70:. HMt: C~OUP o J . ; ,)IJRCE 10. CONCLUSION ' 4. NUMBER OF OBJECTS LENGT H OF OBSERVATION TYPE OF OBSERVATION 8 . PtiOTOS . -Vi :~t:ll 9. PHYSICAL EVIDENCE BRIEF SUMMARY ANO ANALYSI S O...J::cr\"e" :;i._:ht:: t licht e~&!:.~t~d 40,CJO feet tr.:::, ccscc:.icd :..ruvclcd KE and d:!.=::a1 :::..:a in lit,;ht see;.:ed. to l.rrc.: ~o r a :;:llor.. Prevloua edltlone o f lhla form a:a y b e uaed, 17. DID YOU OBSERVE THE PHENOMENON THROUGH ANY OF THE FOLLOWING> INCLUDE INFORMATION O N MODEL, TYPE, FILTER, LEN S PRESCRIPTION OR OTHER APPLICABLE DATA . X EYEGLA SSES CAMERA VIEWER SUNGLASSES BINOCULARS WI N DSHIELD . TELESCOPE SIDE WINDOW OF VEHICLE THEODOLITE WINDOWPANE OTHER 18 WHAT 'fAS YOUR I MPRESSION OF THE SPEED OF Tfib PHEN O MENON ? GIVE ESTIMATE OF SPEED flet'"{ (..:._. r 19. WHAT WAS YOUR I MPRESSION OF THE DISTANCE OF THE<. PHEN O M E N ON> _GIVE ESTIMATE_OF DISTANCE it>' <.>\.1' 20. I N ORDER THAT WE MAY OBTAIN AS CLEAR A PICTURE AS POSSIBLE OF WHAT YOU SAW, DESCRIBE I N YOUR OWN WORDS A COMMON OBJECT OR OBJECTS WHICH, WHE N PLACED IN THE SKY. SIMILAR TO WHERE YOU NOTED THE PHENOMENON . OULD SEAR SOM E RESEMBLANCE T O WHAT YOU SAW. DESCRIBE SI MILARITIES AND DIFFERENCES BETWEEN THE COMMO N OBJECT AND WHAT YOU SAW. H . whf'n I Jrs1-s be.<} 111 e {/ f-e> I r pfJ~5 fC,(/Ncl ~ v,cJ tl or nt~re t: ttes_ ,.., ' . hnf~t-~ s rlt e. _hr,rld~J't Sfw~". llt~me'~l unfll /f .s!'?~t'( h1t}Yr~jc clT'>V"YJ, 'lh_en t!-,v~;J-/Jci~) fo ~ r~u.t,, ./ Je. '1-m~re #/, e sl-c.-r-/'f~"t,. It-stc. ecllh~7tt~y ltJ?ft-i ,'f-hl~J.<.ec{ (f)q-1-d>;.., .s ljJ,f-. 21. OlD YOU NOTICE ANY ODOR, NOISE, OR HEAT E MANATING FROM THE PHENOMENON OR ANY EFFECT O N YOURSELF, ANIMALS O R MACHINERY IN THE VICINITY? 0 YES ,RNO . IF "YES," DESCRIBE. 0 YES ~NO. A . DID THE PHENO MENON DISTURB THE GROUND OR LEAVE ANY PHYSICAL EVIDENCE. IF "YES," DESCRIBE PAGE 7 OF 9 PAGES 27. INFORMATION WHICH YOU FEEL IS PERTINENT BUT WHICH IS NOT ADEQUATELY COVERED I N THIS QUESTIONNAIRE ALTERNATIVELY PROVIDE A NARRATIVE EXPLANATION O F THE SIGHTING. ' h~ cl ,b ec,n b /J 1~ tie.. /4, Stt/'e. / ccttlcl )dt/e. A e~ n{ s,y-,n e IJ <!Jt .. rQ.. , el/en ir .;vt//sh of ?he. c-/r. h-it!, T/,/r ;-J,n,y I hettp(l (Jb.so!JI(tf@j PAGE 9 OF 9 PAGES MAC-IAI"B, Ill ei3UI DEPARTMENT OF THE AIR FORCE HEADQUARTERS 1400 AIR BASE WING (MAC) SCOn AIR FORCE BASE, IlliNOIS 62225 8 January 1969 suaJect. UFO Report TO: FTD ( TDPT (UFO) Wright Patterson AFB, Ohio ttached AF Form 117 on a UFO sighting on 15 Decem~er 1968 by is f orwarded for appropriate action. Weather information for Scott AFB during the applicable time period was as follows: b . Ceiling: None c . Visibility: 25 miles d . Amount of cloud cover: None , HN B. DODGE, Captai'n, USAF Assistant Base Operations Officer AF Form 117 6A. NOW IMAGINE YOU ARE AT THE CENTER OF THE COMPASS ROS E . PLACE AN "A" O N THE COMPASS TO I NDICATE THE DIRECTION TO THE PHENOMENON WHEN FIRST SEEN. PLACE A a ON THE COMPASS TO INDICATE THE DIRECTION TO ,- THE PHENOMENON WHEN LAST SEEN. 1 . IN THE SKETCH BELOW, PLAC E AN "A" AT THE POSITION O F THE PHEN O M E N O N WHE N FIRST SEEN , AND A a AT THE POSITION OF THE PHENOMENON WHEN LAST SEEN. CONNECT THE "A" AND a WITH A LINE TO APPROXIMATE THE MOVEMENT OF THE PHENOMENON BETWEEN "A" AND "a. THAT IS, SCHEMATICALLY SHOW WHETHER THE MOVEMENT APPEARED TO BE STRAIGHT, CURVED OR ZIG-ZAG. REFER TO SMALLER SKETCH AS AN EXAMPLE OF HOW T O COMPLETE THE LARGER SKETCH. PAGE 2 OF 9 PAGES SIGHTING OF UNIDENTIFIED PHENOMENA QUESTIONNAIRE BUDGET BUREAU APPROVAL NUMBER 'H R 258 THIS QUESTIONNAI R E HAS OEEN PREPARED SO TIIAT YOU CAN G IVE TilE U.S AIR FORCE AS MUCII INFORMAT ION A S POSSIBLE CONCERNING T H E UNIDENTIFIED PHENOMENON THAT Y O U HAVE OBSERVED. PLEASE TRY TO ANSWER i\LIJ OF THE QUESTIONS. THE INFORMATIO N YOU GIVE WILL B E USED FOR RF.SEARCII PUI~POSES. YOUR NAME Wl'ct NOT BE USED I N CONNEC T I O N WITH ANY OF YOUR STATEMENTS OR CON C LUSI O N S WITHOUT YOUR PERMISSI N . RETURN TO AIR FORCE BASE INVESTIGATOR FOR FORWARDING TO FTD (TDETR}, WRIGHT- PATTERSON AFB,OHI 0 4 5 433,1A'N AFR80-f7 . (IF ADDITIONAL SHEETS ARE NEEDED FOR NARRATIVE OR SKETC HES ATTAC H SECURELY TO THIS FORM OR ANNOTATE WITH YOUR NAM E FOR IDENTIFI CATION .) I. WHE N DID YOU SEE THE PHEN OM E N O N 1 2. WHAT TIME DID YOU FIRST SIGHT THE PHENOME NO N > HOUR MINUTES 3. WHAT TIM E DID YOU LAST SIGHT THE PHENOM EN ON> HOUR MINUTES TIME ' ZONE 0 D AYLIGHT SAVIN GS 0 STAND ARD !)(cENTRA L 0 MOUNTAI N S. WHERE WERE YOU WHEN YOU SAW THE P HENOM E NO N > IF IN CIT Y GIVE THE N E AREST STREET ADDRESS AND I NDICATE O N A HAND DRAWN MAP WHERE YOU WERE STANDIN G WIT H REFERE NCE T O THE ADDRESS. IF I N THE t:OUN TRY. IDENTIFY THE HIGHWAY YOU WERE O N O R N EAR AND TRY TO FIX A DISTAN C E AND DIRECTION FROM SOM E RECOGN IZABL E LANDMARK. ,,r k:1cHllt ) 'f~J.o ;1/JI, lf'fc. s s I vtl~ s ~ I Frlf!" JJ;;iwtk I .J I r-COl/ld 6 . I MAGINE YOU ARE AT THE POINT SHOWN I N THE SKETCH. PLACE AN " A " ON THE CURVED LINE T O SHOW HO W HIG H THE PHENOM E N ON WAS ABOVE THE H ORIZO N . OR SKYLINE WHEN FIRST SEEN . PLA C E A a O N THE SAME CURVED LINE TO SHO W HO W HIGH ABOVE THE HORIZO N THE PHE NO MENO N WAS WHEN LAST SEEN . OBSERVER .. WHERE WERE YOU WHEN YOU SAW THE PHEN OMENON' (Check appropriate blocks.) OUTDOORS I N BUSIN ESS SECTION OF CITY I N BUILDIN G IN RESIDENTIA L SECTION OF CITY 0 AS DRIVER 0 AS PASSENGER I N OPEN COUNTRYSIDE NEAR A IRFIELD IN A IRPLANE 0 AS PILOT 0 AS PASSENGER FLYIN G OVER C ITY FLYING OVER OPEN COUNTRY IF YOU WERE IN A VEHICLE, COMPLETE THE FOLLOWING: WHAT OIRI!:CTION WERE YOU MOVING' H O W FAST WERE YOU MOVIN G 1 DID YOU STOP ANYTIME WHILE OBSERVIN G THE PHENO M E N O N ? RTHEAST SOUTHEAST EXPLAIN WHETHER SUC H MOVEMENT AFFECTS YOUR SKETCHES IN ITEMS 5 AND 6 . DESC R IBE TYPE O F VEHICLE YOU WERE I N AND TYPE O F R OAD. TERRA I N OR BODY OF WATER YOU TRAVERSED DURING THE SIGHTING. STATE WHETHER WINDOWS OR CONVERTIBLE TOP WERE UP O R DOWN. HOW MUC H OTHER TRAFFIC WAS THERE? DID YOU NOTICE ANY AIRPLANES 0 Y E S 0. I F yEs. DESCRIBE WHE N THEY WERE IN SIGHT REL ATIVE TO THE T IME OF SIGHTING THE PHENOMENON AND WHERE HEY WERE I N THE SKY RELATIVE TO THE POSITION OF THE PHE N OMENO N . HOW LONG WAS THE PHEN O MENO N I N SIGHT LENGTH OF TIME ,,p/Jrc'( CERTA I N O F T I M E OT VERY SUR E FAIRLY CERTAI N JUST A GUESS How wAs TIME DETERMINED 1 Jc."lc/('f' cl A.; WAS THE PHENOMENO N IN SIGHT CONTINUOUSLY1 [gYES Q N O . I F No . I NDICATE WHETHER THIS IS OUE TO YOUR MOVEMENT OR THE BEHAV I O R OF THE PHENOMENO N , ANO O E CRIBE SUCH MOVEMENT OR BEHAVIOR . I NDICATE OISAP - PEARANCES O N PREVIOUS SKETCHES . PAGE 3 OF 9 PAGES 15. DRAW A PICTURE THAT WILL SHOW THE SHAPE OF THE PHENOMENO N . INCLUDE AND L ABEL ANY DETAILS THAT MIGHT HAVE APPEARED A S WINGS OR PROTRUSIONS, AND INDICATE EXHAUST OR VAPOR TRAILS. INDICATE BY AN ARRO W THE DIRECTION THE PHENOMENON WAS MOVING. /f(J1-f( AS t 16. WH A T WAS THE ANGULAR SIZE1 HOLD A MAT C H AT ARM'S LENGTH IN F R ONT OF A KNOWN OBJECT, SUCH AS A STREET LAMP O R THE MOON. N OTE HOW MUCH OF THE OBJECT IS COVERED BY THE HEAD O F THE MATCH. N O W IF YOU H A D BEEN ABLE T O PERFORM THIS EXPERIMENT A T THE TIME O F THE SIGHTING, ESTIMATE WH A T FRACTION OF THE PHENOMENON WOULD HAV E BEEN COVERED BY THE MATC H HEAD .J t.t st ~ J,r,,, i I tJ~' PAGE 6 O F 9 PAGES I~ DID THE PHENOMENON YES N O UNKNOWN MOVE I N A STRAIGHT LINE1 STAN O STILL AT ANYTIME' SUDDENLY SPEED UP AND RUN AWAY' BREAK UP I N PARTS AND EXPLODE1 CHANGE COLOR' G IVE OFF SMOKE? CHANGE BRIGHTNESS' CHANGE SHAPE? FLASH O R FLICKER? ISAPPEAR AND REAPPEAR' SPIN LIKE A TOP1 MAKE A NOISE? FLUTTER OR WOBBLE' 14. WHAT DREW YOUR ATTENTION TO THE PHENOMENO N ? I f J. .... I ....J... I /i tvt.~ t'tftJ!I,/-e,,c"f'"' to J""Tntt<:>rrc-" ,,.... A . HOW DID I T FINALLY DISAPPEAR? ' /~ht' ;f. c/es-c-en dcx../ To j f d rP ,_ec( , 1't se.ei1Jcf To IJ~ /,'fie r/,j ,'' 1/,en / t ju sf tv en r oct 1', er~h~ fJI~i~t B . DID THE PHENOMENON MOVE BEHIND OR IN FRONT O F SOMETHING, LIKE A CLOUD. TREE. OR BUILDIN G AT ANY TIMEI 0 YES ')Zt NO. IF vEs, DESCRIBE. PAGE 5 OF 9 PAGES 22. HAVE YOU EVER SEEN THIS OR A SI MILAR PHENOMENON B E FORE? 0 YES NO. IF "YES, GIVE DATE AND WAS ANYONE WITH YOU AT THE TIME YOU SAW THE PHENOMENON? 0 YES 0 YES 0 NO. NO. IF yEs, DID THEY SEE I T TOO' A . LIST THEIR NAMES AND ADDRESSES 24 GIVE THE FOLLOWING INFORMATION ABOUT YOURSELF LAST NAME, FIRS INDICATE ADDITIONAL INFORMATIO N INCLUDING OCCUPATIO N AND ANY EXPERIENCE WHIC H MAY BE PERTINENT. I h? s e !f-~'nf'lt:''l ~C'I I c.fc,/r-Tfi~,;f, eref-t't t-t)aJ I ftS>I c': 1/(.:>llj ztJc>rl /f /ltJ~.s h'f fi~-' //1~ .f~sf(JJ1 ft)Jr'y I 25. WHE N AND T O WHO M DID YOU REPORT THAT YOU H A D SIGHTE D THIS PHEN O MENON? MONTH YEAR 2 6 . D ATE YOU COMPLETED THIS M ONTH YEAR PAG E 8 OF 9 PAGES r \