...:o.~CLUSION ~\A YION 111. BRIEF SUMMARY AND ANALYSIS '). f'rlYSICAL EVi~.:NC; Object !4~d a r-=::i rir1! l."l. oottorJ. Objec-.. r~3 :.tov~.-- U.S. AIR FORCE TECHNICAL INFORMATION T~ i ~ questionnaire has been prepared so that you con give the U.S. Air Force as much informcr1on os possible concerning the unidentified aerial phenomenon that you have observed. . Please ry ~o answer as many questions as you possibly can. The information that you give will be us4!1d for research purposes. Your name will not be used in connection with any statements, ccnc l~s .o,s, or publications without your permission. We request this personal i"formation so that ,, n i s deemed necessary, we may contact you for further details. 1. When did y ::1.1 see the obiect? 3. Time Zone: f'JCJ 8 c J--1 (Circle One): b. Centra l d. Poe ;fie e. Oth.e'" wh en you saw th~ ooj~ct? (Circle One): (Circle One): Hour Minutes a. Dayli9ht Saving b. ~tundo@ City or Town 5. how I ong wos .,b,.,ct in sight? ( I or:! Durotion) Hours Minutes Q C:ar.:in c. Not very sure b. =c !r iy certain d. Just a guess 5.2 Was obje-c-, .. r.11~nt cc.ntinuous!y? Yes_ 6. What was t he c~r.c !rion of the sky? o. 3 r i;ht b. C ioudy State or County 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked at the obiect? f)J' 0 (Circle One): a. !:1 front of you b. In bade of you c. To your right d. To your left e. Overheacl f. Don't remember FTO OCT 62 164 Thl form upPd .. FTn 164, .J~I 61, whlch i obaolete. d. IF you s o w the object at NIGHT, what did y o u notice conc~rn ing the ~ T Af<S und MOON? 8.1 STARS (Circle One): 8.2 MOON ((ircle One): a. Briqht moon I ight b. Dull moon I ight () No moonlight -pitch dark d. Don't remember 9. V.hot -N~r~ -,e weather cond 1ti0ns at the time you sow the object? Circle 0:1e): c. S::::~tere':i clouds d. Thick :>r heavy clouds flEA THE R (Circle On~): b. Fog, mist, or li ght rain c. 'Aoderate or heavy rain c . Don't remember s IYC ~, IY Q- 10. The objec7 appeared: (Circl~ One ): e. o~n't remember 11. If i ' :l;')pe:c OS a light, W:JS i! s .. ,;:-:~t?r than the brightest stars? (Circle One): c. About the some ...ilmmer d. Don't know 11.1 C omccr4! brigntn~ss to sorr.e =-:1mmon object: 12. The ed;es oi >n~ :>bj~ct wer~: Did the obi e~'": (Circle One for eoch question) Appec r ~c s!::nd still at any time? Don't know b. Suddenly :; up and rush away at any time? Don't know ~-~ parts or explod~? Don't know d. Give off sm':lke? Don't know Change br i ;n ~ness? Don't know Change s nope? Dont know g. Flash or flicker? Dont know Disappear c:1d reappear? Dont know 14. Did t~e ob,ect disaooear while you were watching it? If so, how? 15. Did ~he obi!tet move b-thin~ som~f41ing at any time, porticul~rly a cloud? (Ci rc ie Cn~): Don't Know. IF you answered YES, then tell what it m ~ind: 16. Did t hf! cSict mnv~t in frnnt of Selmf!thing atony timt~t, particularly a cl<:\ud? (Circ le C;ne }: Yes Don't Know. IF you onsw.,red YES, then tell what 17. T~t!l ir'l o '~w word~ the following thing s obout the obiec:t: b. Color ,~ t:ro A I fD w~ wish to know th~ on~ular siz~. ~old a match stick at arm's length in line with a kn"wn oh;ect and note how much of t~e, obiec:t is covered by ;;.;'-!t h!tod of the match. If you hod perform'!td this ex~riment at the time of the s i ght inc;, ~ow n-uc:h of tht~t object wou:d hove been cover~ by the match head? Draw a p i:ture ~ot will show the> shape of the obiect or objects. Lobel and include in your sketch any details of the ~biee; .. ~et y ou sow s uch c s "'-'ings, protrusions, etc., and especially exhaust trails or vapor trails. Piece ar. or.-.,-~side the drow1:"'g to ~how the direction the object was moving 2Q . Do you thin1c you can estimate the speed of the obiect? (Cirele One) IF you onsw~red YES, then what speed would you estimate? ------- 21. Do y04J th ir.it y~u ::an estimate how for away from you the obiect was? , IF you cn~'-'red YES; then how for away would you soy it was? /1 ::.... n'1 J '-~ S 22. Where w you located when you sow the obiect? (C ircie o~ j : Ins ide ~ ouilding b. In a cor In on ~ ir;>lone {type) ft -EI .t.J 23. Were you (Circle One} In the business section of a city? In the residential section of o city? In opftn country 1 ide? Near on airfield? Flying over o city? Flying over open country? f. Oth~r g Other T BE F .s .Ll'l r H E 24. IF y ou wer't MOVING IN AN AUTOMColLE or other vehicle at the time, then complete the following questions: 24.1 Wh>It cirection were you moving? (Circle One) o~ r.oor*t c. East e. South g. West ..,. N,~neast a. South~ast f. Southwest h. Northwest 24.2 How f::sT Wftre you moving? miles per hour. 24.3 Did y ou stop at any time wh i ie you were looking at the obiect? (C;r:i~ One) 25. Did you obs~ the object throu;h any of the following? Eyeglc:ss~ Binoculars b. Sun :;1c-!ues Wind si-t i-ttid Theodolite Yes Windo-::t:3S In order thc:t you :::n g ive ~s c1ecr c picture as possible of what you saw, describe in your own words a common obiect or obj-.cts which, when placed up in the sky, would give the same appearance as the obiect which you sow. A FL.fll"!G 27. In the following sketch, imagine that you ore at the point shown. Place or A" on the curvd I in to show how high the obiect was above the horizon (skyline) when you first sow it. Place a ''B" on the same curved line to show how high tne obiect was above the horizon (skyline) when you last saw it. Plaee an .. A .. on the compass when you first ~ow it. Place o "B" on the compass where you last sow the object 28. Oraw a pietur~ that wi II show the m~tion that the obieet or objects mode. Place on "A" at the beginning of the .. path, o ~" ~ the end of the patr , end show ny changes in direction during th~ course. 29. IF tnere was MORE THAN ONE object, then how many were there? N_._,31Qo::;...._ _ Drow a picrt:r!! ::.f !";ow they were crrenged, on.:l put an arrow to show the direction that they were traveling 39~ Hove you ever seen this, or a similar obiect before. If so give dote or dah a nd ICK:atlon. 31. War. yo~ ., ise w it :, you at the time you saw the obiect? (Circle One) 31.1 IF '/C'J onswered 'fES, did they see the obiect too? (Cirde One) 31.2 ~ h~o3e I ist their names and cddresses: 1-f-Jfrt= VJE.t.u .OA1U kiNNC'L.oN f'V 32. Plecs~ ~iY~ the following information about yourself: Firat Name Middle Nome Zone Stat~ TE L E PHCN~ NUMBE Jndicot& a ny oeditionol infor,otiof' -:::>out yourself, including any special experience, which might be p~rtinent. ~ C/ V iE /7 S T A Off) o N 1 /9/Yo (O>o oN 0 r: rE N 33. When and to w~ott1 dicf you report that you had seen the ohiect? m'l FR1e1vo 34. Dote you completed thi1 que1tionnoire: 35. Information wh;-:n you feel pertinent and which is not adequately covered in the specific points of the questionnaire Ci" ;; :-,arrotive explonotilln of your sighting.