 15. Did the objl!tct move ~hind s om.,thing atony tim~, pnrticularly a cloud? (Circle One): Don't Know. IF you onswered YES, then tell what mtwetd ~hind: ----- 16. Did th~ object move i n front of something at any t ime, particula r ly o cloud? (Circle OM): No Don't Know . you a nswl!tred YES, then te II what 17. T n il in a f :w word s t he following things about the obj!!ct: 18. We wish t o know th~! angular size. Hold a match s t ick a t arm's len g th in l in e with o known obj.,ct and no~" h o w much of th e obj~ct is covered by the h~ad of the match. If you had pe rformed this experiment l"t tl,e ti me c.f tne I sighting, how muc h of the object would hove been covered by the match head? 19. Draw a picture that will show the shape of th e obje c t or objects . Lobel and include in your 3k~tch ony details the obje c t thot you sow such a s wings, protr u s ions, e tc., and especia lly exhaust trails or vapor t rails. Place on a rrow bes ide the crowing t o sho w the direction the obje c t was moving. cv 0 you t in you C<Jil estimate the sp~!!d or the Clbjfl.::? (Circl" One ) I F y~ onswo rttd Y ES, t h.,n whol s~lld would y o u &stimot.,? (i .... _. =-'--L...r _ ... _:S_I'Y' 21. Do you think you con estimot~ ho w for away from you th~ o b je c t wo:>? (Circle On'J) e No f : IF you answered YES, th<~tn how for owoy would you soy it was?_, CY.J11{l. _ 22. Wh?r" Wi!r" yov located when you saw the obj~ct? (C irc:!e One): a. lnsid., a building b. In o cor tZ_?utdoor}> d. In an oirplcM (l'y~) w,re you (Circle One) o. In t!-;c business !i'!ction of a city? b . !n t he residential :saction o f o city? / c . In open c o untryside? d. Nea r -::~n airrte u . Flying over u c ity? f. Flying ov~r o~ar country? 24. IF you wer~ MOVING IN AN AUTOMOBILE or other vehicle at the time, then corr.plete th e following questions: 24. 1 What dir~ction \Of'!re you moving? ( Circle On..,) c. E tl :st e. South b. Northeast d. Sout he ast f. Southwest h. North 'HI! !it 24.2 How fast were you moving? _._m,iles p~r hour. 24.3 Did you stop at any time while you were looking a t the object? (Circle One) D d you obse rve the obj~ct through any of the following? Eyegla,ses Binoculars b. Sun glosses Wir.dshictld g. Theodolite Yes d. w:ndow gla~s 26. In order that you c o n give as clecr o ;:>icture as possible of what yoJ sow, d escrii:e in your o.:.rn w ords a corrr.on I o bj-,t:t o r obj.,cts "'hich, when placdd up in the sky, would giv-e tn'! SOil'~ appearance <1s the obj~ct which you sow . '27. In th~ foll:>w ing sketch, imogire lha~ you noe ot th, poirt shown . PI<Jce or"/, CJI"l :L.~. c.u o l1no: t'> d,.,..., high the object was above t h e horizon (s~yline) wl,~n you f ,rsf snw t. Pl~ve a ''tj' o., t r ~C'M .. c.t.rv,...J 1:~ ' ' show how high the object was above the horzon (sl<yl1ne) whtm you /a-;t ~ow it. Plac~ a.., "A"-:!" he comr .. -n., wh .. n you fi rs t saw it. Place a "B" on the compass where you las t sow tl: '>b1ect. 28. !)row a picture thot w i ll show the motion rhot t he object or objec t s mode. Place on "A" at th e heqinnmg ()f the path, o " B " at t he end ,f the path, and show any changes in ~ir~ction duri ng tht. course . 29. lr there was MORE THAN ONE object, then how many were there? J.--:. _ Draw a picture o f how th~y were arranged, anJ put on a r row t o sho w t h e dir tion that t hey were tr aveling . I 31. Wos anyone ~I s~ with you ot the time you sow the obj.oct? (Circle One ) 31.1 IF y01J onsw:'tr'jd YES, did they seo!l the object too? (Circld One) 31.2 Ploo5e l ilt th~ir names and addre.ss.,s: j 32. Please giv~ the following infor:notion about yourself: tndicote any additional inform'=ltion nbout yourself, including a ny special exp.,rionce, which mignt be P<lrtl"'',.n!. 33. \Jth~n and r.> 'Hhom d id you r~p01t tha t you hod seen , :,., obj ! ct? I 34. Dot~ you complet.,d this questionnaire: ./ Month~/ 35. lnformction which you feel pertine nt and which i3 no t od"~ly covered in th~ specific points o f t he qu~tstionnoir~ 0< o narrativ e explanation o f you r sighting. R t PI.Y TO A fr<o OF DEt-~RTMENT O F THE AIR FORCE HEAOQUA~T.UU F O,.'!IGN TI!:CHNO LOGY OIIII'!IION I ~V"SC I UFO Observati on El bow Lake, Minneso Reference y(1u r unidentified observation. 'The information \ihich we have received is not sufficient for a scientific evaluation. Request you complete the attached FTD Form 164 and return it in t h e envelope pr ovij ed . Thank you for reporting your observation to the Ai r For r e . ~JAMES C. r-1ANA'IT, Colonel, USAF 1 Atch jfr Director of Technology and Subsystems F?D Form 164 v/envelope