08S~RVATlON OnSc~VATION ) . r""~HYSICAL EVIDENCE ediUona ot thh forro m<~;o b, U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force as much information as possible concerning the unidentified aerial phenomenon that you have observed. Please try to answer as many questions as you possibly can. The information that you give will ba used for research purposes. Your nome will not be used in connection with any statements, ccnc Ius ions, or publications without your permission. We request this personal ;,Format ion so that if it is deemed necessary, we may contact you for further details. 1. When did you see the obiect? Hour Minutes (Circle One): 3. Time Zone: (Circle One): a. t:astern b. Ceo.tt~ <::c. Moun~n Poe ific 4. Where were you when you sow the object? (Circle One):~Doylight Saviny b. Standard Nearest Postal Address City or Town Stare&-County 5. how long was object in sight? (Total Duration) Hours Minutes Seconds ~ tertain c. Not 'Very sure b. Fairly certain d. Just a guess. 5.2 Was object in sight continuous1y? 6. What wos the condition of the sky? Yes X ' No 7. IF you saw the object during DAYLIGHT, where was the SUN located as you looked ot the object? (Circle One): a. In front of you d. To your left b. In bock of you e. c. To your right f. Don't remember 8.2 MOON ( ( rrclt! One). @ Elright moonliqlt '-c./ Many b. Du II moon I i gh t c. No mocmiight-p 1tc h d a rk d. Don't r~member d. Don't retnemlJ~r 9. V.hat were the weather conditions at the time you ~ow the object? CLOUDS (Circle Q;,e ): NEATH E R ( C irc/e O n e): (y Clear sky b. Hozy b. Fog, mist, o r I i gh t rai n c. Scattered clouds ,'.;oderote or heavy ro in Thick or heavy clouds d. Snow Don't rem~mber 10. The object appeared: ( Circle One): CdJ'As a I ight Transparent e. Don't remember it a ppeared as a ligh:, was it brighter than the brightest stars? ( Circle O ne): o. Brighter c. A bout the some d. Don't know 11.1 Compare brightness to somrt c ommon object: 12. The edges of the obj~ct were: (Circle One): a. Fuz:z.y or bluaed @ike a bri~ht star c. Shor!"IY outlined d. Don't remember 13. D id the object: a. Apoear to stand still at any time? b. Suddenly soeed up and rush away at any time? c . Break up into parts or explode? d. Give off smoke? e. Change brightness? f. Change shape? g. Flash or flicker? h. Disappear and reappear? (Circle On e for eoc h qu~stion) Don't know Don't k n o w Don't k:1ow Don'1 know Don't know Don't know Don't know Don't know 15. Did !h abjftet move ~ind aom"tnino at any time, l)orticul~rty a cfcn.d? (C ;rc:le One): Yes Don't Know. IF you answered YES, then tell what 16. Did the objct move in frnnt of something at any tirntt, p(lrtic:ulnrly a c:laud? ( C ;,.c le Ornt ): Don't l(now. you onswred YES, then tell what 17. Tel I in a ff!tw word!~ the following things about the obiact: 18. We wish to know the angular size. Hold a match stick ot arm's length in line with a known objttet and not~ how much of the objKt is covered by the httnd of the match. If you had performed this ex$)11tritnent ot the time of the sighting, how much of the ob;ect WOf.:t~ have been covered by the match head? 19. Draw a picture that will show the shape of the obiect or objects. Label ond include in yovr sketch any detai Is of the obiect that you sow such as wing$, protrusions, etc., and especialty exhaust trails or vapor trails. Place on arrow beside the drawing to show the direction the obiect was moving. 20. Do you thinlc you con estimate the spa~d of the object? (Circle One) Yes (.,/ IF you answ.red YES, then what speed would you estimate? --------- 21. Do y~ think you can &l'timate how far away from you the obiac:t was? (Circle One) IF you answe,.d YES, then how far away would you say it was?---------- 22. Where were you located when you saw the object? (C ire /e One): 23. Were you (C;rcle One) a. In the business section of a city? a. Inside a building b. In a cor l9o~tdoors d. In on airplane (type) b. In the residential section of a city? (c.J n open countryside? d. Near on airfield? e. Flying ov1tr a c:ity? e . At sea f. Flying ove r open country? 24. IF you were MOVING IN AN AUTOMOBILE or other vehicle at the time, then complete the following questions: 24.1 What direction were you moving? (Circ:/e One) a. Nortn e. South g. Wttst b. Northeast d. Southeast f. Southwest h. Nonhw~st 24.2 How fast were yt:N moving? miles per hour. 24.3 Did you stop at any time while you were looking at the object? (Circle One) Yes No Did you observe the obiect through any of the following? Eyeglasses e. Binoculars b. Sun glasses Telescope Yes Windshield Theodolite d. Window glass 26. In ord~r that you can give as clear a picture as possible of what you saw, describe in your own words a common ob ject or objects which, when placed up in the sky, would give #,e same appearance as the obiec:t which you sow . 27. In the following l~llttch, imagine th nt y ou o.-e o t the point shown. Place or ''A" on t iu curv.,d I i ne to ~how how high the obiect was above the horizon (skyline) whttn you /erst ~ow it. P lac" o "B'' on the ' om .. curved lint ' o show how high the obiect was above the horizon (skyline) when you lost saw it. Place an "A" on the c~mO\lSI wh~n you first saw it. Place a .. B" on the compass where you lost saw the ob!.,ct 28. tJraw a picture that will show the motion that th'! object or obje:ts mode. Place on .. A" at th--beginning of the path, a "B" at the end of the path, and show ony changes in direction during tht: course 29. IF there was MORE THAN ONE object, then how many were there? .loCh;...;:;;.. _ Draw a picture of how they were arranged, on.:! put an arrow to show the direction that they were traveling. 31. Wo ' anyone else w ith you at the tima you :~ow the objsc:t? (Circle One ) 31.1 IF you answered YES, did they see the object too? (Circle Orte) their names and addresses: 32. Please give the following information about yourself: Last Name Firat Name Middle Name Z one Statct SEX /?r / e TELEPHONE NUMSE lndicat~ any additional information about yoursalf, including any sp&eial experi~nce, which might be pertiner.t . 33. When e nd to whom d id you report t hat y ou had s~en the object? 34. Date you completed this questionnaire: Information which you feel pertinent and which is not adequately covered in the specific points of th@' questionnaire or o narrative explanation of your sighting. U.S. AIR FORCE TECHNICAL INFORMATION This questionnaire has been prepared so that you can give the U.S. Air Force os much information as possible concerning the unidentified aerial phenomenon that you have observed. Please try to answer as many questions as you possibly can. The information that you give will be used for research purposes. Your nan~e will not be used in connection with any statements, conclusions, or publications without your permission. We request this personal information so that if it is deemed necessary, we may contact you for further details. 1. When did you see the object? 3. TirT'e Zone: (Circle One): a. tastern b. Centr_ol Cf. Mountainl d. Poe if ic 4. Where were you when you saw the object? Nearest Postal Address 2. Tir.,e lljf:t l)'l p Hour Minutes (Circle One): l. A.M.~ or (Circle One):(a. Daylioh ~ .. --.;1 b. :>tone ore City or Town State or County 5. how long was obiect in sight? (Totot Duration) "''f_,e il'')( Hours Minutt!s Seconds ( a. Certain l c. Not very sure b. Fairly certain d. Just a guess 5.1 How was time in sight determined? jW -f~C;tt.tl:._ _ 5.2 Wos object in sight continuously? 6. What was the condition of the sky? . a. Bright t: a. Briq ht :J 7. IF you saw the object during DAYLIGHT, where was the SUN tocoted as you looked at the obj~ct? (Circle One): a. In front of you b. In back of you c. To your right d. To your left e. Overhead f. Don't remember Thl form atptJraet1 FTn 164, Ju1 61, 'which is obsolet. tl. IF you sow the object ot NIGHT, whot d tci you notice concerning the ~ T Ak S lind MOON? 8.1 S T AR5 (Circle One): d. Don't remember 8.2 MUON ((rrcle O"c): a. Bright moonli ht b. u moon ig t c. No moonlight -pitch dark d. Don't remember 9. ~hot were the weather conditions at the time you saw the object? CLOUDS (Cirde One): NEATHER (Circle One); ca. Clear sky:> b. Hazy b. og, mist, or I ight rain c. Scattered. c: I oud s c. ;-Aoderote or heavy rain d. Thick or heavy clouds e. Don't remember 10. The object appeared: (Circle One); d. As a light b. Transparent 11. If it appeared os a light, was it brighter than the brightest stars? (Circle One): a. Brichter c. About the some d. Don't know Compare brightness to some common object: (. b. Dimmer J 12. The edges of the objeet were: (Circle One): Ca. Fuzzy or blurr b. Like a briyht star c. Shorp1y out I ined d. Don't remember 13. Did the object: a. Appear to stand still at any time? b. Suddenly speed up and rush away atony time? c. Break up into ports or explode? d. Give off smoke? e. Change bri~tness? f. Change shape? g. Flash or f1 icker? h. Disappear and reappotar? (Circle One f o r each question) Don't kno w Don't know Don't know Don't know Don't know Don't knooN Don't know Don't know 14. Did tne object disappear while you wfHe watching it? If so, ho.-..? 15. Did the object move J,.,hind somflthinq at any time, pt.~rticularly a cloud? (Circle One): Yes No Don't Know. IF you onsweriJd YES, then tell what 16. Did the object move in front of something at any time, particularly a cloud? (Circle Omt ): Yes No Don't Know. IF you answered YES, then te ll whoz 17. Tell in o ft~tw words the following things about the obiect: a. Sound No 0 s" "',v /) 18. We wish to know the angular size. Hold a match stick at orm's length in line with a known object and note how much of the object is covered by the head of the match. IF you had performed this experiment ot the time of the sighting, how much of the object would hove been covered by the match head? 19. Draw o p icture that wi II show the s hcpe of the obie