co,:CLUSIC:-i PrlYSIC.\L :v.).:"=.: U.S. AIR FORCE TECHNICAL I N FORMA TIOI'I T~ .; ::jl..esli onnoire has be::n prepared so that you con g ive t he U.S. A ir Force as much u-: r-= ., as p ossible concerning the u n identified aer ial phnno menon that y o u hove ob!;erverl. p i,::::o!: :o answer os many quo.stions as you p ossibly con. The informa tion t hat you giv., will be l.!l~: ~r roseorch pur poses. Your nome will not be used in c o nnection with any statements , ccncl.~.':ns, or publications with o u t your p e rmission. We re q ue s t this p"trsonol informa tion so th-=t j f i s de~rned nece s sary, we ma y c ontact y o u for further de t ails. 2. T ir.'c o f doy . 1. '.Vhc::n .:Jid yC s e e the object? (C,c/c One): :?. Ti.:TeZone : Circle One):Co. c. Mour:~in d. Pacific 4. W~ ere "'ere ';' Ov when you sow the c:>~:t? (Circle One):~.., o . 1'\o:sn' stcl Address 5. ho., lcl'lg ""~5 ::Sjec t i n sight? (Tc:~' J- :toon) 6. Wha t wos :~r.:'r.:m o f the sky ? o. E. i c;h I C it y o r To w n c No t very b. tCI~uCJi, Da y light Sa v ing) Standard -- Stoto or Cou nty 7 . IF you s o w t he object during DAYLIGHT, when: was the SUN locotod a s you looked at the obje c t ? (Circle Onei: a , In fr ont o f you b. In bock o f you c. T o your right oyovr left e. Ovc rhe-od f. Do n ' t rcmemb~r FTD OCT 62 164 , tl. IF you !'Ow the object o t NIGIIT, whot d,cl you noticf" concNrHn:J the ~TAI<S und MOO~? o. 11r i r;h t moo:1l i gh t b. (_o;;ll rilo~;l i jG"t' ' c. No mooulight-pitch dark d. Don't rert~em!Jor 9. \'that .,.. !:: .. -e weather conclit i l'ns a t the time you sow th._, object ? d. Thid r: heavy cloud-; \'fl:.l\ l HER (Crrc-/ .. One): CIT f1yht roin c .. /iC'riN>~t' or hcwy roin t: . Oc.n't r:,ncrr.b.:r 10. Thc ob1 .: op?Cared: (Circl~ One): c . D:m 't r':l:r>ember 11. It I T op'le :: .. .j as a light, wos it br1ght~r tl:on th! bflghtcst s t ar;? (Circ.:lc One): o. 3rightef) c . About the some d. D on't know 11.1 c:)-:. :~ brightne<;<; t o some cc;-:~mon object : ::. Srtu r o ly ou I ne- on t rciT"i!r:-: '!' o . App.o.~.:: :.?.,~st ill a t any t ime? b . SudJ--~' .. :;c-!>d up and rush owoy at any tirnc? c . Brec~ v ~:>port~ or e><plod~? c . Chonqe , j -I; nes s? Don't know Don' t ~now (Don't .... kn~J D o n ' t know Don' t know Do11' t know lJon't kno w 19 . D~-~ ::::: = will $how th~ ~' ... :::e o f the objt-ct or objects. Lo~l and includtt in your sketch any details of tr. c :: ':: :>u sow s uc h o s .~i:-~:>, protrusions, etc., and especial ly exhaust trails or vopor trails. Plo::o c~ - -.., : '5 ~e the da.win:: to , :,ow tho direc tion the objoct wa!> moving. . . I I It~ VI ~ do 20. Do you thin~ you con estimoto t h e spoed o f the objoct ? (Cird!l One) IF y ou ons .. ;""d YES, then what speed would you e5timotc? 22. Wh "rc wer,. ~OJ.J located whan yc-.u sow tho object? @ hsid~ .:. !)uilding b. In o c or In on al,!ono (type) e . At S'!ta 23. Were y ou (Circle Om:) o. In t he bu.>ine~s section of o city? (b', In th~ rosid, n tiol section of o cit y ? In o;>Dn coun1rysirJe? d. N~or on oirtiold? flyingovAocity? f. Flying ov::tr op.3n country? _ ... 1:= y-:;, w~r~ VOVING IN AN AUT0 "031~:: or oth~:r vehicle at the time, than complete th~t f o llowing question:.; 24.1 'trhot ::.~ction were you movin;? ( Circle On~) a. N~r., c . Eosl d . Sourneo:st f. Southwest h. Northw~st 24.3 o~ ,:; .. sop a t any t ime whi:~ pu ...,~,., looking a t t h e object ? 25. Di~ y~ o~"'"'l: ; obj~ct t h rou;r ~..,v ~!the follo"Ving? e. Binoculars Yos No Tele:ocope Yes No Y!!s ~.:. g. Theodolite Yus No 26. In ord3r tho objec t or o!:) ~..: con ~ive as c lear a picture as p os:oibl!l of what yo u ~ow, d:tScribe in Y"Ur own words o comm~n c -. .... ~ich, when placed up in !ho sky, would give tho sam~ appea rance as th~ obj"!ct which y ou saw 27. In th& follo,...i-;; !~'!tch, imagine th'Jt ycu 01., ot th_, point sho.Yil. Plo -:,. 01 ''A" Cn t'; ~tr., J la:lJ to :hov h~''' high th~ o!>,~-: wos above the horizon (skyline) \<~hen you first o;Q,J it. fluco a or. t .. ,. .em -::urved lm. t~ sho w ho,... ,.,;::~ .,, Clbt~ct wos above the horizon (s!<yl in.,) wh'n you 1-J~t ~ow at. Pice-: en "A" on ,!-:., compo .. ~ P lace o " 6 " on th~ compass where you /o5 <:0"' t ltc ob!"Ct. 23. ,l'J""' o oic' . ~ that will show the no~i"n t!-ot the object or objr,cts mode. Picco on " A " a t the boginnin~ of the pot!-o, a "b" ::_;,the e nd of the path, :: ... ~ srow any chongs in diroc tion durin:] th~ c"Jrse. Oro'"' o :>ic. -.;i :w they were o"::-g~::. on.:l put on arrow to :.how tho di~cction t h o t th.:y were: traveling. -tH, ) r II N 30. Hovo you ev-:~r .> Htn this, or a simi lor obj :~ct b.tfor~. 3 1. Wo'\ ory~,~ ,..,<) with you a t th., t ime you saw the obj Jct? (Circle One) 31.1 IF y .. .-::nlwored YES, did th~y SJe the object too? (Circla Ontt) 31.2 PI:::~:>.:-i b t the!lir names and oddresstts: /..JFI!lvl'll d .Dr:.. 32. Please giv~ ~h_, following inforrn~tion about yoursolf: Lost Nom .. Fit Norne ).4idd I~ !!o'Ht Str'Je! City TELEPHO:\E NUMBE tndrcor-, ::ry .::dditional information .JSout yovr:..,(f, incluJing oi'ly sp~ciol exporit:nc<~, which might~ pcrtin.:nl. 33. When and to ""I.,_,,.., d 1d you ro port tho r you hod S't1n tht1 objl,ct? lc. .r: 1/. -f. 1/. Doy Month Yoo r 34. Dot e you compl~htd t his questionnaire: lnform.olion wrt:h you feel pertinent and which is n ot od-quotely d h .. coverc in t e specific points of the quo$tlont'IC ~ ~r a n.:.:rrotive explonati?n of your sighting. OC:t-ARTMENT OF TH.E AIR FO::lCZ HEAOQUA lH!:l.<J FO"'!:IGN T~CHNOLOGV DIVISION C AF5C ) WRIGHT-I"ATT&tft'ION AI~ I"O,tC'! D.\"11:. OHIO -4!:! 43:> tii"O ,:nervation, r( Hay 196'7 Re:-~.:- c::nce your unide:'ltifioed oboervation. The informati on vhich W!::' :~ve received is no:. s.!fficient for a scienti fic evaluati on. RP.<;-:..-st you complete the a ttached FTD Form 164 end return it in the ;nvelope provide d . T. you for reporting your observation tc-:.:1c Air Force. J!...:S3 C. MANA'l-r' : tor of Technology d Subsyste~s I r vP#TIZ (t F~D Form 164 w/envelopo U.S. AIR FORCE TECHNICAL I NFORMA TION 7l.is questionnaire has been prepored :;o that you can give the U.S. Air Force os muc h ir: ;, . -.... :-n as possible concerning the unidentifie d aerial phenomenon tha t you have observed. P '::c':>o:-.. v t o answer as many q uestio n s as you possibly can. The information that you give will b~ us ... :: !or research purposes. Your name will not be used in connection with any statements , concl .; ~ns, or publica tions without your p e rmission. We request this personal info r mat ion s o t:~:l' . is deemed necessary, we may contact y o u f o r further detail s 1. 'ifhcn did yo ... see t he o bject ? 2. Tiro1e o f day: {Circle One): ( Circle 011e):' o. tostem \.-k 'Central c. Mount o h d. Pacific (Circle One): a . Daylight Soviny b . Standard 4. \\her:: were fOU when y o u sow the o~;e~t? N"C""~ =astol Address City or Town Sto t o 0 1 County 5. ho..t bng w::s .:lbje c t in sight ? (T~-~ ::.vro r ion) Hours Mnvtes c. Cer~o in c. Not ve ry sure Yes .... No 6 . What was t',:: c:: .c: tion o f the sky? o . ~-rgnt !>. C !ovJy o.~ Bright 0?_ Cloudy 7. IF you s ow th e o!>ject during DAYLIGHT, where was the SUN located a:; you looked at the o bject? (Circle 0 .1e): a. In front o f you In bock of y o u To your ri gh t To your left c . Ove rhead f. Don' t remember tL lr y ou sow the object a t NIGHT, whot d1d y ou notict: concerning the STAI~S end MOON? 8.1 STARS Circle One): d. : ~r t remember 8. 2 MOON ( ( 1rclo: One): (a., nrght moonlight b. Dull moonlight c . No moonlight-pitc h dark d. Don' t remember 9. thor \\ere 1e weather conditions o t the ti me y ou !;Ow th e object ? CL OUt)S C.rc/c One): c . Sco'l~re: clouds -'t. T.1ic~ c neovy clouds WEATHER ( C irclc One ): b. Fog, nHst, or light c . ,o\orlt-ra t.! or heuvy rain e. Don't remember (Circle One): (])As o I igh t e. L>o~ '~ remember 11. If I =iJ:>f!'::J. ~: o s o light, was it hri;nter than the brightest star!:? (Circle On'.!): ~righter c . About tho some c. ~ ..... mer d. Don' t know c ;:,::" _.brigL,tno:;s to SOMe c:-,-,C'_r. obj~ct; Don't know Do n't know Don' t know Don't knoY Don't know Don't know Dvn't know 13. Did the (Circle One for cc.cl. qu~stion) a. App .. "'r r: s:nd still o f any time? b. Suddon'v s::eT:d up and rush awa y a t a ny time? < t..:: ., ports or explode? c . Ch.::mge on)llne ss? f. Change:: sL,o?e? g. Floldl o r