? i<OJECT 10073 RECORD )~, ~ :"!c~ no-c observed .?HCfL'C; :>rocessing i~regulari ~Y ~. LENGTH OF OBSERVATION j 11 BRIEF SUMMARY AND ANALYSIS 6. TYPE OF OBSERVATION 8. PrlOTOS 9. PHY SICAL EVfOE~CE Object was not observed but appeared in photo. Preloua edlUOfta of thla fo,_ mar b. ud. O.S. AIR FORCE TECHNICAL INFORMATION "Thi1 questionnaire has been prt!pared so that you can give the U.S. Air Force os much infor~ction os possible concerning the unidentified aerial phenomenon that you have observed. P l.::! a t~ to ans~er os many questions as you possibly can. The information that you giYe will us~:i ior research purposes. Your name will tJot be used in connection with ony statne"ts, co~:i.;sions, or public.otions without your permission. We request this p~traonal information 10 th:~ i f i t is deemed necessary, Wf! may contact you for further details. 1. When d id y:,u see the object? 3. Time Zone: (Circle One): a. Eastern b. Central Co M,oQunl d.("'Poc ifi ... 4. n' here wer you when you saw the obiect? \ Neort Postal Addr S. How long wes object in sight? ( T c t ' l \>uration) o. Cadq.i~ Hour Minvtes (Circle Ons): (Circle One): a ciyligh-t Saving) b. -slandord - -- - City w Town Stote Of' Covnty Mlnvtea Second a c. Not very sur d. Juat a guess 5.1 H=w wo.s ti:-e in sight derermined? -------'------------ 5.2 '""'o s ':l~c~ h i igh t continuou siy? 7. IF you s:w r~e ::bi~et during DAYLIGHT, wher~ was the SUN locotd o you loolced at the object? (Circl e Q.,e): a . In front of you b. In bock of you c. To your ri~t d. To yOYt left e. Overh~ f. oont rensmb.r FTD OCT 62 164 Reproduced by Library of Congress, Thl lwm au..-d I"TD U4, Jul 61, ""Meh &a obolete. Legislative Reference Service 8. IF you sow thf! obtt!Ct at NlliHT, what did you notice coce-ming the 5 TARS and MOO~? 8.1 STARS (C irde o~e J: 8.2 MOO~ (Circle One): Bright rnonnlight Ou II mOftn I i gh t t -pitch d~,j;) Con 't remmber d on't remember WEATHF.~ (Circle Ond: CLOUDS (Circle o,~): b. Hazy b. Fo~, ..,i:.t, or light r~in I c. Scotter~d cloudc c. Mod~,,, ... nr heawy rain I d. Thick ::>~ neovy cf?uds d. Snow f 10. The obiecr ODDeored~ fCirele On~t ): l b. Trans .,orent e. Don t rernembet l 11. If it oppeor-.d as a ii .,as it brightr then the Drighte tars? (Circle One): b. Oirnmer -d. Can't lcnow 11.1 Compore brigh.,._,, te oh eo"AAtOft ;ct: : 13. Did the ~:>iee~: (Circle One for eaeh question) b. Sud ::u~"" iv s t1 uo omJ f\lsh oway at ""Y time? c. Bro'-uc ,~,~ onrfs .,.. ewolotfe.., Cho~oe b-r~t.,~s~ f. Chon so sr. -,pe-? s;. Fla~ or ilic:~er, h. Oisopo.M or.d , .. Di'Deer? Don't lcnow Don!t lcnow Don't know o~, lcnow Don't know Don't know Don't "now Don't "now Did the ob ect disappear while you were watching it? If so, how? I 15. Did the 's,~ct move behind something at any time, particularly 0 cloud? Don't Know, IF you answered YES, th~n tell whot it rr.cved behind: Did th~ c~ject move in front of som~thing at any time, particularly o cloud? Don't Know. IF you answered YES, the~. .- .~--i i7. Tell in a few words the following things about the obiect: We w ish ro know the angular size. Hold a match stick at arm's length in line with a known object ond note how f rr.uch of e ob1ect is covered by the head of the match. If you had performed this experiment at the t ime of the l s i i n ! i,g, how much of the obj~ct would hove been covered by the match head? Dr ow o :> ; :: ~ure tnct wi II show ,:.,e sh ope of the obiect or' obiects. Label and include in your sketch any detoi Is of t:1~ o:: ~-= ~ot you saw s uc h os w ings, protrusions, etc., and especially exhaust trails or vapOt trails. Pi..:~e ::r :::-~-::eside the dra...,i:--g to show the direction the obiect was moving u rr, ,, j e 20. Do you fhin\c you con etstimot., the :.$J~-'d of the oLject? ( C i rc IC! Ont) If you a:'\s"'fe1ed YES, then wha h speed would you ~stimate? D.,;) you ~ ,..,;( you c cm e~timot~ how f:!r owoy from you the obj"ct was? !,cotttd . ,.:.~r. v=u .ow th~ object? a . l'ls:c.~ a building o. In the busn:.:ss section o f o city? b, In th~ resid~ntiol ~ecrivn of o city? h. Northwe~l i: The(<hl it~ In the following sketch, imagine that you are at the point shown. Place on "A" on the curved I ine to show how high the object was above the horizon (slcyline) when you lirst saw it. Place'a "B" on the acme curved line to show how high the object wos above the horizon (slcyline) when you lost saw it. Place an ~'A" on the compasa when you Firs: sow it. Place o "8" on the compass where you last aaw the object. 2 3. Ore ... c ;> ic!~re that wi II show the mot io~ that the object or objects mode. Place on "A" at the beginning of the ;>~th, o "B" tne end of the poth, and s.!.u.,. vny changes in direction during the course. . 29. IF t h.:re wos MOr<E THAN .ONE ob~ec:, then how many were there? ------------- Draw a ~i:ture ot how they were orro~ged, and put an orrow to show the directiOI'I that they were traveling. H<lvtt ycu llVft'r st-en this, or a similar object before. If so give date or dat~s and location. J 1 , Wos ~ny ~not-e l.;~ with you ot th~ time you saw the object? (Circle One) 3 L l IF 'J')..: ~nsw-"rftd YES, d id tney Sf'e the object too? (Circle OneJ Zor,. Stohr ... CJQ ~ :J./- .... --::m~ did you report tnot you had r~n th~ object? , Der Moftth Veer 34. Date you completed this questionnaire: Information which you feel peftinent and which is not adequately covered in the specific points of the queationnair or o narrative explanation of your sighting. my s-tf-/;r t dcJt" -td I -l:_ rtl/f/lf_'f'